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Invited Commentary
Health Care Reform
June 14, 2010

A Call for Evidence of Benefits Outweighing Harms Before Implementing New TechnologiesComment on “Diffusion of Computer-Aided Mammography After Mandated Medicare Coverage”

Author Affiliations

Author Affiliations: Departments of Epidemiology and Biostatistics, Medicine, and Section of General Internal Medicine, Department of Veterans Affairs, University of California, San Francisco, California.

Arch Intern Med. 2010;170(11):990-991. doi:10.1001/archinternmed.2010.137

Variability in the accuracy of screening mammography is well documented and varies across populations of women and radiologists.1,2 Variability in the accuracy of screening mammography has paved the way for new technologies to be developed that could improve breast cancer detection. New evidence reported in this issue of the Archives describes the diffusion and annual cost of one such technology, computer-aided detection mammography (CAD) technology. Fenton et al have described a rapid increase in CAD use from 5% in 2001 to 27% in 2003 after Congressionally mandated Medicare coverage occurred in 2000. Supplemental fees for CAD use cost Medicare an estimated $19.5 million in 2003 alone.

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