Maynard says he believes the variability is driven, if not by the dramatic increase in reimbursement to hospitals, "around local culture and a few influential physicians or thought leaders pushing the agenda."
"There's certainly a driver fiscally. And that's for the people who sell these devices, pushing them, because people are being unduly influenced by the promotion of them, thinking that they're protecting patients."
In an accompanying Viewpoint in the same JAMA issue, Vinay Prasad, MD, Jason Rho, MD, and Adam Cifu, MD, of the National Cancer Institute called for the U.S. Food and Drug Administration to step in.
They pointed out the need for studies to prove these filters benefit patients, "given the known harms and lack if efficacy data" for them.
"Unfortunately, there is little incentive for manufacturers of filters to embark on trials that can only eliminate their products market share," so the FDA should "require current filter manufacturers to perform efficacy studies of their devices as a condition for remaining on the market, or a large federally funded study to determine if this expensive device leads to greater benefit than harm."