Physicians overestimate value in cases where there is a low risk of serious illness
TUESDAY, March 5 (HealthDay News) -- Although further primary care visits may be reduced, diagnostic tests for symptoms with a low risk of serious illness actually do little to reassure patients, decrease their anxiety, or resolve their symptoms over the short or long term, according to research published online Feb. 25 in JAMA Internal Medicine.
Alexandra Rolfe, M.B.Ch.B., of the University of Edinburgh, and Christopher Burton, M.D., of the University of Aberdeen -- both the United Kingdom, performed a systematic review and meta-analysis and identified 14 randomized, controlled trials involving 3,828 patients in an effort to evaluate the relationship between diagnostic tests in cases where there is a low pretest probability of serious disease on patients' anxiety, the persistence of symptoms, and their subsequent health care resource utilization over the short and long term.
The researchers found that, overall, three trials showed no overall effect of diagnostic tests on worry, and two tests showed no effect on nonspecific anxiety. In 10 trials, diagnostic tests did not have an effect on patients' overall long-term symptom persistence. Eleven trials measured subsequent primary care visits. After exclusion of outliers, the meta-analysis suggested that patients were 23 percent less likely to visit their primary care physician after diagnostic testing.
"Subsequent use of health care resources may be reduced by diagnostic testing, although the number of patients needed to investigate and avoid one subsequent visit varied from 16 to 26 depending on the symptom," the authors write. "In the context of widespread belief that diagnostic testing reassures patents, these findings suggest that physicians overestimate the value of testing when the serious disease is low."
Abstract
Full Text (subscription or payment may be required)