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Special Report |
1 From the Stanford Center for Biomedical Ethics, Department of Medicine (J.I., B.A.K., T.A.R., D.K.) and Department of Radiology (J.I., E.F., S.W.A.), Stanford University Medical Center, 701 Welch Rd, Stanford, CA 94304-5748; and the Hoover Institution, Stanford University, Calif (S.W.A.). Received August 28, 2002; revision requested October 25; final revision received February 26, 2003; accepted March 18. Supported by The Greenwall Foundation. Supported in part by the Stanford Medical Student Scholars Program. Address correspondence to J.I. (e-mail: illes@stanford.edu).
PURPOSE: To conduct an empirical analysis of self-referred whole-body computed tomography (CT) and develop a profile of the geographic and demographic distribution of centers, types of services and modalities, costs, and procedures for reporting results.
MATERIALS AND METHODS: An analysis was conducted of Web sites for imaging centers accepting self-referred patients identified by two widely used Internet search engines with large indexes. These Web sites were analyzed for geographic location, type of screening center, services, costs, and procedures for managing imaging results. Demographic data were extrapolated for analysis on the basis of center location. Descriptive statistics, such as frequencies, means, SDs, ranges, and CIs, were generated to describe the characteristics of the samples. Data were compared with national norms by using a distribution-free method for calculating a 95% CI (P < .05) for the median.
RESULTS: Eighty-eight centers identified with the search methods were widely distributed across the United States, with a concentration on both coasts. Demographic analysis further situated them in areas of the country characterized by a population that consisted largely of European Americans (P < .05) and individuals of higher education (P < .05) and socioeconomic status (P < .05). Forty-seven centers offered whole-body screening; heart and lung examinations were most frequently offered. Procedures for reporting results were highly variable.
CONCLUSION: The geographic distribution of the centers suggests target populations of educated health-conscious consumers who can assume high out-of-pocket costs. Guidelines developed from within the profession and further research are needed to ensure that benefits of these services outweigh risks to individuals and the health care system.
© RSNA, 2003
Index terms: Cancer screening • Computed tomography (CT) • Economics, medical
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