In a recent study, researchers found that 10 medical treatments are overused most in the US.
While doctors do a smashing job with limited resources, sometimes striking a balance between time and costs is quite hard.
This means drugs and surgeries are used even they are not in the patient’s best interests.
In the study, the team considered 2,252 papers. Among them, 1,224 addressed the overuse of medicine directly.
These were further whittled to 122 papers which were identified as significant. The researchers then agreed on their following ‘top ten’ unnecessary treatments:
Transesophageal echocardiography
This procedure takes pictures of your heart using ultrasound via a tube inserted into your oesophagus.
A doctor may use this to replace an electrocardiogram, but research has shown that any extra detail it might produce isn’t worth the risks of being sedated.
Computed tomography pulmonary angiography
This is a diagnostic test using a CT scan to get images of the pulmonary arteries in patients with respiratory symptoms.
The method isn’t invasive and is highly sensitive, but it gives patient lots of radiation.
In addition, the wait for this test is likely to result in delays that raise the risk of complications developing.
Computed tomography in any patients with respiratory symptoms
Any kind of CT scan on a patient with non-life threatening respiratory symptoms, according to the researchers, cannot improve the patient’s outcome.
What is more, these scans can raise risks of false positives, where the test indicates a non-existent pathology.
Carotid artery ultrasonography and stenting
Doctors conduct carotid ultrasounds to test the width of arteries at the neck. It could help show the risk of stroke.
Although the early diagnosis can be a lifesaver, the study found 9 out of 10 tests being done on asymptomatic patients that resulted in an artery-widening ‘stent’ being inserted were done on inappropriate grounds.
Because stents require surgery, it’s likely several these are inflating risk unnecessarily.
Aggressive management of prostate cancer
Prostate cancer is cancer that can be treated easily if detected early.
A blood test for markers called prostate antigens can do that, but it’s hard to tell if they’re produced by an aggressive tumor that needs to be dealt with or a slow-growing one that the patient can take to their grave in years to come.
Just 1% of men who had their prostate removed – risking the complications that go with that – died of cancer.
Of those who kept their prostate? About the same.
Supplemental oxygen for patients with chronic obstructive pulmonary disease
The researchers found that giving more oxygen to patients with lung illness COPD didn’t help their lungs work better or improve their wellbeing.
But it can cause them to retain carbon dioxide. Which isn’t good.
Surgery for meniscal cartilage tears
Ripping the C-shaped shock-absorbing discs of cartilage inside your knee is no laughing matter.
But going to the trouble of repairing it surgically was found to have few benefits. You can get the benefits through conservative management and rehabilitation.
Nutritional support in medical inpatients
Overall, malnutrition doesn’t do a patient much good.
On the other hand, giving nutritional support to critically ill patients made no difference in terms of hospital stay or mortality, even if it helped them put on weight.
For failing organs or metabolic complications, that support might carry risks that aren’t balanced by benefits.
Use of antibiotics
In a 2016 study, researchers estimated 506 prescriptions were being written in 2010 to 2011 for every 1000 people. But only 353 could be considered appropriate.
The CDC’s National Action Plan for Combating Antibiotic-Resistant Bacteria aims to reduce inappropriate antibiotic use by 50% within the next few years.
Maybe the most effective was to use social pressures, encouraging doctors to take note of good prescription practices among their colleagues.
Use of cardiac imaging
Cardiac imaging for patients with chest pain was found to have tripled over the past decade while doing nothing for low-risk patients.
This risk leads to unnecessary hospital stays and interventions.
The solution? According to the researchers, doctors should share decision making with their patient.
None of these results should be taken to mean these tests and procedures are to be avoided. The best advice is to ask your doctor.
This research is published in JAMA Internal Medicine.
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