A couple weeks ago I wrote about new research questioning routine dental x-ray screening safety. This issue of over-testing patients with potentially dangerous screening tests is actually quite a big deal, and this important issue got even more coverage just a couple weeks before with a major new campaign in the US called Choosing Wisely. This organization of all the top physician groups published a list of 45 tests which they feel are routinely over-ordered, as the risks outweigh the proven benefits. For example, my American Academy of Family Practice recommends:
- No antibiotics for acute sinusitis infections
- No x-rays of the low back during the first 6 weeks of an injury
(unless there are obvious “red flag” danger signs) - No routine ECG during any annual physical for a healthy person
- No DEXA bone scan in healthy women under 65
- No Pap smears for women under 21
These are very common tests and treatments all over the world, but the fact remains that there truly is little proof that these tests help more than hurt most patients. I think this Choosing Wisely campaign is a very important new program that really sheds some evidence-based prudence on what were previously considered de-facto tests. This is a wake-up call for all doctors everywhere, and I welcome the discussion.
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