Talk:Full-body CT scan

Suggested rename

The article (before my upkeep) was clearly about the use of full-body scans in preventative screening. I therefore propose the title be changed to either:

• "Use of full-body scans for disease screening"
• "Full-body medical scan"

And the addition of the following redirects:

• "Full-body scan" -> either this article or an article on security —Preceding unsigned comment added by 98.169.86.44 (talk) 03:01, 4 January 2010 (UTC)

References

This needs appropriate citation from peer reviewed publications. The references are not at all appropriate. Also, the comparison of non-CT technologies like carotid dopplers, angiography, and nuclear lung scans to full body CT scans is not apt whatsoever. -- Samir धर्म 07:45, 29 August 2006 (UTC)

• Although references are always a good thing, they are not necessary in terms of an article being NPOV. Despite this fact I've included many references, including notable sources such as the AARP and the FDA. The majority of featured articles don't even reference peer reviewed articles, so the expectation that a new article would seems idealistic at best. In fact, the very point that there are no peer reviewed articles on this topic is a key point of the article. At no point does the article state there is conclusive peer reviewed evidence in either direction, in fact the opening says there is no conclusive evidence either way. As for inadequate comparison to other techonologies I don't disagree, this article is certainly not complete yet, but until you make clearer argument I disagree that it is POV. Vicarious 11:55, 29 August 2006 (UTC)
  • Okay, let me make it clearer. In short, bold statements require bold evidence:
    • The statement "it's (CT's) use in patients without symptoms is highly controversial" is uncited. It's frankly incorrect, actually.
    • "As a result any abnormalities found on a full-body scan are likely to be benign growths, scar tissue, or the remnants of previous infections" is unsourced. Is there primary evidence to support this?
    • "When abnormalities are found on the scan it is not mandatory that a doctor do more tests, however the doctors awareness of these abnormalities increases the standard of care and the associated legal liability, so in practice doctors always perform more tests." uncited, unreferenced, and again incorrect.
    • You quote "www.scandirectory.com" as a reference for the benefits and risks of heart scans / chest CT's / CT colography. How is that a source for anything? Primary sources are required. The New England Journal paper on CT colography that describes sensitivity of 90% for polyps > 6 mm is a source. scandirectory.com is not.
    • Is the CT scan image representative of a patient who had a full-body scan for screening purposes? According to Commons, it was done to search for metastasis (not the correct indication).
  • As an aside every medical FA (cystic fibrosis, AIDS, keratoconus, Helicobacter pylori uses at least some primary evidence to back its claims. This one needs a complete rewrite. -- Samir धर्म 12:18, 29 August 2006 (UTC)
  • I'll address your complaints respectively:
    • My statement that it's use in patients without symptoms is controversial is not a quotation, but I don't think it's an outlandish paraphrasing, I think the most controversial component is that I didn't say "without symptoms and without a genetic risk", but otherwise I think the sources referenced in the article refer to premptive CT scans having dubious benefits.
    • This is metadata and improvosation, and to be honest the flimsiest part of the article. It is not meaningless but certainly is in need of clarification, sourcing, and likely rewrite. Although I'll not complain if it's removed now, I expect it will be reborn at some point in different form.
    • I confess the burden of proof is on the person inserting information into the article, but I find it interesting you're so prompt to declare information "incorrect" without any references of your own. This statement drew from the articles listed, the tv shows mentioned, the wiki article on standard of care and my vague understanding of medical lawsuits. None of these are even remotely conclusive, but they're all better then you're completely unsorced contradictions.
    • Only three of my eight references were to scandirectory.com. Two of them were only hosted at the site, but had no affiliation or publication associations with the site, and if you look closely at the list of "news and articles" on the site you'll find a remarkably well balanced list, giving merit to the two references contained therein. As for the third reference, it's very nature was to reference what the common terminology was relating to full-body scans and having nothing to do with it'd medical efficacy, and the very first result of a google search for "full-body scan" seems like the perfect barometer for that.
    • The CT scan image does not pretend to be what it's not. The caption is accurate. I confess it's not a perfect fit, but it is theoretically what could show up on an elective lung scan. If anything I thought it might balance the slightly anti-scan sentiment of the article, but if it really bothers you then feel free to remove it.
    • Articles only need a complete rewrite when their content is incorrect, not when it's insufficiently verified. Irregardless of that I think this article, despite having admitted flaws, has valid sources. If I were nominating this article for WP:FA status I'd have much more sympathy for your argument, but treating a 6 hour old article the same as a featured article seems rediculous to me. Vicarious 13:02, 29 August 2006 (UTC)
      • Perhaps I was a little hard. I really don't like medical articles here that are not grounded in primary sources. I'll edit the areas that I thought were non-neutral, cite things, and then take off the banner. -- Samir धर्म 02:09, 30 August 2006 (UTC)

NPOV

Why do we need that paragraph?

• "At a cost of $600 to $3000 dollars full-body scans are expensive, and are rarely covered by insurance. Clinics offering full body scans have been accused of misleading scare tactics to convince customers to spend large sums of money for unnecessary and unhelpful procedure." NCurse _work 14:39, 29 August 2006 (UTC)

Without a solid source (e.g. quackwatch) this shouldn't be there. But there have been high-profile critics of the "scan for safety" panic movement. JFW | T@lk 16:03, 29 August 2006 (UTC)

That paragraph doesn't say, "clinics are using scare tactics", it says, "clinics have been accused of using scare tactics". To prove this statement I only have to reference a reasonable website that makes such an accusation. I've already referenced two. Vicarious 22:44, 29 August 2006 (UTC)

There is precedent that statements along the lines of "have been accused of..." (even with copious web refs) are insufficient: the article G. Patrick Maxwell had a similar statement removed by WP:OFFICE. Jim Shapiro was deleted for similar reasons. I think that unproven allegations remain unproven, and as such, shouldn't be mentioned even as "unproven" -- Samir धर्म 09:34, 30 August 2006 (UTC)

Need for NPOV tag

I'm not completely supportive of the NPOV tag. What the article says at present is actually quite neutral, and it doesn't seem Samir or NCurse are really disputing its neutrality. I do agree that better primary sources should be sought, especially for the scandirectory site but even for radiologyinfo. This has several reasons: (1) Websites are prone to change, journal articles - when cited - have staying power. (2) Secondary sources tend to include interpretation, extrapolation and speculation. (3) Websites are not necessarily neutral; the problem also exists with journal articles but they are somewhat more predictable. JFW | T@lk 16:03, 29 August 2006 (UTC)

I think neutrality is disputed because of the paragraph mentioned by me above. If we'd remove it (as it has no place in an article), we could remove NPOV tag too. NCurse _work 16:12, 29 August 2006 (UTC)

I agree that most of the complaints seem to be about sources rather than POV. If this article were tagged {{sources}} I'd still disagree, but I'd at least agree with the validity of the argument. As for JFW's point, I absolutely agree that primary sources are preferable, but I don't think they're mandatory. This article already has more, and more credible sources than the majority of wikipedia's articles. Vicarious 23:01, 29 August 2006 (UTC)

MRI

This article should also include full body mri, which is just as well possible, although still less popular. --WS 22:41, 29 August 2006 (UTC)

I saw very little mention of full body MRI scans which I found strange. Perhaps MRI scans are too expensive to be common. If you find any sites that address this issue please feel free to add the info. Also, some mention should probably be made of EBT which is used for this (infrequently). Vicarious 23:05, 29 August 2006 (UTC)

Some edits

First, I wanted to apologize if I came off as harsh; that wasn't my intent. I've spent a bit of time reading the relevant literature in this area that is somewhat outside of my area of expertise (save the GI screening). I found two supplements to major radiology publications that were dedicated to full body CT scans (Eur Radiol 15 Suppl 4 from Nov 2005, and an earlier one AJR Am J Roentgenol 180 (2) from Feb 2003) that I used as primary sources. I've removed or rewritten the comments that I thought were non-neutral, or were unsourced. I've left one line on the other scans that links to the scandirectory web site, as I can't find much in the primary literature on operating characteristics for heart CT scans, bone CT scans, etc. I've removed the CT image, with the promise that I will ask my patients who've had virtual colonoscopy for their permission to upload representative pics, as that would be an appropriate CT screening image. The brain tumor CT image of metastasis was also done for screening, and may be an appropriate replacement. I'm indifferent to the popular culture references, and have left them in. And I've taken down the POV banner -- Samir धर्म 09:27, 30 August 2006 (UTC)

This is one bad article

I am a complete outsider who came her by clicking some links, and I know nothing about this procedure or the details you are discussing here, but my opinion is that this is one bad article. I expected an article on a medical procedure, explaining in detail how it is done etc. and I read a pamphlet crying out "full-body scan is wrong". It reads like an ideological manifesto! No matter whether it is "well referenced" or not (I believe there is something more to creating an encyclopedic article than putting together a bunch of statements with citations), it is just wrong.

It begins with stating that is is controversial and goes on with describing how it is not what it promises to be, how different sources say that it is wrong to perform it etc. Come on! This is not an article on a medical procedure! If you think it is important to note that there are some controversies regarding the effectiveness of the procedure, do create a short section on that somewhere in the article, and don't turn this article into an uninformative pamphlet!

Two more things - in my country there are guys who accused a number of prominent politicians and other persona of being alien agents (I mean alien as in the X-Files). They did it in print and on nationwide TV (during their campaign air time). Does it mean that I have to start every article on a person featured in their campaign ads as "Mr. X Y is a politican, accused of being an alien agent" and go on how he is or isn't one?

And definitely trying to have an upper hand in a discussion by pushing a disputed statement on DYK is bad practice. Regards, Bravada, talk - 22:38, 30 August 2006 (UTC)

I think a lot of the problem is that the intro contains more than it should - it almost starts to discuss the cons of FB scans. The intro should just be that - starting to set out the anti-FB scan agenda in the into tips the balance of the whole article. 86.134.15.14 14:59, 31 August 2006 (UTC)

Samir, thanks for rewriting the lead, but is this procedure really THAT controversial? Quite many medical procedures have their supporters and dectractors, pointing towards different aspects of their employment. Still, if this is a commonly performed procedure (I am just wondering, as I said, I know nothing of it and I do my best to stay clear of hospitals), I believe it should not be stated in the lead that it is "controversial", as this can be said about almost any type of medical procedure. For example, the benefits of flu vaccination are being constantly disputed, but somehow the flu vaccine article goes by without calling it "controversial" in the lead (though, on the other hand, the employment of the word "recommended" and the section heading "Who should get it?" are different examples of inappropriate wording). Regards, Bravada, talk - 00:09, 1 September 2006 (UTC)

Certainly all medical procedures have supporters and detractors, even within the medical community, I think the reason that 'controversial' is such a pivotal part of this article is that there is a vast lack of consensus on it. I'm speaking without sources now, but in my opinion, the strong majority of medical professional defer to peer reviewed articled articles for their decision on the validity of a procedure. Things like the flu vaccine have had studies done on them, and the majority of doctors have no argument with the results of those studies or their interpretations, the minority takes sides one way or the other. In relation to full-body scans there are no studies and there is not proof, in the absence of evidence that majority is forced to draw their own conclusions and it seems to be quite divided. Vicarious 06:19, 1 September 2006 (UTC)

That said, it seems to me that it is rather a "still unresearched into" rather than "controversial" procedure (I mean, as you have said, almost any procedure is controversial, this one is unique in that it lacks research backup). Oh, and the fact that the lack of consensus is a pivotal part of the article results only from the fact that you have edited it so :D , so this is a rather weak argument.

What occurred to me now is also the lack of the worldwide perspective in this article. It reads like "Full-body scans in the US". Mentioning the FDA (many people on this side of the Atlantic have no idea what it is) in the into paragraph is a bad example of "localization". What is the situation in other countries on other continents? Are the scans performed routinely there? What is the stance of the medical authorities and community there?

I believe the article shoudl start with explaining the procedure, its possible applications and benefits, as well as possible downsides (while it can mention the lack of research in that section), and then go on to describe to what extent the procedure is popular and widespread, and only then go on to describe the controversy, and not begin with it.

I am also quite disturbed by the use of "popular culture" to support one side of the argument - have there been no medical dramas where full body scans were ordered without controversy or protests, and proved useful? Besides, almost all kinds of medical procedures have been featured in this way or another in the heaps of medical dramas (and even non-medical ones) produced all over the world in bulk. I believe we should limit such sections to situations when the subject is central to the plot (and I don't mean plot of a series episode, as almost everything once was, from flatulence to casual shoplifting), or the media appearance caused much uproar. Regards, ~~

I conceed a lack of non US references, but I live in the US. That doesn't mean this article shouldn't include information from other parts of the world, just that I lack the means (or strong desire) to add it. I'd love to see someone add in information from different parts of the world though. As for the popular culture references, I was not at all attempting to use tv shows as a valid medical argument; that would be rediculous. As for both of them being negative, it's only two references I've seen, I'd be happy to see more, irregardless of whether they're positive or negative. I've watched quite a few medical shows and I've never seen an MRI referred to as directly as full-body scans were in the two references included. Especially in the scrubs epsiode full-body scans are a large portion of the epsiode's plot. I hightly doubt that section will get oversized. As for describing the procedure in the intro, the CT article dampens the opportunity, since this procedure is so strongly correlated. Vicarious 08:03, 29 September 2006 (UTC)

"However, the radiation risk of CT scanners used for screening may be less than this, and depends upon the mathematical model used for calculation." Does anyone else find this to be a strange sentence? Risk depends on a calculation? —Preceding unsigned comment added by 160.39.168.57 (talk) 04:22, 23 December 2007 (UTC)

Certain algorithms could (hypothetically) require less resolution or tolerate more noise, and therefore require less exposure time. —Preceding unsigned comment added by 98.169.86.44 (talk) 01:54, 4 January 2010 (UTC)

US-centric

"Cost is an additional disadvantage; at a cost of US$600 to $3000 full-body scans are expensive, and are rarely covered by insurance.[9][10] However, in December 2007, the IRS stated that full-body scans qualify as deductible medical expenses, without a doctor's referral. This will likely lead employer-sponsored, flexible-spending plans to make the cost of the scans eligible for reimbursement.[11]..." this is US-centric. --134.100.5.65 (talk) 20:54, 24 February 2008 (UTC)