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Chest X-rays in healthy people, ergometries in asymptomatic patients, and transvaginal or thyroid ultrasound are some of the 400 medical studies that “should no longer be used,” said specialists.
In a recent research published in eLife that evaluated some 3,000 articles from three well-known scientific journals (JAMA, The Lancet, and The New England Journal of Medicine), researchers demonstrated that these practices “are not supported by sufficient evidence,” and pointed out among the categories most questioned to interventions in cardiovascular diseases .
“The problem arises from the recommendations of medical societies or international organizations, which encourage practitioners to adopt practices. Other times there is an interest in using methods that seem innovative, or patients ask for studies that are not necessary to check their state of health,” explained clinician Carlos González Malla.
González Malla , also a member of the Fundación Cardiológica Argentina (FCA), said that “overdiagnosis” and “overtreatment” happens “very often” because doctors “are unaware of the risk that generates.”
“Doing an unnecessary study does not achieve the goal of preventing a disease and also brings risks, such as false positives or finding something like a nodule, that would never bring consequences to the patient and yet forces him to embark on a lot of further analysis,” he explained; the specialist.
The doctor commented that “there is a lot of social pressure,” since “people sometimes sit down and ask you to do this or that study because they googled it or did it to an acquaintance and told him it helps prevent the cancer ”.
González Malla clarified that in the case of cancer, for example, “the only types that medicine can prevent are colon and cervix.”
“There are institutions that recommend full check-ups in one day or things like that, a product that is sold and that always finds something. But we don't know who is making money with that,” he questioned.
According to research published in eLife , 92% of “unnecessary” studies were conducted “in populations in high-income countries,” and the most questioned categories were cardiovascular disease, public health/preventive medicine and care intensive.
Also, the work showed that medication is the most common type of intervention, that is, what is most often indicated even if it is not necessary.
“Ergometry does not prevent infarction or sudden death, as a lung X-ray does not prevent lung cancer. The same goes for studies such as chest x-rays: if you detect something with that, it's already late,” González Malla resumed.
The expert said that whenever they are healthy people with no family history or basic illnesses, “the only thing that can be done is to lead a good, healthy life.”
“It is crucial that, beyond the guidelines developed by different scientific societies, physicians evaluate the particular characteristics of each patient in order to choose the most appropriate alternative,” concluded FCA President Jorge Tartaglione .
Publication Date: 22/08/2019
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