Analysis of the Scientific Article
The purpose of this paper is to analyze the article “Head CT Scan Overuse in Frequently Admitted Medical Patients”, interpret the intentions of the authors, and make corresponding conclusions.
The authors of this article are Mina Owlia, MD, Lan Yu, PhD, Christopher Deible, MD, Marion A. Hughes, MD, Franziska Jovin, MD, and Gregory M. Bump, MD. Since all of them have medical or scientific degrees, I assume that they are highly professional in the area of study. According to the note, all of them had access to the data and contributed to this paper. The mentioned authors produced this document based on the study that they conducted during 2011. The article was published in May 2014, which signifies that the authors spent two years processing and verifying the data, as well as making conclusions.
The intended audience of this document is the readers of The American Journal of Medicine and all professional medical workers. In the recommendations, authors also accosted hospitalists, emergency departments, and radiologists to decrease unnecessary imaging. On the other hand, we can state that this document is also intended for public because it is aimed to pose the problem of CT usage in the public discussion. The authors are convinced that the majority of people do not know about negative effects of CT on their health and, consequently, they do not pay enough attention to this problem. Moreover, there is a suggestion that head CT scans are overused. As this opinion has no documental or scientific proofs, the authors define it as the central hypothesis of their study.
In the first part of the paper, authors state the purpose of writing and acquaint readers with the background of the problem. They use appropriate arguments and statistics that persuade the target audience to consider this issue significant. In the last paragraph of this part, they form a hypothesis and represent two main aims of the study and further writing. The document is well-structured; as a result, it is easy to follow. Represented tables help to visualize the data and emphasize the main points of the study. Every part has a separate heading, and it gives a reader an opportunity to understand what kind of information it contains.
It is important to concentrate on the original goal of creation of this document and the mechanism of its intercommunication with the target audience. The leading aim of this paper is to show proofs of CT scans’ overuse and motivate internists and radiologists to develop measures to identify and reduce the number of unnecessary CT scans as well as decrease the expenditures for senseless medical procedures. After the publication of this paper, the authors expected doctors and hospitals to take steps in order to solve the problem.
The main argument in favor of the mentioned hypothesis was the study of head CT scans of 130 patients at the University of Pittsburgh Medical Center (UPMC). The statistical results had to objectively prove the fact of CT scans’ overusage. To exclude possible inaccuracies because of the human factor, two investigators suggested their methods and scales with intention to continue working only in t case of consensus. The same procedure was related to CT scans’ evaluation. Then, researchers calculated the results and represented them. The description of the study was quite convincing for the public, but it still could raise more questions in scientific circles.
The authors make assumptions that all cases of CT scanning can be divided in accordance with the meaning of findings they produced. The whole study is based on these criteria, although they might be doubtful. For instance, a score of 2 meant that the findings were not of immediate clinical significance, but could require follow-up. In such a circumstance, why was the importance of these findings underestimated? There were not enough explanations; hence, the reader had to rely on the subjective opinion of the researchers.
In addition, the generalization of results and their projection on all medical care centers are doubtful. It can be supposed that one study (even with such an impressive result that 95% of CT scans have no significant findings) cannot represent a common situation related to all medical cases in the whole country. This assumption of authors is doubtful despite all their explanations. Furthermore, the authors recognized that there is no normal percentage of head CT scans usage because little research had been conducted. To overcome the lack of data, they could also use the theory of probability and discover the probability of missing a serious illness if the number of scans decreases.
In the part “Discussion”, the researchers clearly state the limitations of the study. They specify information they missed in this paper, as well as determine that a lack of facts hinders them to make further assumptions. They also summarize the information and suggest potential solutions for the reduction of unnecessary CT scans. These suggestions are reasonable since they include different aspects of physicians’ work. If we agree with the fact that the number of CT scans has to be reduced, the recommendations in this paper should be taken into consideration.
Considering all the points, this document and the study it represents may be reliable. Although it can be supposed it would have had more influence and success in achieving its goal if it had included the facts, elucidating how scanning was injurious to our health and why doctors should not assign it without the urgent necessity. The authors did not have to adopt the results of studies of other scientists, but they could at least mention the resources, where readers could find the detailed information that proved possible harm from extra radiation.
This document demonstrated several facts about the society that produced it. Firstly, science in this society has been highly developed. Thus, people use it to solve common problems. Consequently, science is a practical tool. The field of medicine also has a significant importance for society, which is why people are trying to find ways to improve it. Another aspect is saving. It is worth paying attention that this community wants to help its members preserve their health as well as optimize the expenditures of resources. This document also shows how numbers are important for the culture, where it is produced. The main persuasive argument is based on the percentage of unnecessary CT scans. Other indexes are also numerical. Thus, we can make an assumption that in this society numbers are believed to be the most convincing tools and indispensable part of the culture. The authors find the problem of CT scanning important and help the community solve it at least by identifying the key points. Considering the fact that the authors also are the members of this society, we assume that it is a self-regulating system, where members are preventing, protecting and acting elements.
This scientific article informs about one of the disturbing issues from this field. As far as I am a medical student, I probably belong to the target audience of this paper. Therefore, after reading it, I am supposed to try to solve the problem of unnecessary head CT scanning. The main impact of this document on me includes the increase of my interest in the applied issue. I will read more about reasons for and ways of reducing the number of CT scans. I have to admit that this document makes people who have an authority within the medical institutions think more profoundly about the issue. They might want to change their work system and spare some money.
The paper can also have an impact on public opinion regarding CT scanning. All the descriptions are understandable for every citizen. If only the media decided to spread the paper, the amount of applications from patients for CT scanning could decrease.
In general, this document is a good contribution to society and medicine, in particular, because it provides transparent generalizations. Although sometimes they are quite one-dimensional, they contain reasonable conclusions and, most importantly, solutions to the problems.
This document has an impact on medical circles as well as the whole society. Among all the articles that tell about head CT scans overuse, this one includes statistical indexes, which can help to persuade hospitals, emergency departments, and radiologists to decrease unnecessary scanning. Undoubtedly, this paper has several minor disadvantages that are mainly connected with the research itself, but they do not influence the general impressions of the document. We can see three main peculiarities regarding the society, where the article has been produced: high level of science, tendency to self-protection, and self-regulation. Another interesting observation about this society is that its culture extensively relies on numbers. The research is meaningful to me because it reflects the problems from my field of study.