Press Esc to close
Sunday 05 July 2015
News updated at 3:12 AM IST
Weather
Max: 33°C
Min : 21°C
In Bengaluru
Rain lightly

Most medical tests are useless

Last updated: 08 June, 2010
Washington, June 8, (AP):

More medical care wont necessarily make you healthier it may make you sicker. Its an idea that technology-loving Americans find hard to believe.

Anywhere from one-fifth to nearly one-third of the tests and treatments we get are estimated to be unnecessary, and avoidable care is costly in more ways than the bill: It may lead to dangerous side effects.

It can start during birth, as some of the nation’s increasing C-sections are triggered by controversial fetal monitors that signal a baby is in trouble when really everything’s fine. It extends to often futile intensive care at the end of the life.

Overtreatment means someone could have fared as well or better with a lesser test or therapy, or maybe even none at all. Avoiding it is less about knowing when to say no, than knowing when to say, “Wait, doc, I need more information!”

The Associated Press combed hundreds of pages of studies and quizzed dozens of specialists to examine the nation’s most overused practices. Medical groups are under way to help doctors ratchet back avoidable care and help patients take an unbiased look at the pros and cons of different options before choosing one.

“This is not, I repeat not, rationing,” said Dr Steven Weinberger of the American College of Physicians, which this summer begins publishing recommendations on overused tests. It’s trying to strike a balance, to provide appropriate care rather than the most care. Rare are patients who recognise they’ve crossed that line.

“Yet let me tell you, with additional tests and procedures comes significant harm,” said Dr Bernard Rosof, who heads projects by the nonprofit National Quality Forum and an American Medical Association panel to identify and decrease overuse.

“It’s patient education that’s going to be extremely important if we’re going to make this happen, so people begin to understand less is often better,” he said.

Put a stop to more

Not even doctors’ families are immune. A hospital appropriately did six CT scans to check Dr Steven Birnbaum’s 22-year-old daughter for injury after she was hit by a car. But the next day, Molly had an abdominal scan repeated as a precaution despite having no symptoms. When a doctor ordered still another, “I blew a gasket,” said the New Hampshire radiologist, who put a stop to more.

There are numerous reasons that one of three US births now is by caesarean, but Dr Alex Friedman blames some on an imprecise monitor strapped to labouring women. Too often, he has sliced open a mother’s abdomen fearing the worst, only to pull out a pink, screaming bundle.

Electronic fetal monitors record changes in the baby’s heart rate, a possible sign of too little oxygen. They became a tradition – now used in 85 per cent of births – years before research could prove how well they work. Guidelines issued last summer, aiming to help doctors better interpret which tests are worrisome, acknowledge the monitors haven’t reduced deaths or cerebral palsy. But they do increase the chances of a C-section.

Texas author Liza Ely had lined up hospice care for her 93-year-old mother, Verna Burnett, as she lived her last days with Alzheimer’s and heart failure. Yet when Burnett developed an irregular heartbeat, the care provider recommended seeing a cardiologist, to have a tube threaded through blood vessels to her heart to check it out. Ely said: “We asked what could be done if something showed up on the test.” The response: “Nothing, really.”

Ely said the family refused the “painful, expensive and unnecessary test.”

Push back overtreatment

In Minnesota, the influential health cooperative HealthPartners saw use of MRIs and radiation-heavy CTs growing between 15 per cent and 18 per cent a year.
So the insurer began a new program: National radiology guidelines pop up on each patient’s electronic medical record whenever a doctor orders a scan. It’s not a requirement, but a gentle reminder of when such tests are recommended. In two years and counting, they estimate it avoided 20,000 unnecessary tests, preventing dangerous radiation exposure and saving $14 million.

Medical director Pat Courneya recently examined a young man who wanted a brain CT because of dizziness. Courneya’s physical exam turned up no neurologic red flags like weakness or eye problems, but seeing the guidelines issued helped reassure the man.
An American Medical Association journal just began a “Less is More” series to educate doctors about the risks of overused treatments.

To increase patients’ savvy, around the country are testing “shared decision-making”. That process uses plain-English guides, often DVDs, to explain the advantages and disadvantages of test and treatment options. Given full information, patients choose a less aggressive approach than doctors initially recommend about 20 per cent of the time, says Dr Michael Barry of Foundation for Informed Medical Decision-Making.

“No one would say, ‘I’m going to let the dealer figure out what car I want or need.’ Now we are taking a little of that spirit to the doctor’s office,” he said.


Go to Top

Photo Gallery
Kalari Academy of performing Arts students presenting Kalaripayattu...

Kalari Academy of performing Arts students presenting Kalaripayattu...

Actor Prakash Rai at a photography exibition on Tigers in Bengaluru on Saturday...

Actor Prakash Rai at a photography exibition on Tigers in Bengaluru on Saturday...

Sky Diving Demo in Chennai...

Sky Diving Demo in Chennai...

Cadets of officers Training Academy performing free fall para jumping from AN 32 Aircraft...

Cadets of officers Training Academy performing free fall para jumping from AN 32 Aircraft...

Villagers cross Rambi Ara River...

Villagers cross Rambi Ara River...

British Grand Prix 2015...

British Grand Prix 2015...

Derailed coaches of a goods train after collision with a truck in Purulia district in West Bengal...

Derailed coaches of a goods train after collision with a truck in Purulia district in West Bengal...

Stray cows jumped the barricade to eat the grass in front of Vidhana Soudha in Bengaluru...

Stray cows jumped the barricade to eat the grass in front of Vidhana Soudha in Bengaluru...

Labourers extract sand from the Jhelum River in Srinagar on Saturday....

Labourers extract sand from the Jhelum River in Srinagar on Saturday....

Bollywood actor Salman Khan with singer Mika Singh during the launch of an Eid song...

Bollywood actor Salman Khan with singer Mika Singh during the launch of an Eid song...

Copyright 2014, The Printers (Mysore) Private Ltd., 75, M.G Road, Post Box 5331, Bengaluru - 560001
Tel: +91 (80) 25880000 Fax No. +91 (80) 25880523