| Buyer beware
A growing number of Americans are paying thousands of dollars out of pocket for elective whole-body MRI scans offered by companies like Prenuvo, SimonMed and Ezra (part of Function Health). But some radiologists and healthcare researchers are calling on people to think twice before paying for these tests. Last month, Dr. Matthew Davenport of the University of Michigan and Dr. Scott Reeder of the University of Wisconsin published an editorial in JAMA arguing that this fast-growing industry is marketing a product without being able to prove that the benefits outweigh the harms. Drs. Davenport and Reeder believe the scans are more likely to trigger harmful downstream procedures than to catch anything that needs catching. They painted the following picture: say the scan turns up an ambiguous finding. The provider doesn't know what it is, so they order a biopsy. Maybe the biopsy comes back benign, or maybe it causes bleeding that lands the patient in the hospital. Or perhaps it finds a low-grade cancer that would never have shortened the patient’s life — but now they had a kidney removed. Many physicians and researchers — including Johns Hopkins’ Dr. Otis Brawley and Brown’s Dr. Ateev Mehrotra — agree with the JAMA editorial, saying that patients aren’t being given the full picture about what a positive finding on one of these scans actually means for their health or their wallet. Soundbite
“Early detection is a message that is so in the fabric of our country, it's like a prejudice, meaning that we have difficulty questioning it,” Dr. Brawley stated. A different view
Not surprisingly, the companies selling whole-body MRI scans see things very differently. Dr. Dan Durand, chief medical officer of Prenuvo, said that the editorial’s argument centers on whether whole-body MRIs can find cancer in low-prevalence populations. By focusing only on cancer, he argued that they are misrepresenting what these scans actually do. Preventive MRIs don’t just look for cancer — Dr. Durand pointed out they can also identify fatty liver disease, aneurysms, cardiac abnormalities, early signs of MS and other conditions. Another leader in the space — Dr. Daniel Sodickson, chief medical scientist at Function Health, which owns Ezra — thinks that this debate often overlooks the fact that there is no single standardized definition of “whole-body MRI,” as well as the significant differences in how imaging is performed and integrated into care, he wrote in a statement emailed to MedCity News. Dr. Sean Raj, chief medical officer and chief innovation officer at SimonMed, also noted that the JAMA editorial didn’t analyze preventive MRIs across a wide range of settings. The op-ed references the industry broadly rather than calling out specific companies by name, he pointed out. — By Katie Adams |
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