U.S. Physician Groups Identify Commonly Used Tests or Procedures They Say are Often Not Necessary

Nine physician organizations have each identified five tests or procedures that may be overused or unnecessary as part of the Choosing Wisely campaign led by the ABIM Foundation, with Consumer Reports in an effort to improve health care quality and patient safety.

Patient advocates are calling the move a significant step toward improving the quality and safety of health care.

The lists of “Five Things Physicians and Patients Should Question” include:

· Do patients need brain imaging scans like a computed tomography (CT) or magnetic resonance imaging (MRI) after fainting, also known as simple syncope? Probably not. Research has shown that, with no evidence of seizure or other neurologic symptoms during an exam, patient outcomes are not improved with brain imaging studies. (American College of Physicians)
· Do patients need electrocardiograms (EKGs) and stress tests for annual checkups? Not if you are an otherwise healthy adult without cardiac symptoms. These tests rarely result in any meaningful change in patient management. (American College of Cardiology)
· Should patients going into outpatient surgery receive a chest x-ray beforehand? If the patient has an unremarkable history and physical exam, then no. Most of the time these images will not result in a change in management and has not been shown to improve patient outcomes. (American College of Radiology)
· Do patients need a CT scan or antibiotics for chronic sinusitis? Most acute rhinosinusitis resolves without treatment in two weeks and when uncomplicated is generally diagnosed clinically and does not require a sinus CT scan or other imaging. (American Academy of Allergy, Asthma & Immunology)
· Should dialysis patients who have limited life expectancies and no signs or symptoms of cancer get routine cancer screening tests? These tests do not improve survival in dialysis patients with limited life expectancies, and can cause false positives which might lead to harm, over treatment and unnecessary stress. (American Society of Nephrology)
· Should women under 65 or men under 70 be screened for osteoporosis with dual energy x-ray absorptiometry (DEXA)? No, research has shown that in patients with no risk factors DEXA screening is not helpful in this age group. (American Academy of Family Physicians)

The complete lists from the specialty societies, available at www.ChoosingWisely.org, include additional detail and evidentiary information communicating when a particular test or treatment may be appropriate based on clinical evidence and guidelines.

The Midwest Business Group on Health and NBCH have signed on as participating organizations. To view the lists or learn more, visit www.ChoosingWisely.org.