When it comes to a person's health, one can never be too safe. Flu shots, shingles vaccinations, and even wisdom teeth removal are all preventative measures that can help us out in the long run. However, at what point does 'too safe' become 'too much'?
A recent study narrowed down 10 diagnostic procedures and treatments that got overused last year. Ultimately, the doctors and other medical professionals who collaborated on this study wanted to show how the healthcare system could be more effective.
The team of researchers from the University of Maryland's School of Medicine went through archives and searched for terms like 'overtreatment,' 'inappropriate,' and 'unnecessary.' They gleaned over 2,200 papers; half of those addressed overusing medicine and medical procedures directly.
"Too often, health care practitioners do not rely on the latest evidence and their patients don't get the best care," said researcher Daniel Morgan from the University of Maryland's School of Medicine.
"Hopefully this study will spread the word about the most overused tests and treatments."
So what procedures and medical events made the top 10?
Use (and Overuse) of antibiotics
Over 500 prescriptions were being written for ever 1,000 people seen by a doctor, according to a 2016 study. However, that same study found that only 353 of those prescriptions were actually needed. The Center for Disease Control looks to reduce the amount of antibiotics prescribed by 50 percent over the next few years. The CDC created the National Action Plan for Combating Antibiotic-Resistant Bacteria. They noted that "the emergence of drug resistance in bacteria
is reversing the miracles of the past eighty years, with drug choices for the treatment of many bacterial infections becoming increasingly limited, expensive, and, in some cases, nonexistent. The ... CDC estimates that drug-resistant bacteria cause two million illnesses and approximately 23,000 deaths each year in the United States alone."
The University of Maryland study also said social pressures on doctors to make smarter prescriptions could offer a solution.
This style of imaging has tripled in patients experiencing chest pains over the last 10 years. However, this doesn't do anything for low-risk patients, the study noted. The researchers determined that most cardiac imaging led to unnecessary hospital stays.
Computed tomography pulmonary angiography (CTPA)
CTPAs are diagnostic tests that analyze the pulmonary arteries in patients using a CT scan. They're traditionally used in patients with respiratory symptoms. While it's not an invasive procedure, it does expose patients to a decent dose of radiation.
Computed tomography (CT scans) in patients with respiratory symptoms
CT scans, according to the study, aren't helpful to anyone with non-life threatening symptoms. Scans actually boost the chances of a false positive. In 2015, James Duncan, a radiologist at Washington University, had not one but two CT scans. The first scan was due to severe abdominal pain presumably caused by kidney stones. The second was due to a mistake on the part of the technician.
"I later learned that the technician running the CT mistakenly believed that the first scan didn’t include the top of my kidneys, and decided to acquire more images ‘just to be sure,’ " Duncan said. "The irony: I was getting ready to give a lecture on reducing radiation exposure from medical imaging. And there I was, reluctantly agreeing to a CT scan and then getting overexposed."
Carotid artery ultrasonography and stenting
Carotid ultrasounds can test the width of arteries and help indicate the risk of a stroke. While any medical professional will certainly agree that early diagnosis is the best diagnosis, the researchers found that 9 out of 10 these tests resulted in unnecessary actions.
Aggressive prostate cancer management
In the United States alone, more than 2.9 million men have been diagnosed with prostate cancer at some point in their lives. Detected early, this type of cancer is easily treated. However, just 1 percent of men who had their prostate removed for treatment purposes died of the cancer. Those who kept their prostate and opted for alternative treatments faired about the same rate.
Additional oxygen for those struggling with COPD
Chronic obstructive pulmonary disease or COPD is a larger term that includes issues like emphysema, chronic bronchitis, non-reversible asthma and several formss of bronchiectasis. However, the researchers found that giving COPD patients more oxygen didn't improve their breathing at all. In fact, it sometimes caused them to retain carbon dioxide -- an issue far worse.
Surgery for tearing meniscal cartilage
Anyone who loves running will agree that the cartilage inside their knee is one of the most important parts of their overall health. Injuring that or tearing it leaves one in a lot of pain as the leg's shock absorbers are now gone. As much as surgery seems like the only fix in that situation, the doctors noted that going under the knife had few benefits that couldn't be duplicated with rehab and proper management of the area.
This is when a doctor gets an image of the heart by using ultrasound. It's often an alternative of an electrocardiogram. However, the researchers found that extra detail that doctors could get by using the esophagus rather isn't worth being sedated.
Inpatient nutritional support
In the study, the researchers clarified that malnutrition is never a good sign in any patient. However, Giving extensive nutritional support to critically ill patients didn't affect hospital stay or mortality rate. The study noted that these two elements didn't change even if the patient put on weight.
Another study noted that specialized diets can actually have more negative effects on a patient. "Although special nutritional formulas may be promising in a variety of clinical settings, based on currently available data, these cannot be recommended for routine use in critically ill patients," the study said.
Think Twice (or More) Before Saying 'Yes'
Consumer Reports suggests asking yourself five questions after a doctor suggests a medical procedure. Ideally, these questions help patients (and ultimately doctors) limit overuse. The report emphasizes taking these questions even more seriously if your medical professional recommended an invasive procedure or surgery.
1) Do I really need this test or procedure?
2) What are the risks and side effects?
3) Are there simpler, safer options?
4. What happens if I don't do anything?
5. How much does it cost, and will my insurance pay for it?
Note that this study doesn't qualify these procedures as completely useless. Talk to several medical practitioners before deciding on any potential major treatment.