While direct-to-consumer imaging has opened up new opportunities for patients to consider affordable imaging exams, researchers warn that such offers often come with substantial ethical and safety concerns.

Discounted radiology, in particular, can lead to unnecessary testing, false positives, and incidental findings, among various other issues, according to a publication in the JAMA Internal Medicine. Researchers also discovered that some 84 odd companies were offering discount vouchers for their services through Groupon, an eCommerce marketplace. However, only one explained the potential risk factors associated with such medical imaging.

Given the fact that consumers purchased over 28,000 imaging coupons as of early February of 2020, cost-conscious medical solutions could become a serious problem, explained the team in the new research document.

Sheena Desai, BS, a dermatologist with the Brigham and Women’s Hospital, and her colleagues further explained, “Even though there are free-market solutions available to increase the flexibility of patients while curtailing healthcare expenses, consumer independence should be balanced with the risk for harm. Promotions highlighting unproven medical claims can lead consumers to buy unnecessary and potentially unsafe exams.”

Desai and her colleagues completed the cross-sectional analysis involving Groupon vouchers that were offered in America on February 6. They identified 84 companies endorsing discounted medical imaging exams across 27 states, targeting the largest city of the state.

The highlights of their research are as under:

• California recorded the highest number of coupons available at 10, with Illinois standing second at 9, Nevada acquiring the third position at 7, and Georgia at fourth position with 6.
• Among some 28,380 vouchers distributed at a discount price by February 6, consumers purchased CT scan the most at 41.3% coupons and fetal ultrasonography at 36.9% sales.
• The average cost of imaging services was different for varied imaging scans – while biofeedback or body scan started at $60, MR imaging was as high as $687. According to the authors, the average retail price for all such exams was $126 and $2000 respectively.
• 38% of companies made unproven medical claims, with one even notifying patients of the potential risks of such imaging. One particular claim revealed that a CT scan can help prevent cardiac or heart diseases and even predict future risks of heart attacks.
• The average consumer rated their overall experience a 4.8/5. After thoroughly analyzing 2044 reviews, 4.4% (90) said that someone upsold them on this added imaging during the first visit. All patients revealed that they had self-referred for an appointment.

The authors of this study noted the research was limited by their incapability to determine why consumers sought to confirm sales, imaging, and assess the quality of these exams. Desai and the team suggested that further research is required to weigh the potential health benefits related to imaging vouchers against the financial savings of consumers.

The authors concluded by saying, “Future studies have to examine the accuracy, appropriateness, safety as well as follow-up of the necessary DTC imaging services to understand their real benefits. Improved medical advertising regulations are quintessential at this hour to reduce such false claims and contribute to improved patient safety, thus maximizing DTC imaging service benefits while reducing the potential for extensive damage or harm to patients.”

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