Free MRI Scan's for over 40's countrywide?

Andy From Sligo · 04-03-2018 3:13pm #1

Hi all , I am back with might seem another madcap idea (I seem to be having a lot of them lately as I get older) but what about a free national scheme (not just for private patients) whereby all can avail of a free (or low price) MRI scan on the brain, Heart and Lungs.

This could be just the thing to maybe catch early diagnosis of something serious, such as if they MRI the brain maybe see something not right with it, onset of dementia maybe or aneurysm or something else.

If they then scanned the heart and lungs (at the same appointment) things like enlarged heart could show up or blocked arteries and start of lung cancer.

At the moment the way its done is that people wait until they are ill (more headaches than normal, out of breath, pain in chest ) and then (if your lucky) the GP will refer you for a load of tests and (if your lucky) a CT or MRI scan. - but what if there was a national scheme? it could show up some life threatening thing before it even happens so they can catch it early? - would certainly save patients ... and also could save the HSE money in the long run maybe?

I dunno, what do you reckon? - maybe there could be some people who dont want to know if they have something wrong with them and just wait until they pop their clogs one day.

I personally would jump at the chance - last time I checked I think it was something like 300quid to get an MRI, but then I suppose you have to get a consultant or 2 to look over the scans to look for anything abnormal, I know the costs most probably be astronomical and in this day of the HSE making cuts to this and that I couldnt see it happening ...

Fr_Dougal · 04-03-2018 3:22pm

Given up on the free coffee?

OldMrBrennan83 · 04-03-2018 3:24pm

This post has been deleted.

Anita Blow · 04-03-2018 3:26pm

You don't MRI a heart or lungs and it's not used to pick up dementia/lung cancer/blocked arteries. You only MRI specific locations and even then it's only if you're looking for something in particular. An MRI without any signs or symptoms to give an indication as to what you might find is entirely useless.

Nevermind the fact it's one of the most expensive imaging tools and we have a 1-2 year elective waiting list to deal with the current load.

piplip87 · 04-03-2018 3:29pm

Waiting lists are ridiculous by introducing free or low cost ones to the general public those with MS for example who may need a MRI to check on medication progress would then face even longer waits.

Wesser · 04-03-2018 3:30pm

This is called screening. Screening only works if certain criteria are met.
For example. There is no.point screening for a condition for which there is no cure. Ie there is no cure for dementia.
Also dementia cannot be seen on an MRI. Heart diease us best detected wuth angiography.

People think that MRI detects all ....i t does not.

When you say cheap MRI.... somebody has to pay for it.... that s the government.....so money has to come out of somewhere else of the healthcare budget.... so less miney to treat the conditions that you actually detect.

In short it would be a total waste of money.

Loueln · 04-03-2018 3:33pm

would increase morbidity and mortlity. asymptomatic benign lesions identified by screening mri would have to be investigated with invasive tests to prove they are harmless. and then the cost

Rodin · 04-03-2018 3:33pm

Andy From Sligo wrote: »

Hi all , I am back with might seem another madcap idea (I seem to be having a lot of them lately as I get older) but what about a free national scheme (not just for private patients) whereby all can avail of a free (or low price) MRI scan on the brain, Heart and Lungs.

This could be just the thing to maybe catch early diagnosis of something serious, such as if they MRI the brain maybe see something not right with it, onset of dementia maybe or aneurysm or something else.

If they then scanned the heart and lungs (at the same appointment) things like enlarged heart could show up or blocked arteries and start of lung cancer.

At the moment the way its done is that people wait until they are ill (more headaches than normal, out of breath, pain in chest ) and then (if your lucky) the GP will refer you for a load of tests and (if your lucky) a CT or MRI scan. - but what if there was a national scheme? it could show up some life threatening thing before it even happens so they can catch it early? - would certainly save patients ... and also could save the HSE money in the long run maybe?

I dunno, what do you reckon? - maybe there could be some people who dont want to know if they have something wrong with them and just wait until they pop their clogs one day.

I personally would jump at the chance - last time I checked I think it was something like 300quid to get an MRI, but then I suppose you have to get a consultant or 2 to look over the scans to look for anything abnormal, I know the costs most probably be astronomical and in this day of the HSE making cuts to this and that I couldnt see it happening ...

Any idea how long a whole-body MRI would take?
It's a terrible idea.
Sorry

And €300 wouldn't get much MRI'd.
A full body scan would be 4 figures - not to mention the workload on radiologists.
PET-CT to screen for cancer - now I'd possibly pay for that.

Andy From Sligo · 04-03-2018 3:33pm

Anita Blow wrote: »

You don't MRI a heart or lungs and it's not used to pick up dementia/lung cancer/blocked arteries. You only MRI specific locations and even then it's only if you're looking for something in particular. An MRI without any signs or symptoms to give an indication as to what you might find is entirely useless.

Nevermind the fact it's one of the most expensive imaging tools and we have a 1-2 year elective waiting list to deal with the current load.

well you sound like you know what your talking about so what scan does detect heart lungs and brain and arteries? - a CT scan?

Calibos · 04-03-2018 3:35pm

Doable once AI radiologists/machine learning are up to snuff and liability issues are worked out.

Apparently we're getting close in the former where testing is showing the machine learning algorithms are better than humans at diagnosing certain diseases. The liability issue might be harder. Who do you sue when the algorithm misses your cancer?

I know MRI machines are a very expensive bit of kit but the more its used then the cheaper each scan is as the cost of the machine is amortised across a lot more people. The roadblock is the cost of the human specialists to interpret the scans which is where the bulk of the cost of a scan is. If Humans can be taken out of the equation for the bulk of the scans and replaced with an AI, then it would be a case of Miniature American Flags for some and free MRI scans for everyone!!

Rodin · 04-03-2018 3:36pm

Andy From Sligo wrote: »

well you sound like you know what your talking about so what scan does detect heart lungs and brain and arteries? - a CT scan?

Depends on what you're looking for.

CT does better with bone while MRI is superior for soft tissues.
CT is much quicker but is irradiating. MRI much slower but no radiation.

The problem of false positives is also a big issue.
One big screening test, Breast Check, is a disaster if looked at objectively.

Andy From Sligo · 04-03-2018 3:37pm

Rodin wrote: »

Any idea how long a whole-body MRI would take?
.....

well it wouldnt be a full body scan, it would just be head heart and lungs

dxhound2005 · 04-03-2018 3:37pm

People won't even stay indoors when told to do so. So unless everyone turned up for the MRI there would be no herd immunity. I would go if there was free coffee.

bazz26 · 04-03-2018 3:38pm

And who pays for all these "free" MRI scans? Who pays for the equipment, the maintenance of it and the training involved to use it? Maybe in cuckoo land it's free but here in the real world these things cost money and usually by the taxpayer.

Would you be happy Andy to pay more tax for a "free" MRI?

Rodin · 04-03-2018 3:39pm

Andy From Sligo wrote: »

well it wouldnt be a full body scan, it would just be head heart and lungs

What about liver, pancreas, bowel, stomach, prostate, ovaries, uterus, breast....

Wesser · 04-03-2018 3:39pm

Your GPis slow to order one for you because he feels you don't need it.
There i s a massive waiting list for MRI scan for people who actually need one. By ordering one that you don't need your GP is just making the waiting list longer for everyone else.

ytpe2r5bxkn0c1 · 04-03-2018 3:40pm

Andy, as your ideas go, this is absolutely average.

MRI would be too expensive and ineffective. There are many more screening programmes that would be prioritised before this.

bazz26 · 04-03-2018 3:42pm

Maybe they can through in a free coffee with each scan. :pac:

Andy From Sligo · 04-03-2018 3:43pm

where are the hold-ups /waiting list in MRI scans? - I know they take a long time to do per patient, but is that really where the backlog/waiting list is/are?

discobeaker · 04-03-2018 3:43pm

piplip87 wrote: »

Waiting lists are ridiculous by introducing free or low cost ones to the general public those with MS for example who may need a MRI to check on medication progress would then face even longer waits.

I have MS and am with the Mater hospital. I have to have an MRI every 2 years to check if there is any progress with my illness but I have spoken to people who have other problems less serious that have waited up to 6 years for an MRI.

Problem is we don't have enough MRI machines in the country and enough consultants to review the findings. I was meant to have an MRI 6 weeks ago but it was cancelled due to a consultant leaving the practice so now there is a backlog and I've no idea when I will get another appointment

Rodin · 04-03-2018 3:44pm

Andy From Sligo wrote: »

where are the hold-ups /waiting list in MRI scans? - I know they take a long time to do per patient, but is that really where the backlog/waiting list is/are?

Yes.
Only so many hours in the day.

Wesser · 04-03-2018 3:49pm

More patients trying to get through the system than there is scanners.

Doctor a don't just order scans ' to check things'. The have to listen to what the symptom is, examine the patient and then mentally come up with a list if possible diagnosis. Then then pick a test tailored depending on what they think is going in. They don't just pick a scan just to have a look. They have to have a specific question or condition in mind with each test they order. Some conditions are not detected by MRI scans. For example dementia is not detected with a scan.

04-03-2018 3:54pm

The cost of the equipment. The cost of operating the scheme. The cost of expert assessment of the results. The cost of making it available nationwide. The cost of publicizing the scheme.

I for one have no idea why this hasn't happened.

Andy From Sligo · 04-03-2018 3:54pm

is there anything online to say what/which hospitals in the country have MRI scanners - I know Sligo has one

Capt'n Midnight · 04-03-2018 4:48pm

Rodin wrote: »

PET-CT to screen for cancer - now I'd possibly pay for that.

The cancer risk from an abdominal CT scan is something like 1 in 2,000* Depending on who you believe it's nearly 1% of your cancer risk in the US.

*the data is still being investigated and as sensors improve lower X-ray powers are needed. Older people have lower risk because they'll have died of something else by the time that cancer catches up. Regardless , annual full body CT scan are not recommended.

Anita Blow · 04-03-2018 4:57pm

A single PET CT gives you 8 years worth of background radiation. Definitely not something you want to be having done without good reason.
Generally radiologists will not approve a request for imaging without a good reason for the request and how the result effects your management.

Andy From Sligo · 04-03-2018 5:20pm

Anita Blow wrote: »

A single PET CT gives you 8 years worth of background radiation. Definitely not something you want to be having done without good reason.
Generally radiologists will not approve a request for imaging without a good reason for the request and how the result effects your management.

so CT gives you a dose of radiation, but MRI doesnt and its much clearer/better pictures .. Have i that right?

Icemancometh · 04-03-2018 5:47pm

Don't forget the opportunity cost. It's be a huge expense to buy all the MRI machines and hire radiologists to do this. What expected benefit would you get and what else could you spend that money on?

Also agree that MRI scans for general population screening is a poor idea from a false positive POV.

Andy From Sligo · 04-03-2018 5:55pm

Icemancometh wrote: »

Don't forget the opportunity cost. It's be a huge expense to buy all the MRI machines and hire radiologists to do this. What expected benefit would you get and what else could you spend that money on?

Also agree that MRI scans for general population screening is a poor idea from a false positive POV.

Money costs aside though if it started detecting problems at an early stage with yourself or a member of your family and it could be treated because something showed up which didnt look right with the organ it was scanning and saved a life or much more complications down the line this would be immeasurable would it not.

How many times do we hear that someone has quickly passed away because of an underlying undiagnosed health condition?

Capt'n Midnight · 04-03-2018 6:21pm

DNA screening is getting cheaper as time goes on. The big question is when it's cheap enough to do a whole population. Or rather at what point the benefits of doing it now outweigh the savings of waiting a little longer for the cost to drop even more.

It's fairly non-invasive so low risk.
It's not a precise science, but as more data and stats are gathered the predictions will get better. Oncogenes indicate a likely hood of certain types of cancer, but DNA won't tell you anything about how much you smoked or drank.

There are a few data protection issues of course. At least , thanks to the EU, we don't have to worry about the insurance companies loading for genetic conditions in the same way the US companies are.

goose2005 · 04-03-2018 6:22pm

https://www.youtube.com/watch?v=R9hEa8LKG4c

_Brian · 04-03-2018 6:24pm

Having endured maybe 10 mri’s is sugfest this is a mad idea.

Why use a really expensive investigation when people could and should just go to their gp once a year for a decent checkup, if anything is seen then further investigation is a good idea.

Maybe a free gp checkup for PAYE workers similar to free dentist visit.

OldMrBrennan83 · 04-03-2018 6:29pm

This post has been deleted.

_Brian · 04-03-2018 6:33pm

If people attended their gp for an annual medical lots of additional cases of cancers and other illnesses would be caught, will they catch everything - no, but then an MRI won’t catch everything either and it would cost mad money, between machine time and radiographers to review all these pointless scans.

OldMrBrennan83 · 04-03-2018 6:35pm

This post has been deleted.

BailMeOut · 04-03-2018 6:44pm

I wish people would stop using the word 'free' when it relates to state funded services as they are never free! Example 'Free GP Care' should be referred to 'Tax Payer Funded GP Care".

Nonoperational · 04-03-2018 6:47pm

Just wouldn't work and you'd have the system bogged down with incidentalomas to breaking point. Screening needs very specific conditions to be met to be effective.

mariaalice · 04-03-2018 6:51pm

Patww79 wrote: »

They take your blood pressure, weigh you, and do fasting bloods if you're lucky. That will catch very little.

The option should be there, especially if you have an ongoing issue, to be able to ring up and book one yourself. I'm not saying they should be free, but they should be available.[/QUOTE

Hypochondriacs charter, plus its shown not make much difference in outcomes and it would be a complete waste of resources.

OldMrBrennan83 · 04-03-2018 6:54pm

This post has been deleted.

Andy From Sligo · 04-03-2018 7:01pm

_Brian wrote: »

Having endured maybe 10 mri’s is sugfest this is a mad idea.

Why use a really expensive investigation when people could and should just go to their gp once a year for a decent checkup, if anything is seen then further investigation is a good idea.

Maybe a free gp checkup for PAYE workers similar to free dentist visit.

I dont know about anyone else's GP's but particularly my own GP as good as they are (sometimes) do not have magical powers to detect stuff that a scan can , they cannot look at organs in 3D with their eyes nor take away layers of the organ like you can with MRI results.

and dont get me started on when GP's mis-diagnose or dont detect the underlying problem that is making you ill - most of the time they are at best pill dispensers ... (paid by the pharmaceutical companies - ooh, arent i cynical? LOL

)

Martina1991 · 04-03-2018 7:35pm

As a screening tool MRIs are not cost effective or realistic with waiting lists.

Screening tools already exist in the form of routine blood tests.
-PSA: Prostate cancer
-Beta HCG: Pregnancy and testicular cancer
- Ca153: Breast cancer
- Ca 125: Ovarian cancer
- Ca19.9: Pancreatic cancer
- CEA: Colorectal cancer
- AFP: Liver cancer
- ProBNP: Cardiac deficiency
- Lipid Profile: Risk of cardiovascular disease.

However, if your GP does not request these tests, disease will not be detected.

Be in the know about your own test results and your own health.

Andy From Sligo · 04-03-2018 7:53pm

cannot find it now - but there was an advert on UK TV channels years ago think it was 180quid and they showed a fella going into (what I presume) a MRI Scanner - and it said about checking for early diagnosis of strokes, angina, heart attacks and anuerisms etc.. print out at the end (to presumably give to your doctor or specialist) - good to give you peace of mind.

As you get older a lot of people you do get to thinking "are these just normal headaches or is it something more serious" or if you get out of breath "is it just because I am not fit or is my heart working right" (hypochondriac I suppose some could describe it as) and then you just get others say "when its time to go , your times up" - and then there are other that just simply do not want to go to the doctors/GP because they might not like needles or for some other reason.

OK if not a scan for all over 40's say what about for people on their notes where there is a history in the family of something medical - say if a persons mother or father is suffering from angina or passed away from heart attack or something or who had an aneurysm or something or neurological disease . How about just scanning this sector to make sure they havent inherited something and if they have then catch it early if it can.

Rubberchikken · 04-03-2018 7:57pm

Why do i click into these posts:eek: must not

Wesser · 04-03-2018 7:58pm

sugarman wrote: »

Wesser wrote: »

Your GPis slow to order one for you because he feels you don't need it.
There i s a massive waiting list for MRI scan for people who actually need one. By ordering one that you don't need your GP is just making the waiting list longer for everyone else.

Nonsense! If your GP suspects in the slightest you need one, they will write you a referral no problem ..and even if you request one yourself, if only to put you at ease, your GP will also write you a referral. Its nothing on him or her!

Noticed how I said referral too. They do not "order" an MRI. They write referral letters you can take to either a private clinic or public clinic of your choice. It doesn't even have to be in Ireland!

It's not nonsense at all. Like I said, a GP will.only refer you for one if need one. Which is what you then stated yourself...if your GP suspects that you need one they will do a referral for you. You are actually agreeing with me .

Wesser · 04-03-2018 8:05pm

OK if not a scan for all over 40's say what about for people on their notes where there is a history in the family of something medical - say if a persons mother or father is suffering from angina or passed away from heart attack or something or who had an aneurysm or something or neurological disease . How about just scanning this sector to make sure they havent inherited something and if they have then catch it early if it can.[/quote]

Such a system is already in place, in the form of blood pressure checks, ECG s, weight, glucose, lipids, with your GP and cardiology referral for an exercise stress test and angio if needed. Happens every day across the country. Not an MRI in sight.

Capt'n Midnight · 04-03-2018 8:06pm

mariaalice wrote: »

Hypochondriacs? They'd be fairly minimal if it cost a couple of grand.

But they might really have Munchausen by Proxy :eek:

Andy From Sligo · 04-03-2018 8:48pm

Rubberchikken wrote: »

Why do i click into these posts:eek: must not

maybe an MRI scan on the brain may show up why haha

you have an underlying desire to click on my posts to see if your missing something good

Andy From Sligo · 04-03-2018 8:51pm

Wesser wrote: »

OK if not a scan for all over 40's say what about for people on their notes where there is a history in the family of something medical - say if a persons mother or father is suffering from angina or passed away from heart attack or something or who had an aneurysm or something or neurological disease . How about just scanning this sector to make sure they havent inherited something and if they have then catch it early if it can.

Such a system is already in place, in the form of blood pressure checks, ECG s, weight, glucose, lipids, with your GP and cardiology referral for an exercise stress test and angio if needed. Happens every day across the country. Not an MRI in sight.[/QUOTE]

are all those tests accurate enough to detect early? - or are they chosen because they are cheaper than having a scan for the health service?

Anita Blow · 04-03-2018 9:05pm

Andy From Sligo wrote: »

Such a system is already in place, in the form of blood pressure checks, ECG s, weight, glucose, lipids, with your GP and cardiology referral for an exercise stress test and angio if needed. Happens every day across the country. Not an MRI in sight.

are all those tests accurate enough to detect early? - or are they chosen because they are cheaper than having a scan for the health service?

They are more accurate than an MRI for what they check. Imaging as a screening tool just isn't effective. Here's the WHO criteria a test has to meet for it to be considered in screening

the condition should be an important health problem
there should be a recognisable latent or early symptomatic stage
the natural history of the condition, including development from latent to declared disease, should be adequately understood
there should be an accepted treatment for patients with recognised disease
there should be a suitable test or examination that has a high level of accuracy
the test should be acceptable to the population
there should be an agreed policy on whom to treat as patients
facilities for diagnosis and treatment should be available
the cost of screening (including diagnosis and treatment of patients diagnosed) should be economically balanced in relation to possible expenditure on medical care as a whole, and
screening should be a continuing process and not a ‘once and for all’ project.

If you can't define what specifically what you're looking for then it fails on the first test. Looking for anything that might pop up isn't appropriate because you have to know what you're looking for, so an MRI on otherwise healthy people wouldn't yield much information. And as someone mentioned above, you'd get tons of incidental findings that would have to be acted upon which would end up doing more damage to people with invasive tests for zero benefit

Wesser · 04-03-2018 10:01pm

Andy From Sligo wrote: »

Wesser wrote: »

OK if not a scan for all over 40's say what about for people on their notes where there is a history in the family of something medical - say if a persons mother or father is suffering from angina or passed away from heart attack or something or who had an aneurysm or something or neurological disease . How about just scanning this sector to make sure they havent inherited something and if they have then catch it early if it can.

Such a system is already in place, in the form of blood pressure checks, ECG s, weight, glucose, lipids, with your GP and cardiology referral for an exercise stress test and angio if needed. Happens every day across the country. Not an MRI in sight.

are all those tests accurate enough to detect early? - or are they chosen because they are cheaper than having a scan for the health service?[/quote]

No they are just tests for risk factors.
The ultimate test for heart disease is an angiogram which I already mentioned. It is an invasive test which carries risks. Ie you could have a cardiac arrest during an angiogram . So you could have no heart disease but end up dying as a result of a test to detect it. It is a very I vasuvevtest which is only done on the advice of a cardiologist and you would have to sign a consent form stating that you u sweat and the risks. The other less invasive option is a CT Anglo, but that obviously involves radiation, which has already been explained to you.

In short there is no clear cut answer to wether or not everyone over 40 should have these tests. Is an question for each individual considering their own particular circumstances. Invasive expensive tests often cause harm.and worry for no reason.

Andy From Sligo · 04-03-2018 10:03pm

if a competent consultant is looking at a clear MRI he will know what looks normal and what doesnt look normal surely?

a dark area on a lung, an enlarged heart something quite not right looking on the brain from a heathy brain, surely?

then if something abnormal shows up - then another back up scan(s) to confirm something or a biopsy or (if medication can help) some medication and a check up scan/exam

Free MRI Scan's for over 40's countrywide?

Comments