Small scanners could spot hidden heart disease

At UW-Madison, doctors have done neck scans with portable ultrasounds on about 900 patients. They charge $295, and three local HMOs agreed to pay. Most insurers do not, because of limited proof of the value of such tests.

Others are selling neck scanning directly to consumers.

Dr. Robert Bonow, cardiology chief at Northwestern University and a past heart association president, recently got an ad in the mail for screening at a shopping center near his Glencoe, Ill., home. He worries about the accuracy of such testing.

Suppose the scanning is 90 percent accurate, and the normal rate of heart disease is 10 percent, he said. That would mean 20 out of 200 people would have heart disease and 180 would not. But the scan would tell 18 people they had it when they didn't, and would miss heart disease in two who did.

Because of the false alarms, "you may be treating twice as many people as you have to," he said. "If you're dealing with 2 million people, that's a lot of people who don't need treatment."

Robert Rosner, an ultrasound technician in Fort Myers, Fla., sells screening to police, fire and other municipal workers and through doctor offices and health clubs. He charges $180 and offers a personal testimonial. At age 42, he scanned his own arteries and was surprised to see a 30 percent narrowing in one. A doctor put him on medications, and a couple years later, the plaque was gone.

"Without needles or radiation or pain ... there's disease in the body that can be reversed," he said. "I'm living proof."

Andy Manis / ASSOCIATED PRESS Dr. James Stein holds a small ultrasound machine in Madison, Wis., that is used by medical professionals to check whether a patient has heart disease that can be detected in neck arteries.

UW's Stein is leading a study to see whether family practice doctors can be trained in a weekend to accurately do the tests. SonoSite donated equipment, and a university-administered grant is paying for the study, which will test 350 patients.

"The danger of overtreating is low, especially in an environment where we dangerously undertreat risk factors," Stein said. Screening itself can be good, he pointed out. A previous study found that even those whose arteries were found to be normal were motivated to exercise more.

It should do even more good for people who do have heart disease, said Dr. Sanford Carimi, a Janesville, Wis., physician participating in Stein's study.

"If I tell you your cholesterol is 130, that won't bother you," he said. "If I show you you have a plaque in the blood vessel leading to your brain, you're more likely to make some changes."

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