More articles from Smart Testing
- Are we causing anemia by ordering unnecessary blood tests?
Iatrogenic anemia from blood draws is common, serious, and unnecessary.
- Serum allergen-specific IgE testing: How much is too much?
The Choosing Wisely campaign and others advocate against indiscriminate IgE testing in evaluating allergy.
- Do healthy patients need routine laboratory testing before elective noncardiac surgery?
Testing often increases costs and anxiety, with little benefit.
- Does this patient need ultrasonography of the leg to evaluate for deep vein thrombosis?
If the pretest probability of deep vein thrombosis is low, a normal D-dimer level is enough to rule it out.
- When does an adult with headaches need central nervous system imaging?
Without red-flag symptoms, central nervous system imaging is unwarranted and may be harmful.
- Should all patients have a resting 12-lead ECG before elective noncardiac surgery?
If the risk is low, an ECG could unnecessarily delay surgery, drive up costs, trigger further testing, and increase anxiety.
- Better care is the best defense: High-value clinical practice vs defensive medicine
Viewing every patient as a potential lawsuit is bad for patients, practice, and the health care system.
- Do imaging studies have value in a patient with acute, nonspecific low back pain?
Consider imaging only in patients who have red flags for fracture or malignancy.
- Is cardiac stress testing appropriate in asymptomatic adults at low risk?
This test is most useful in patients who have chest pain and shortness of breath on exertion.