diagnostic imaging alone estimated at more than $25 billion, according to Newman-Toker. For example, a study conducted by
Newman-Toker, an expert in vertigo and dizziness, found that the number of patients going to the emergency room for acute dizziness more than doubled in the past two decades. Dizziness can be a sign of stroke,
and the standard diagnostic tool used in the emergency department to detect stroke is a CT scan. “In our research, we found that CT
scans are grossly overused in an effort to ‘rule out’ stroke,” he tells Newsmax. “About half a billion dollars is wasted on CT imaging alone, which is basically useless, since it misses 80% to 90% of the strokes it is supposedly looking for.” Instead, relatively simple,
noninvasive, bedside physical examinations repeatedly have been shown to identify more than 99% of strokes in these patients. Prostate-specific antigen (PSA)
screening for cancer is another test that may not always be beneficial. The test is valuable to monitor people who already have a positive cancer diagnosis, but as a cancer screening tool, it yields many false-positive results. In fact, studies have shown that between 70% and 80% of men with elevated PSA levels who went on to have biopsies did not have cancer. The U.S. Preventive Services
5 Questions to Ask T 1
he Choosing Wisely initiative has helped identify more than
100 examples of tests or treatments that are commonly used in specialty fields but lack strong supporting evidence. Important questions to ask your doctor:
Do I really need this test or procedure? Medical tests should
help you and your doctor or other health provider decide how to treat a problem, and what medical procedures help to treat it.
of getting results that aren’t accurate? Could that lead to more testing or another procedure?
2 3 4
5
Are there simpler, safer options? Sometimes all you
need to do is make lifestyle changes, such as eating healthier food or exercising more.
Ask if your condition might get worse — or better — if you
don’t have the test or procedure right away.
How much does it cost? Ask if there are less expensive tests,
treatments, or procedures, what your insurance may cover, and about generic drug options.
Task Force says that the “decision to undergo PSA-based screening for prostate cancer should be an individual one.” The organization recommends
What are the risks? Will there be side effects? What are the chances
that for men ages 55-69, PSA screening should be done with a clear understanding of risk versus benefit, and screening for those over 70 is not recommended. For men with symptoms, MRIs are of greater value to detect cancer.
WHY TESTS PERSIST Labos says there are several reasons physicians order too many tests. “Sometimes, it is easier for doctors
to order tests than to explain why a popular test isn’t necessary,” he explains. “I personally found that a lot of
people expect a stress test when visiting a cardiologist, and having to explain to them why it’s not that useful in many circumstances often feels like it is more trouble than it’s worth. “Some of it is defensive medicine,”
he adds. “People are much more afraid of errors of omission than commission. “Some doctors order tests to make
sure they aren’t missing something. And of course, there is the fear of litigation.” Labos adds that another reason
for medical over-testing is the shifting screening guidelines. “So, you have a number of factors
at play,” he says — “the expectations of patients, physicians trying to protect themselves, and an ever- changing evidence base.”
DECEMBER 2023 | NEWSMAX MAXLIFE 89
DRAGANA GORDIC/SHUTTERSTOCK
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