HEALTHY LIVING Do You Really Need That Test?


Pricey evaluations not only hurt the pocketbook, but also can cause undue physical and mental stress. ::


BY LYNN ALLISON O


ne of the great problems in Western medicine is the epidemic of over-testing.


While it is tempting to assume


that doing more tests results in better outcomes for patients, this isn’t always the case. Cancer screening tests, such as


the Pap smear for cervical cancer and colonoscopy or other tests to detect colon cancer, have a demonstrated benefi t, says Christopher Labos, M.D., a cardiologist with a degree in epidemiology at the McGill University Offi ce for Science and Society in Montreal. Also, checking people for high


blood pressure or high cholesterol after a certain age has value, because these health conditions produce no obvious symptoms and treatment prevents heart attacks. But many tests do not have much


merit when assessed subjectively and can trigger a cascade of more pricey


evaluations that not only hurt the pocketbook, but also can cause undue physical and mental stress. Choosing Wisely, an initiative


of the American Board of Internal Medicine Foundation, promotes conversations between clinicians and patients about what tests, procedures, and treatments are needed, and those that are not. For example, Choosing Wisely


does not recommend sending patients with low back pain for X-rays unless there is some reason to suspect a structural problem, says Labos. “Most low back pain is muscular,


while X-rays can only detect bony pathology,” he says. In addition, experts polled


by Choosing Wisely advise against routine chest X-rays and electrocardiograms to evaluate heart function in low-risk patients because they don’t add enough information and value in assessing health in most cases. Labos, co-host of a popular


For men ages 55-69, a PSA screening should be done with a clear understanding of risk versus benefi t. For men with symptoms, MRIs are of greater value to detect cancer.


podcast called The Body of Evidence, which wades through the existing evidence on health topics, says that routinely checking vitamin D levels is another interesting example of unnecessary testing. “Firstly, there is little


evidence that correcting low vitamin D levels prevents any signifi cant diseases like cancer or cardiovascular disease,” he tells Newsmax. “In fact, most of the trials


on this have been frankly negative, showing no benefi t whatsoever. The data for osteoporosis is more equivocal and less defi nitive.” Labos says that doctors often


prescribe this test annually, even if the previous test was normal. “If it was normal then, there’s


probably little value in checking it again. While the price of bloodwork may be minimal, it can add up to a staggering amount when you do it a million times over with no clear medical benefi t,” he says. In the United States, overly


aggressive testing and treatment is estimated to cause 30,000 deaths among Medicare recipients alone, while unnecessary interventions are estimated to account for 10%-30% of spending on healthcare. Diagnostic testing probably


accounts for 10% of all healthcare costs, which now exceed $2.7 trillion, and that percentage is increasing over time, with advanced diagnostic imaging leading the way and diagnostic laboratory testing a close second, says David E. Newman- Toker, M.D., professor of neurology, ophthalmology, and otolaryngology and director of the Armstrong Institute Center for Diagnostic Excellence at Johns Hopkins School of Medicine. Some diagnostic tests are misused or overused, with waste from


88 NEWSMAX MAXLIFE | DECEMBER 2023


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