Guidelines for routine tests

Posted by: admin on: March 28, 2012

Unnessary screening tests draining  the National Health Care Scheme could be avoided as per the new guidelines.Primary care givers need to know this.


Recent headlines offered a fresh example of how the health-care system subjects people to too many medical tests – this time research showing millions of older women don’t need their bones checked for osteoporosis nearly so often.
Chances are you’ve heard that many expert groups say cancer screening is overused, too, from mammograms given too early or too often to prostate cancer tests that may not save lives.
It’s not just cancer. Now some of the nuts-and-bolts tests given during checkups or hospital visits are getting a second look, too – things like routine EKGs to check heart health, or chest X-rays before elective surgery. Next under the microscope may be women’s dreaded yearly pelvic exams.
The worry: If given too often, these tests can waste time and money, and sometimes even do harm if false alarms spur unneeded follow-up care.
The American College of Physicians’ push for what it calls “high-value, cost-conscious care” aims to get more doctors to think twice so their patients won’t be put in that uncomfortable position. Another group, the National Physicians Alliance, is studying whether to train primary care doctors about the most overused care will change their habits.
For now, some recent publications offer some guidance.
• No annual EKGs or other cardiac screening for low-risk patients with no heart disease symptoms.Simple blood pressure and cholesterol checks are considered far more valuable.
• Discuss how often you need a bone-density scan for osteoporosis. A study published last week found that a low-risk woman whose initial scan is healthy can wait up to 15 years for a repeat; those at moderate risk might need retesting in five years, high-risk women more often.
• Women under 65 need that first bone scan only if they have risk factors such as smoking or prior broken bones, say the two new overtesting lists.
• Most people with low back pain for less than six weeks shouldn’t get X-rays or other scans.
• Even those all-important cholesterol guidelines generally advise every five years except in high risk patients.
• Pap smears for a routine cervical cancer check are only needed once every three years by most women.


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