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Substitution of Magnetic Resonance Imaging for Computed Tomography: An Exploratory Study

Published online by Cambridge University Press:  10 March 2009

K. Michael Peddecord
Affiliation:
San Doego State University
Edward A. Janon
Affiliation:
Magnetic Resonance Center of San Diego
Jon M. Robins
Affiliation:
Magnetic Resonance Center of San Diego

Extract

Deapite the importance of understanding factors related to physician adoption and use of diagnostiv technologies, relatively few studies have been published. Results of a two-year study of the adoption of magnetiv resonance imaging (MRI) and its substitution for computed tomography scanning (CT) are presented. The literature on physician adoption and use of technologu is used to provide a frame-work for this study. Differences in adoption and substitution among medical specialties, early versus late adopters, and high versus low users of MRI are examined. Results show that neuerologists and internists more rapidly adopt MRI and substitute it for CT than do orthopedists and other surgical specialists. Referral of higher number of patients is the best predictor of more rapid substitution. Physicians who were late adopters more quickly substituted MRI for CT. The cost and social implications of empirical versus “ideal” substitution rates are discussed along with various regulatory, technology assessment, and finicial strategies influence substitution. The role of individual physicians, radiologists, and specialty societies in determining substitution rates is also discussed.

Type
General Essays
Copyright
Copyright © Cambridge University Press 1988

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References

REFERENCES

1. American College of Radiology. Index for Roentgen diagnosis, 3rd edition, with 1985 draft index for radiological and diagnostic sound section 1, skull and contents. Chevy Chase, MD: American College of Radiology, 1976.Google Scholar
2. American College of Radiology. Site list of magnetic resonance imaging devices. Arlington, VA: American College of Radiology, 1986.Google Scholar
3. American Hospital Association. DiMonda, R.NMR issues for 1985 and beyond. Hospital Technology Series, Guideline Report Vol. 4, No. 3 and 4. Chicago, IL: American Hospital Association, 1985.Google Scholar
4. Avorn, J., Chen, M., & Hartley, R.Scientific versus commercial sources of influence on the prescribing behavior of physicians. American Journal of Medicine, 1982, 73, 48.CrossRefGoogle ScholarPubMed
5. Baker, H. L., Berquest, T. H., Kispert, D. B., et al. Magnetic resonance imaging in a routine clinical setting. Mayo Clinic Proceedings, 1985, 60, 7590.CrossRefGoogle Scholar
6. Banta, H. D.The diffusion of the computed tomography (CT) scanner in the United States. International Journal of Health Services, 1980, 10, 250–68.CrossRefGoogle ScholarPubMed
7. Bauer, R. A., & Wortzel, L. H.Doctors choice: The physician and his sources of information about drugs. Journal of Marketing Research 1966, 3, 4049.CrossRefGoogle Scholar
8. Caplow, T., & Richmond, J. J.Factors influencing the selection of pharmaceutical products. Journal of Marketing, 1954, 19, 1824.CrossRefGoogle Scholar
9. Chen, M., Daley, H. M., Kim, J. I., McIntyre, B.J., & Rogers, E. M.The diffusion of medical technologies in a practitioner community. Final Report, Office of Medical Application of Research National Institutes of Health. Stanford, CA: Institute for Communication Research, 1983.Google Scholar
10. Coleman, J. S., Katz, E., & Manzel, H.Medical innovation: A diffusion study. Indianapolis, IN: Bobbs-Merrill Co., 1966.Google Scholar
11. Evens, R. G., Jost, R. G., & Evens, R. G.Economic and utilization analysis of magnetic units in the United States in 1985. merican Journal of Roentgenology, 1985, 145, 393–98.CrossRefGoogle ScholarPubMed
12. Fineberg, H. V. Effects of clinical evaluation on diffusion of medical technology. In Institute of Medicine Assessing medical technologies. Washington, DC: National Academy of Sciences, National Academy Press, 1985.Google Scholar
13. Freiman, M. P.The rate of adoption of new procedures among physicians: The impact of specialty and practice characteristics. Medical Care, 1985, 23, 939–45.CrossRefGoogle ScholarPubMed
14. Hillman, A. L., & Schwartz, J. S.The adoption and diffusion of CT and MRI in the United States: A comparative analysis. Medical Care, 1985, 23, 1283–94.CrossRefGoogle ScholarPubMed
15. Hillman, B. J.Government health policy and the diffusion of new medical devices. Health Services Research, 1987, 21, 681711.Google Scholar
16. Jacoby, I., & Rose, M.Transfer of information and its impact on medical practice: The U.S. experience. International Journal of Technology Assessment in Health Care, 1986, 2, 107115.CrossRefGoogle ScholarPubMed
17. Kaluzny, A. D., Barhyte, D., & Reader, G. G. Health Systems. In Gordon, G. & Fisher, G. L. (eds). The diffusion of medical technology: Policy and research planning perspectives. Cambridge, MA: Ballinger Publishing Co., 1975.Google Scholar
18. Linn, L. S., & Davis, M. S.Physicians' orientation toward the legitimacy of drug use and their preferred source of new drug information. Social Science and Medicine, 1972,6, 199203.CrossRefGoogle ScholarPubMed
19. Manning, P. R., & Denson, T. A.How cardiologists learn about echocardiography: A reminder for medical educators and legislators. Annals of Internal Medicine, 1979, 91, 469–71.CrossRefGoogle Scholar
20. Manning, P. R., & Denson, T. A.How internists learned about cimetidine. Annals of Internal Medicine, 1980, 92, 690–92.CrossRefGoogle ScholarPubMed
21. National Center for Health Statistics. Graves, E. J. CAT scan use in short-stay non-federal hospitals: United States, 1979–1982. NCHSAdvance data, No. 100. U.S. Public Health Service, 09 28, 1984.Google Scholar
22. National Center for Health Services Research and Health Care Technology Assessment. Feigenbaum, E.Health Technology Assessment Series: No. 13 Magnetic Resonance Imaging. Health and Human Services, PHS, OASH, Rockville, MD. Publication No. NCHSR 85130, 1985.Google Scholar
23. National Health Planning Information Center, U.S. Public Health Service. Summary of Nuclear Magnetic Resonance (NMR) Regulations by States within Regions, Washington, DC: U.S. Government Printing Office, 1984.Google Scholar
24. Office of Statewide Health Planning and Development, California Department of Health Services. Table 16, Non-Federal Physicians by County, Specialty, Age, Board Certification and Sex. Sacramento, CA. 12 1982.Google Scholar
25. Peddecord, K. M., Janon, E. M., & Robins, J. M.MR imaging in an outpatient MR center. American Journal of Roentgenology. 1987, 148, 809–12.CrossRefGoogle Scholar
26. Schroeder, , Steven, A.Magnetic resonance imaging: Present costs and potential gains (Editorial). Annals of Internal Medicine, 1985, 102, 551–52.CrossRefGoogle Scholar
27. Steinberg, E. P., Sisk, J. E., & Locke, K. E.X-ray CT and magnetic resonance imagers: Diffusion patterns and policy issues. New England Journal of Medicine, 1985, 313, 859–64.CrossRefGoogle ScholarPubMed
28. Tannon, C. P., & Rogers, E. M. Diffusion research methodology focus on health care organizations. In Gordon, G. & Fisher, G. L. (eds). The diffusion of medical technology: Policy and research planning perspectives. Cambridge, MA: Ballinger Publishing Co., 1975.Google Scholar
29. U.S. Congress Office of Technology Assessment. Policy implications of the computed tomography (CT) scanner. Washington, DC: U.S. Government Printing Office, 1978.Google Scholar
30. U.S. Congress Office of Technology Assessment. Steinberg, E. P, Kaiser, H. J., & Cohen, A. B.Nuclear magnetic resonance imaging technology: A clinical, industrial, and policy analysis. Health Technology Case Study No. 27. Washington, DC: U.S. Government Printing Office, 1984.Google Scholar
31. U.S. Department of Health and Human Services. Public Health Service-Health Care Financing Administration. International classification of diseases 9th Revision clinical modification (ICD9). DHHS Publication No. (PHS) 80–1269, Washington, DC: U.S. Government Printing Office. 2nd Edition, 1980.Google Scholar