Bottom Line: This observational study looked at patterns of use for computed tomography (CT), magnetic resonance imaging (MRI), ultrasound and nuclear medicine imaging in the United States and in Ontario, Canada, from 2000 to 2016. Medical imaging use increased rapidly from 2000 to 2006 and this analyzes its use in more recent years among 16 million to 21 million patients enrolled in seven U.S. health care networks and for patients in Ontario, Canada. The analysis included 135 million imaging examinations. Among adults over 18, imaging rates were higher in 2016 compared with 2000 for all types except nuclear medicine, which has declined in use among adults and children since 2006. Among children, imaging rates continued to increase except for CT, which has declined since 2006. Limitations of the study include U.S. patients enrolled in health care systems that used HMO models of care, which may not represent imaging use among patients covered by other plans. Also, the reason for imaging wasn't available so it's impossible to know if the imaging was appropriate.
Authors: Rebecca Smith-Bindman, M.D., University of California, San Francisco, and coauthors
(doi:10.1001/jama.2019.11456)
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