Study: In-Hospital MRIs Could Be Wasteful

More body MRI examinations are being performed in-hospital, but are often of poor quality and provide redundant information, according to a study published in the American Journal of Radiology.

Researchers from Beth Israel Deaconess Medical Center in Boston, sought to analyze body MRI utilization trends, quality, yield, and timing among inpatients in a tertiary care academic medical center.

Using billing data from fiscal years 2006 to 2015, researched compared the volume of admissions with the total number of inpatient body MRI examinations. MRI examinations per admissions and discharge were adjusted using the Centers for Medicare & Medicaid Services case mix index by fiscal year. Linear regression was used to assess trends. In addition, each inpatient body MRI examination performed in fiscal year 2015 was evaluated and graded on its quality and yield and was judged as to whether it could have been performed on an outpatient basis.

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The results showed there was an increase in the number of inpatient body MRI examinations, from 637 examinations in FY 2006 to 871 examinations in fiscal year 2015. When adjusted for case mix, the upward trend for body MRI use persisted.

When examining the quality of the MRIs, the researchers noted that of the inpatient body MRI examinations:

• 2.3% were nondiagnostic
• 40.4% were limited quality
• 57.3% were of diagnostic quality
• 20.8% had no yield
• 5.1% of examinations had no yield but incidental findings
• 74.1% of examinations had a positive yield

The researchers also found that 30.2% of examinations could have been performed as outpatient examinations.

The researchers concluded that at their institution, the number of inpatient body MRI examinations had increased significantly over the past 10 years. However, many of the examinations were of poor quality, often gave redundant information, and could have be performed in the outpatient setting.