Association Between Ownership of Imaging Equipment and Appropriateness of Staging Positron-Emission Tomography in Non-Hodgkin Lymphoma.
Scott F HuntingtonWeiwei ZhuJessica R HoagRong WangAmer M ZeidanSmith GiriNikolai A PodoltsevSteven D GoreXiaomei MaCary P GrossAmy J DavidoffPublished in: JNCI cancer spectrum (2019)
Physician ownership of imaging equipment has been shown to be associated with greater use of low-value imaging. However, it is unclear whether ownership also influences utilization of appropriate imaging. We conducted a cohort study of older adults diagnosed with three non-Hodgkin lymphomas with distinct guideline recommendations concerning the use of positron emission tomography (PET) during staging (recommended, not recommended, or equivocal). We found patients who were treated by oncologists with PET ownership were more likely to receive a staging PET regardless of lymphoma subtype. However, the difference in utilization by ownership status was smallest (6%, 95% confidence interval = 2% to 11%, P = .01) in the setting of diffuse large B cell lymphoma, where consensus guidelines recommend routine use of PET. Overall, removing financial incentives related to imaging self-referral may reduce utilization during cancer care, with the potential for greatest impact on imaging of equivocal or low clinical utility.
Keyphrases
- positron emission tomography
- pet ct
- computed tomography
- high resolution
- diffuse large b cell lymphoma
- pet imaging
- primary care
- emergency department
- healthcare
- epstein barr virus
- physical activity
- palliative care
- young adults
- fluorescence imaging
- smoking cessation
- men who have sex with men
- human immunodeficiency virus
- photodynamic therapy