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Review
. 2021 Apr 7;13(4):e14342.
doi: 10.7759/cureus.14342.

The Choosing Wisely Initiative and MRIs: Over- and Under-Diagnosis in Japan and Myanmar

Takashi Watari  1   2 , Tin Myo Hlaing  3 , Hideyuki Kanda  4
Affiliations
Review

The Choosing Wisely Initiative and MRIs: Over- and Under-Diagnosis in Japan and Myanmar

Takashi Watari et al. Cureus. .

Abstract

Recently, the "Choosing Wisely" initiative has gained traction and high-value care has garnered attention. However, the actual situation of high-value care is different between developed and developing countries. To elucidate this, we highlight the differences between the high-value care provided by healthcare systems in Japan and Myanmar, as representations of developed and developing countries, respectively. Despite the total numbers of magnetic resonance imaging (MRI) equipment in Japan being 400 times higher than in Myanmar, and gross domestic product per capita being 32 times higher in Japan, the individual costs (out of pocket expenditures) per MRI scan are the same (USD 60). However, the total cost per MRI scan is different, implying that differing healthcare costs indicate the existence of over- and under-diagnosis problems among different countries. This study suggests that detailed patient histories and physical examinations are important for selecting relevant diagnostic imaging and reducing unnecessary imaging.

Keywords: mri imaging; over-diagnosis; physical examination; under-diagnosis.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. The patient pathway to find healthcare services in Myanmar
The nature of accessibility to health care services in rural areas, townships areas, and state/region areas in line with the cost-sharing payment system in Myanmar
See this image and copyright information in PMC

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