Repeat diagnostic testing is frequently singled out as a prime example of the wasteful expenditures endemic to health care, but is it always unnecessary?

Not according to a new report released by the Harvey L. Neiman Health Policy Institute, a new American College of Radiology think tank.

"In some circumstances repeat imaging is really good," Neiman Institute CEO and research fellow Dr. Richard Duszak told DOTmed News. Lower rates of repeat testing among certain groups may be a red flag that they're not receiving proper preventative care, for example.
When Duszak and his team looked into studies on this topic, they found the term "repeat testing" was used inconsistently, in a way that didn't differentiate between repeat testing that's valuable from repeat testing that's wasteful and unnecessary.

Prescribing a follow-up CT scan to confirm a lung cancer diagnosis, for example, is very different from ordering CT, MRI and X-ray scans for every ER patient with abdominal pain, Duszak said.

The report proposes a classification system that policy researchers can use to more precisely target areas of real waste, and avoid doing away with tests that may actually improve patient outcomes and health care costs in the end.

Duszak hopes that their methodology would also be used as a reference for health systems trying to identify areas for improvement. "Sometimes the goal will be, we need to do more repeat tests. Sometimes it's, we need to integrate our emergency system better, or we need to get all the hospitals in our health network on the same PACs," he said.

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