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A group of medical experts has questioned the validity of many medical tests and procedures. [Photo: Bigstock]

Stop! That test or procedure may not be necessary

Natural Health News — Evidence based care. It’s a phrase we hear a lot but which, studies show, is not always practised in GP’s surgeries and hospitals.

So how do you know if a test, treatment of procedure is appropriate and helpful? An interesting new initiative in the US called Choosing Wisely aims to promote conversations between physicians and patients by helping patients choose care that is:

• Supported by evidence
• Not duplicative of other tests or procedures already received
• Free from harm
• Truly necessary

The initiative challenged 17 national organisations representing different medical specialities to identify five tests or procedures commonly used in their field, whose necessity should be questioned.

The resulting lists of Five Things Physicians and Patients Should Question, which are available to download, are fascinating and applicable to medical practice throughout the world. They should spark discussion about the need – or lack thereof – for many frequently ordered tests or treatments.

Included amongst the lists are:

• Taking antibiotics for sinus infections. Most are caused by viruses, which aren’t affected by antibiotics.
• Induced labour or caesarean section.  Unless there’s a proven medical necessity, babies should go to full term and be delivered naturally, since those delivered before 39 weeks can have lung problems, learning disabilities, and other problems.
• Stress tests if you have no symptoms of heart disease. Asymptomatic, low-risk patients account for up to 45% of unnecessary screening.
• Routine annual Pap test if you’re under age 21 or over age. Once every three years is fine unless you’ve had an abnormal test result.
• DEXA (dual-energy X-ray absorptiometry) screening for osteoporosis in women under 65 or men under 70. Unnecessary unless there are signs of bone loss.
• CT scans for children with minor head injuries: Commonly used, but unnecessary.
• EEG (electroencephalography) for patients with recurrent headaches. It has no advantage over clinical evaluation in diagnosing headache, does not improve outcomes and increases cost.
• Imaging for lower back pain. Unnecessary unless the pain has lasted more than six weeks or special circumstances like neurological deficits are involved.
• Antibiotics for pinkeye (conjunctivitis). This is usually a viral disease, so won’t respond to antibiotic treatment.
• PET or CT scans to screen for cancer in healthy people. There is little chance such tests will detect anything.

Consumer friendly information sheets are currently being developed from this early data. In the meantime more than 35 speciality societies have now joined the campaign, and these first 17 lists complete with references and rationales for the choices made,  represent the beginning of an important conversation about evidence based medicine.