{
  "abstract": "BackgroundMedical imaging is central to modern diagnosis and treatment, yet its contribution to population-level survival has rarely been quantified, and the few existing estimates have been interpreted as evidence that imaging directly extends life. Whether national imaging utilisation reflects a distinct clinical mechanism or a broader process of health-system development has not been formally tested.\n\nMethodsLongitudinal ecological panel study of 38 OECD countries, 2000-2024 (950 possible country-years). CT and MRI availability and utilisation were linked to life expectancy at birth, treatable and preventable mortality, and seven cause-specific mortality outcomes. Two-way fixed-effects models with country and year fixed effects and country-clustered standard errors were adjusted sequentially for log GDP per capita, log health expenditure per capita, population aged [≥]65 years, physician density and smoking prevalence. Three falsification families were specified: lead-exposure (placebo) models regressing current life expectancy on future imaging utilisation; negative control exposures with no diagnostic-imaging pathway to survival; and wild cluster bootstrap inference.\n\nResultsIn the principal adjusted model, CT utilisation at a three-year lag was associated with higher life expectancy ({beta} = 0.85 years per 100 additional examinations per 1,000 inhabitants, 95% CI 0.16 to 1.54; cluster-robust p = 0.015; bootstrap p = 0.034; n = 339, 29 countries). Scanner availability showed weaker, generally non-significant associations. All three falsification analyses failed to support a modality-specific effect. Future CT utilisation predicted current life expectancy as strongly as past utilisation (three-year lead {beta} = 0.86, 95% CI 0.15 to 1.57, p = 0.017), consistent with high within-country autocorrelation of the exposure (r = 0.64 at three years). Radiotherapy equipment density, a therapeutic rather than diagnostic technology, showed an equal and more precise association ({beta} = 0.85 per 10 units per million, 95% CI 0.32 to 1.38, p = 0.0017), as did PET scanner density and health expenditure, whereas physician density showed none. Associations were stronger for preventable ({beta} = -43.3 per 100,000, p = 0.0002) than treatable mortality ({beta} = -13.5, p = 0.19), and all were attenuated to the null under country-specific linear trends.\n\nConclusionsNational CT utilisation is a robust ecological correlate of life expectancy but does not behave as a causal determinant under falsification. It is best understood as a marker of health-system capital development. Claims that imaging adds years of life are not supportable on ecological evidence of this kind.",
  "abstract_shown": true,
  "affiliations": [
    "College of Medical Sciences Warsaw"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 1,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "R. Obuchowicz"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/5n09p9t84hfg9.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.09.02.26362082",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.09.02.26362082v1.full",
  "id": "5n09p9t84hfg9",
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  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.09.02.26362082v1",
  "language": null,
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "public and global health"
    ],
    [
      "openalex",
      "3600|Global Health Care Issues"
    ]
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  "openalex": "W7211947473",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.09.02.26362082v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-02",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/5n09p9t84hfg9.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:54Z",
      "native_id": "10.64898/2026.09.02.26362082",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.09.02.26362082v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:public and global health",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Marker or mechanism? Medical imaging utilisation and population life expectancy in 38 OECD countries, 2000 to 2024 year.",
  "title_text": "Marker or mechanism? Medical imaging utilisation and population life expectancy in 38 OECD countries, 2000 to 2024 year.",
  "type": "preprint",
  "updated_at": "2026-10-30T12:17:54Z",
  "url": "https://research.draconitic.com/paper/5n09p9t84hfg9",
  "venue": "medRxiv",
  "versions": []
}