You can now get tests to check for clogged arteries or weak bones at your local pharmacy, your gym, the mall, or even your church, often at discount prices. Good idea? No, according to an editorial out yesterday in the Annals of Internal Medicine. Our medical experts agree.
The tests may have a veneer of respectability, as they're typically sponsored by well-known community groups, local physician offices, or hospitals. And most of the tests offered, such as electrocardiograms or echocardiograms of the heart to assess your risk of heart disease, or an ultrasound of your heel to measure your risk of osteoporosis, seem harmless enough. But the editorial argues that such tests, used willy-nilly on anyone who wanders in and asks for one, are mostly designed to drum up business, and are a "driver of expensive and unnecessary care."
John Santa, M.D., director of the Consumer Reports Health Ratings Center, agrees. "Preventive screening tests for heart disease, osteoporosis, and other health problems can be fantastic, when used properly," he says. "But to make that determination, you need to better educate yourself, talk with your doctor, and look at our Ratings and those of others, such as the U.S. Preventive Services Task Force, to make sure that the test really makes sense for you. A shotgun approach to testing can result in a lot of collateral damage."
For example, echocardiograms of the heart, along with exercise stress tests, are usually only appropriate for people who have symptoms of heart disease, such as chest pain when exercising. In other cases, the test is more likely to have inaccurate results that lead to follow up tests and treatments that you probably don't need.
Similarly, screening for osteoporosis is a good idea for women 65 and older and some men 70 and older with risk factors. But even then, the recommended test is one called DXA, which takes X-ray images of your hip or spine, not an ultrasound of your heel.
The new Annals editorial is part of an effort by a number of organizations, including the American College of Physicians and the ABIM Foundation, to reduce unneeded medical care
Ethics of Commercial Screening Tests [Annals of Internal Medicine]