On February 4, The Washington Post and others reports the release by Consumer Reports of a new web-based tool to help people be aware of the appropriate use of screening tests for heart and vascular disease. The tool is simple to use and uses pretty straightforward language explaining the value of the tests using the familiar CR circles to indicate "value" for the patient. Accompanying the tool is a variety of more detailed reports on individual components of testing and treatment for heart disease.
On first glance, the tool is excellent. Many critics and physicians are rightfully asking questions about how much testing we, as a society, do and how much is really helpful and worth the additional costs. Doctors and patients should both remember that more testing does not equal better care. Furthermore, the ACC/AHA is at the forefront of trying to use science based guidelines regarding the appropriate use of many types of heart tests and procedures. (cardiac CT, nuclear stress, stenting, etc.) Some of these guidelines have even been incorporated into tools that doctors have on their smartphones and iPads.
The tool does make one notable oversight, which I think could be missed by some consumers. It does not take into account people with symptoms of heart disease (ie: chest pain or shortness of breath). I did not see any mention of this on the web tool. Admittedly, adding this into the equation makes things dramatically more complex. Devising a web tool to account for this would be very challenging and is better suited to an individual assessment by an expert, like your doctor.
So, if your doctor suggests a test, you should definitely feel comfortable asking why the test is necessary and what the benefit will be. Your doctor should be able to answer this question intelligently, and if they do, I would suggest you take his or her advice and trust that they have your best interests at heart. If your doctor cannot answer your question, or they suggest repeated tests despite you feeling well and having no symptoms, a second opinion may be in order.
I would think that once someone is symptomatic with chest pain and/or SOB, they move out of the "screening" population and into a different category .ReplyDelete
Agreed, but I think that point is lost on many people.ReplyDelete