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$1 billion worth of brain scans ordered for headache sufferers in U.S. each year

Health experts say it's a waste of resources, given the extremely low probability of a scan finding a serious issue, such as a malignant brain tumor.

By Brooks Hays
A human brain in a jar (CC/Gaetan Lee)
A human brain in a jar (CC/Gaetan Lee)

Millions of Americans see the doctor each year with worries about a persistent or severe headache or migraine.

And according to a new University of Michigan Medical School study, 12 percent of those visits end in a brain scan being ordered for the patient. Those brain scans add up to a total cost of roughly $1 billion a year.

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Health experts say it's a waste of resources, given the extremely low probability of a scan finding a serious issue, such as a malignant brain tumor.

"There's solid research showing that the number of times you find serious issues on these scans in headache patients is about the same as that for a randomly chosen group of non-headache patients," said Dr. Brian Callaghan, the U.M. neurologist who led the study. "And a lot of the things we find on such scans aren't necessarily something we will do something about."

Researchers analyzed the records: 51.1 million headache-related visits between 2007 and 2010, most of which involved patients younger than 65. More than three-quarters of concerned visitors were women. And 12.4 percent all those visits resulted in a MRI or CT scan of the brain.

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A number of national guidelines have been issued in the last decade advising doctors to refrain from ordering scans for those who complain of headaches. But the frequency of brain scans continues to go up, suggesting patients are advocating for them -- an expensive way to get reassurance that a brain tumor or aneurysm isn't lurking inside the cerebrum.

The answer might be better educating the public about the costs verses the risk, says Callaghan. On top of the fact that statistics show a scan is unlikely to find anything serious, it also exposes the brain to radiation.

And monetarily speaking, the true costs of all these unnecessary scans could be higher. The research doesn't factor in additional costs, such as follow-up tests or treatment for minor issues discovered as a result of the scans.

Callaghan says the bottom line is this: trust your doctor. If he or she doesn't think a scan is necessary, then you don't need one.

The research was published in the JAMA Internal Medicine journal.

[University of Michigan Health System]

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