Home > Health care > Medical tests don’t always ‘make it better’

Medical tests don’t always ‘make it better’

Have you ever heard of an “incidentaloma”? According to family physician Kenny Lin, the increasing use of CT scans often results in detection of incidental findings that could be — but usually are not — cancer.

The problem? When an “incidentaloma” turns up, doctors usually recommend more tests. And incidental findings happen a lot.

A study published last year in the journal Archives of Internal Medicine found that nearly 40 percent of CT and MRI scans performed for research purposes at the Mayo Clinic from January through March 2004 turned up at least 1 incidental finding.

Even the American College of Radiology worries about this, Lin says. ACR recently published guidelines that warn

“Subjecting a patient with an incidentaloma to unnecessary testing and treatment can result in a potentially injurious and expensive cascade of tests and procedures.”

Note the subhead of Lin’s article: Why to Think Twice Before Getting a CT Scan. The U.S. spends so much more than other countries on health care partly because doctors order so many tests, and tests too often yield false positives, and even false positives require treatment or more testing….

Thanks to Gary Schwitzer at Health News Blog for this quote from an essay called “The Last Well Person.”

“[F]alse positives are the arithmetically certain result of applying a disease-defining system to a population that is mostly well. … If the behavior of doctors and the public continues unabated, eventually every well person will be labeled sick. Like the invalids, we will all be assigned to one diagnosis-related group or another. How long will it take to find every single lesion in every person? Who will be the last well person?”

Categories: Health care
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