More questions about medical tests

In a letter to the Detroit News, "Wasteful tests are bad medicine," Dr. Norman Scarborough asserts that "excessive testing costs up to $250 billion dollars annually" and that "these unnecessary tests may be harmful," citing a National Cancer Institute study that "projects that 30,000 cancers will result from the 72 million CT scans Americans received in 2007 alone."

The News noted that he failed to define what constitutes an unnecessary test, which leaves one to conclude that any negative test could be, in retrospect, called unnecessary.

Furthermore, how the NCI can determine that any cancer that develops in a patient who happened to have had a CT scan can be pinpointed to the fact that they had the test, raises questions. One of the more sinister aspects of the current iteration of health care reform is the push to limit patients’ access to needed diagnostic and therapeutic services by labeling such services unnecessary and/or harmful. In real time, determining what is and isn’t necessary is far from cut and dry and only when a negative result has been confirmed can the patient and physician be assured that a potentially life and/or health threatening condition is not present.

There are no guidelines, evidence based or otherwise that can infallibly be relied upon to predict when a treatment or diagnostic test will yield positive results.

Therefore, these decisions must be left between patients and their physicians based upon many factors, with guidelines being only a part of the decision-making process.