This post is part of a series of posts covering my various experiences at ISMRM 2012.
Presentation Type: Lauterbur Lecture
Title: MRI: from Science to Society
Presenter: Vivian S. Lee, M.D., Ph.D., M.B.A.
Date Presented: Monday May 7, 2012
Vivian S. Lee was the ISMRM president for both the Executive Committee and the Board of Trustees. She has served numerous other positions with ISMRM and is the CEO of University of Utah Health Care. She has also served as the Senior Vice President for Health Sciences at the University of Utah and Dean of the University’s School of Medicine. She gave a talk at ISMRM’s opening plenary session early Monday morning discussing MRI’s past, current and future impact on society in relation to past, current and future scientific progress. This was a general talk that I feel all people in the MR industry need to consider in securing a brighter future for MRI in creating a more positive impact on society.
I was helping a dear UW-Madison colleague, Fang Liu, to prepare his final version of his Powerpoint presentation for his talk on MSK relaxometry, so I missed part of Lee’s talk, although I really wish I didn’t! However, I did catch a significant part of Lee’s talk and I feel it still made a significant impact on my perception of MR research.
One question we as MR researchers should consider is if we are focusing on the right issues. Lee pulled up a list of the top causes of morbidity (disclaiming beforehand that this is only one possible approach and not necessarily the best in answering this question) and noted that MR research does cover a fair majority of these causes. However, when comparing 1. the top-ranked medical issues in terms of cost, and 2. the volume of abstracts from ISMRM identified for each category, it is clear that MR researchers place a disproportionate amount of attention toward mental disorders and not enough in arthritis, lung, or cardiovascular disorders. In fact, a correlation measure between the most costly medical issues and the number of abstracts in each category shows very nearly zero correlation (R2 = 0.006)!
Secondly, MR research may be placed under scrutiny by the medical industry for the lack of MR studies utilizing evidence-based medicine. When looking at various medical journals, the median sample size for each study was at least 261 (for articles from medical journals looking at imaging), but the median sample size for studies reported in imaging journals is 32. Imaging journals mostly cover pilot and cohort studies, and not evidence-based medical research. Lee then discussed how, in light of the now limited-than-ever financial situations for the medical industry, clinicians and medical societies are reaching a consensus of recommendations against (or at least, not in favor) of MR imaging for medical strategies. Imaging as a whole, in fact, has received little acclaim in the new financial paradigm for hospitals around the world (minus a few exceptions – Australia was noted). It is obvious that MR is under increased scrutiny from the medical industry and society, and Lee feels that this is likely due to the lack of evidence-based medicine research. In Lee’s words, evidence-based medicine research leads to evidence-based funding.
Furthermore, Lee asked if MR research is adding value to society over other technologies. In other words, are MR researchers in any way demonstrating how MRI is a superior modality for a particular application in any respect over other methods, such as echocardiograms? Lee found a lack of comparative effectiveness research, and noted that it is this lack of CER that we simply don’t know the answer to this question.
Lee believes that creating imaging consortiums may be a potential way for MR researchers to address these key questions. She noted one such consortium, called MESA, short for Multiethnic Study of Atherosclerosis.
In light of the changing medical paradigm, these questions are imperative to securing the future of MR research.