बेकार के मेडिकल टेस्ट पर पैसा न फूंकें : Some Unnecessary Medical Tests

“Millions of Americans are increasingly realizing that when it comes to   health care, more is not necessarily better,” said Dr. Christine   Cassel,  president of the ABIM Foundation. “Through these lists of tests   and procedures, we hope to encourage conversations between physicians   and patients about what care they truly need.”
United States specialty societies representing more than 500,000 physicians developed lists of Five Things Physicians and Patients Should Question in recognition of the importance of physician and patient conversations   to improve care and eliminate unnecessary tests and procedures. See the full list
                12 MEDICAL TESTS TO AVOID               1. Avoid Inducing Labor or C-Section Before 39 Weeks               Delivery prior to 39 weeks is associated with increased risk of   learning disabilities, respiratory problems and other potential risks.   While sometimes induction prior to 39 weeks is medically necessary, the   recommendation is clear that simply having a mature fetal lung test, in   the absence of appropriate clinical criteria, is not an indication for   delivery. (American College of Obstetricians and Gynecologists; American Academy of Family Physicians)

2. Avoid Routine Annual Pap Tests   In average-risk women, routine annual Pap tests (cervical cytology   screenings) offer no advantage. (American College of Obstetricians and Gynecologists)

3.  Avoid CT Scans To Evaluate Minor Head Injuries   Approximately 50 percent of children who visit hospital emergency   departments with head injuries are given a CT scan. CT scanning is   associated with radiation exposure that may escalate future cancer risk. CT technology exposes patients to approximately                    100 times the radiation of a standard chest X-ray which itself                    increases the risk of cancer.  The recommendation calls for clinical observation prior to making a   decision about needing a CT. (American Academy of Pediatrics)
4. Avoid Stress Tests Using Echocardiographic Images The recommendation states that   there is very little information on the benefit of using stress   echocardiography in asymptomatic individuals for the purposes of   cardiovascular risk assessment, as a stand-alone test or in addition to   conventional risk factors. (American Society of Echocardiography)

5. Avoid Prescribing Type 2 Diabetes Medication To Achieve Tight Glycemic   Control The recommendation states that there is no evidence that   using medicine to tightly control blood sugar in older diabetics is   beneficial. In fact, using medications to strictly achieve low blood   sugar levels is associated with harms, including higher mortality rates. (American Geriatrics Society)

6. Avoid EEGs (electroencephalography) on Patients With Recurrent Headaches.               Recurrent headache is the most common pain problem, affecting up to 20   percent of people. The recommendation states that EEG has no advantage   over clinical evaluation in diagnosing headache, does not improve   outcomes, and increases costs. (American Academy of Neurology)

7. Avoid Routinely Treating Acid Reflux Anti-reflux therapy, which is commonly prescribed in adults, has no   demonstrated effect in reducing the symptoms of gastroesophageal reflux   disease (GERD) in infants, and there is emerging evidence that it may in   fact be harmful in certain situations. (Society of Hospital Medicine)             ADDITIONAL MEDICAL TESTS TO BE AVOIDED
              8. Avoid Lipid Profile Tests             Lipid  Profile test checks various parameters of blood, such as cholesterol (good  or high density lipoprotein as well as bad or low density lipoprotein) and  triglyceride levels. Several scientific papers have proven that people with high so-called “bad” LDL cholesterol live the longest and there is noow a large number of findings              that contradict the lipid hypothesis that cholesterol has to be lowered at all.

9. Avoid Mammograms Mammograms and breast screening have had no impact on breast   cancer deaths and have actually been found to increase breast cancer mortality. With toxic radiation, mammogram testing compresses sensitive                    breast tissue causing pain and possible tissue damage. To make                    matters worse, the false negative and false positive rates of                    mammography are a troubling 30% and 89% respectively. Another                    concern is that many breast cancers occur below the armpits;                    however, mammography completely misses this axiliary region,                    viewing only the breast tissue compressed between two plates                    of glass. Considering these drawbacks, breast thermography should                    be given closer consideration. Thermography is a non-invasive                    and non-toxic technique which can detect abnormalities before                    the onset of a malignancy, and as early as ten years before                    being recognized by mammography. This makes it much safer and                    potentially life-saving health test for women who are unknowingly                    developing abnormalities, as it can take several years for a                    cancerous tumor to develop and be detected by a mammogram.

10. Avoid PSA Testing   A PSA blood test looks for prostate-specific                    antigen, a protein produced by the prostate gland. High levels                    are supposedly associated with prostate cancer. The problem                    is that the association isn’t always correct, and when it is,                    the prostate cancer isn’t necessarily deadly. Nearly 20 percent                    of men will be diagnosed with prostate cancer, which sounds                    scary, but only about 3 percent of all men die from it. The                    PSA test usually leads to overdiagnosis — biopsies and treatment                    in which the side effects are impotence and incontinence. Moreover,                    there is some evidence which suggests that biopsies and treatment                    actually aggravate prostate cancer. During a needle biopsy,                    a tumor may need to be punctured several times to retrieve an                    amount of tissue that’s adequate enough to be screened. It is                    believed that this repeated penetration may spread cancer cells                    into the track formed by the needle, or by spilling cancerous                    cells directly into the bloodstream or lympathic system.    11. Avoid Routine Colorectal Cancer Screening   Colorectal cancer screening often results in unnecessary removal of benign polyps which are of no threat to patients and the risks of their treatment or removal far exceed any benefit. The evidence is insufficient to assess the   benefits and harms of computed tomographic colonography and fecal DNA   testing as screening modalities for colorectal cancer.
12.   Avoid DEXA Dual energy X-ray absorptiometry (DEXA or DXA) in a technique                    developed in the 1980s that measures, among many things, bone                    mineral density. The scans can determine bone strength and signs                    of osteopenia, a possible precursor to osteoporosis. Limitations                    abound, though. Measurements vary from scan to scan of the same                    person, as well as from machine to machine. DEXA doesn’t capture                    the collagen-to-mineral ratio, which is more predictive of bone                    strength than just mineral density. And higher bone mineral                    density doesn’t necessarily mean stronger bones, for someone                    with more bone mass will have more minerals but could have weaker                    bones.
Meanwhile, the ABIM effort is gaining momentum and more financial support from key players. The Robert Wood Johnson Foundation announced it has awarded $2.5 million to “fund medical specialty   societies and regional health improvement collaboratives to work in   specific communities to raise awareness of potential overuse of medical   care.”
“Reducing the overuse of health care resources is a critical part of   improving quality of health care in America,” said Dr. Risa   Lavizzo-Mourey, the Robert Wood Johnson Foundation’s president   and chief executive officer. “We want to see what can happen when this   work is targeted in specific geographic regions and are pleased to help   increase the tangible impact of the Choosing Wisely campaign.”