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nradov • today at 4:46 PM • 0 replies • view on HN

Eric Topol has some opinions. Some other cardiologists disagree. There probably is value in CAC for at least a subset of patients.

In the messy real world of medicine there are hardly any definitive screening tests or imaging studies. Everything will have some false positives and false negatives, or even if the output is physiologically accurate it may not be practically useful in improving patient outcomes. For screening tests we also have to weigh the costs versus benefits in terms of the number of procedures performed or dollars spent to save a life; if the numbers are too high then those scarce resources should be expended on other healthcare services.

For broad screening coverage by most health plans the key next step is an evaluation by the U.S. Preventive Services Task Force. This process is already underway but it takes a while for them to evaluate all the evidence and make a decision. For Medicare coverage there is a separate coverage determination process.

https://www.uspreventiveservicestaskforce.org/uspstf/

https://www.cms.gov/medicare/coverage/determination-process