Incidentalomas: Reasons to Think Twice about Getting a CT Scan

Kenneth Lin

First published 4/24/11 on Common Sense MD

Mrs. Smith (not her real name) fidgeted in her chair in my examination room as I scanned the radiology report she had given me. She had visited the emergency room the previous evening with severe abdominal pain that had eventually been diagnosed as gastritis, or swelling of the stomach lining due to a virus. During her evaluation, the ER physician had ordered a CT scan of her abdomen and pelvis. Although Mrs. Smith’s liver and intestinesappeared normal, the radiologist had noted a tiny mass on one of her kidneys.

Continue reading “Incidentalomas: Reasons to Think Twice about Getting a CT Scan”

Book Review: “Overdiagnosed” and the Paradox of Cancer Survivorship

Kenneth Lin

First published 4/12/11 on Common Sense Family Doctor

According to the National Cancer Institute and the Centers for Disease Control and Prevention, the number of cancer survivors in the U.S. has increased dramatically in my lifetime, from 3 million in 1971 to 11.7 million in 2007. From 2001 to 2007 alone, the number of persons living with a cancer diagnosis rose by nearly two million. Most people would probably see these statistics as good news: an indication that our cancer treatments are improving and allowing people to live longer, or that earlier diagnoses are giving people a better chance to survive by catching localized cancers before they spread and become impossible to cure.  Continue reading “Book Review: “Overdiagnosed” and the Paradox of Cancer Survivorship”

Low Value Health Care: Coronary CT Screening In Texas

Kenneth Lin

First published 3/25/11 on Common Sense Family Doctor

Like many states, Texas is facing a fiscal crisis caused by decreased revenue from the economic recession and skyrocketing health care costs. Even without the expansion of publicly financed health insurance mandated by last year’s health reform law, the percentage of the state budget devoted to Medicaid expenses is projected to rise from 28 percent to 46 percent by 2020, even faster if the law withstands current constitutional challenges. The situation is so dire that the Texas Tribune and the New York Times recently reported that state health officials have been considering measures to reduce overuse of pricey neonatal intensive care units by refusing to cover elective labor inductions or Cesarean sections without medical indications.

Continue reading “Low Value Health Care: Coronary CT Screening In Texas”

Will The Value Of Advanced Imaging Prevail?

Brian Baker

So what is the most significant health care technology implemented in health care in the last thirty years? The DaVinci robotic surgery system? Proton Therapy perhaps? No, not those. We want diagnostic, not treatment, technologies.

The answer is advanced imaging. Thirty years ago, a patient presented with non-specific abdominal pain. How did we diagnose it? Palpate, lab tests, order an x-ray. No conclusive results? Send them off to surgery.

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Women and Heart Disease

Bill Bestermann

Download this presentation: Women and Heart Disease 22611

The second floor conference room was filled to capacity for my talk this Tuesday.  Most of those present were women.  They listened very attentively for the entire 45 minute presentation, and there was a lot of head-nodding in affirmation and generally positive signals of an engaged audience.  Then they stayed for 45 minutes to ask questions,  The questions showed that they had “gotten it.”  They were there for an hour and a half.

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Veridex’s Circulating Tumor Cell Technology

Yesterday’s news was lit up by a story – the video below was prepared by the Associated Press – about a blood test that can detect cancer cells. Veridex, a Johnson & Johnson subsidiary, offers a process, Cellsearch, that does this, and provides prognostic information based on the amount of tumor cells circulating in the blood.

I first encountered Veridex several years ago, and it was clear then that this exciting technology holds tremendous promise. See additional short video illustrations of the process here, here and here.

Disclosure: I have a consulting relationship with Veridex.

Google’s New Body Browser

What about an equivalent of Google Earth for the human body? Google has just released Body Browser, a 3-dimensional multi-layered anatomical model of the human body that you can rotate, zoom in on, and search.

To play with it, you’ll need a beta version of Chrome, Firefox or Safari that supports WebGL.

A terrific new resource that, undoubtedly, will become far more powerful over time.

International Federation of Health Plans 2010 Comparative Price Report: Medical and Hospital Fees by Country


This sobering report arrived on my desk today. The International Federation of Health Plans is comprised of “the leading global network of the industry, with one hundred member companies in 30 countries.” Each year they prepare a report that compares pricing for common services.

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