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Wednesday, April 4, 2012

Are You Getting Tests You Don’t Need?

by Daniel J. DeNoon

Are you getting too many medical tests or treatments?

You might be, nine major medical groups say. These common tests can be lifesavers for people who need them.

So what’s the harm of an extra test or two just to be on the safe side?

All medical procedures, including tests, carry some risk. Even if the risk of physical harm is small, there’s the risk of a false-positive result — or of overdiagnosis, that is, finding and fixing a problem that never would have bothered you.

And, oh yes: The extra procedures add to the cost of your treatment.

Are you getting too many tests and treatments? Here’s the list, by medical specialty:

Family physicians say you probably don’t need:

  • Imaging tests for low back pain during the first six weeks.
  • Antibiotics for mild or moderate sinus infections, unless symptoms last for 7 days or symptoms worsen after getting better.
  • The DEXA osteoporosis test if you’re a woman younger than 65 or a man under 70 with no risk factors.
  • Pap smears if you’re a woman under age 21 or a woman who had a hysterectomy for a non-cancer reason.

The American College of Physicians says you probably don’t need:

  • ECG tests if you don’t have symptoms and are at low risk of heart disease
  • Brain imaging (CT or MRI scans) if you fainted and have a normal neurological exam.
  • Pre-operative chest X-rays if you don’t appear to need them.

Cancer doctors say you probably don’t need:

  • Treatments aimed at eliminating solid tumors if you are weak and frail, did not benefit from previous treatments, and there’s no sign more treatment will help.
  • PET, CT, or bone scans if you have early-stage prostate cancer with low risk of spreading.
  • PET, CT, or bone scans if you have early-stage breast cancer with low risk of spreading.
  • Biomarker tests or imaging surveillance studies if you’ve had curative treatment for breast cancer.

Cardiologists say you probably don’t need:

  • Exercise stress tests if you don’t have symptoms or high risk of heart disease.
  • Exercise stress tests or advanced imaging for routine follow-up exams if you don’t have any symptoms.

Gastroenterologists say you probably don’t need:

  • Any more than the lowest effective dose of antacids for long-term treatment of reflux (GERD).
  • Repeat colon cancer screening of any kind for 10 years after a colonoscopy finds no polyps or tumors.
  • Repeat colonoscopy for 5 years after having one or two small polyps removed via colonoscopy.

Radiologists say you probably don’t need:

  • Imaging studies if you have uncomplicated headache.
  • Imaging studies for pulmonary embolism if you don’t have suspicious findings from other tests.
  • CT scans in children with suspected appendicitis, until ultrasound has been considered.
  • Follow-up imaging studies for ovarian cysts that aren’t causing a problem.

Allergists say you probably don’t need:

  • Unproven tests — such as IgG tests or a battery of IgE tests — to find out what you are allergic to.
  • Sinus CT scans or antibiotics for uncomplicated sinus infections.
  • Routine extensive diagnostic testing if you have chronic hives.

So what do you think? Would you miss getting these routine tests or treatments? Have you recently had an unnecessary test or treatment? How much have you been paying for these needless procedures?


Posted by: Daniel DeNoon at 11:08 am


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