When a doctor suggests that you undergo a test, treatment, or procedure, do you just go along with it without question? That may not be wise, if it's one of 10 common procedures that many experts say are often unnecessary, a top doctor says.
Dr. Daniel Morgan, an epidemiologist at the University of Maryland School of Medicine, is lead author of a new report in JAMA Internal Medicine that identifies 10 medical procedures that research finds may be overused or even unnecessary.
“Too often, health care practitioners don’t rely on the latest evidence and their patients don’t get the best care, so we’ve identified 10 tests and treatments that may be overused,” he tells Newsmax Health.
At least $200 billion annually may be wasted on overly aggressive or unnecessary care, experts estimate. In addition, complications from such procedures may result in at least 30,000 deaths annually, studies say.
Morgan’s team of researchers evaluated 2,200 studies published in 2016 to identify the most overused, or otherwise problematic, tests and procedures.
He became interested in the subject of overused medical procedures when he was involved in patient care.
“I recall one patient I had about five years ago. There was uncertainty about the cause of this patient’s chest pain, so he was given a high dose of a blood thinner, just in case it was a heart attack,” he relates.
But the blood thinner caused bleeding in the patient’s brain, resulting in a stroke.
Part of the problem is that the high-tech industry has developed increasingly refined tests, which turn up problems that could actually be harmless, but leads to still more tests and even unnecessary treatments.
“In 2001, about 2 percent of emergency room patients with respiratory symptoms were given CT scans, but now that figure has risen to 10 percent, with no increase in the incidence of the disease,” he says.
“The problem is that CT scans tend to pick up problems that aren’t relevant, like a small nodule on the lung. That can result in the need for a biopsy, which can lead to serious complications.”
The overuse of such imaging tests has also led to radiation overexposure, he says.
“People are getting exposed to a lot of radiation, probably without much benefit, and excess radiation can lead to cancer,” Morgan notes.
He is especially concerned about older people, who are the highest users of the healthcare system.
“The majority of people over the age of 65 have at least one test or procedure performed that isn’t necessary, and that may actually be up to 20 to 30 percent of care that is more harmful than beneficial,” he notes.
While these tests and procedures are not unnecessary in some cases, patients should question their recommendation in the instances that Morgan’s study stipulates.
He suggests asking your doctor these questions:
What is the test intended to show?
Will the results of this test change my course of treatment?
Is there a simpler or safer way you could find out these results?
How will the treatment you are recommending benefit me?
What will the treatment require me to do – such as taking a pill every day or undergoing blood tests to monitor for side effects – and what effect will this have on my daily life?
Here are the 10 medical procedures spotlighted in Morgan’s study:
- Transesophageal Echocardiography (TEE): This test, which is used to diagnose heart issues that can lead to a stroke, does not improve outcomes over a simpler test. It is also invasive and requires sedation, which poses risks.
- Computed Tomography Pulmonary Angiography (CTPA): Using this test to diagnose a blockage in a blood vessel in the lungs, may result in treatment delay, higher costs, and unnecessary exposure to radiation and contrast dye.
- Computed (CT) Tomography: When used in patients with respiratory symptoms, this can result in erroneous findings and subjects patients to excess radiation exposure, and is not beneficial in terms of outcomes.
- Carotid Artery Ultrasonography: This procedure is used to find blockages in the carotid arteries (the vessels on either side of the neck). When performed on patients who have no symptoms, 90 percent of them end up undergoing possibly unnecessary stenting or surgery.
- Aggressive Prostate Cancer Treatment: A PSA blood test is used in the diagnosis of prostate cancer. But in some men who are diagnosed only by the use of this test, research finds no difference in outcomes whether they were treated aggressively with surgery or were not. Also prostate surgery can lead to such complications as incontinence and impotency. It’s best to discuss the pros and cons of PSA testing with your doctor to decide if you’re a good candidate for it.
- Chronic Obstructive Pulmonary Disease (COPD): Giving extra oxygen to patients with mild COPD neither improves lung function or quality of life.
- Surgery forMeniscal Cartilage Tears in the Knee: – Surgery does not improve symptoms; using conservative management and rehabilitation instead carries fewer risks.
- Nutritional Support in Medical Inpatients: Giving critically ill patients nutritional supplementation (Ensure, etc.) does not benefit them.
- Antibiotics Usage: Up to 50 percent of all antibiotic use is inappropriate, and exposes patients to the risk of adverse side effects while also fostering the development of resistant bacteria.
- Cardiac Imaging: The use of advanced cardiac imaging for patients with chest pain has more than tripled over the past decade. Too many low-risk patients undergo such testing, which results in unnecessary hospitalizations and procedures.
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