The impact of diagnostic testing on therapeutic interventions

Article Abstract:

The increase in diagnostic testing in the United States between 1987 and 1993 appears to correlate with an increase in medical procedures, suggesting that managing testing may help in managing care. Researchers analyzed Medicare data, looking at 7 diagnostic tests and the procedures that each of these tests often lead to. From 1987 to 1993 the annual rate at which diagnostic tests were performed increase by 40% for abdominal ultrasound and 300% for prostate biopsy. Rates of testing correlated strongly with rates of procedures for the following five pairs of each: spine imaging with back surgery, mammography with breast biopsy, prostate biopsy with prostate surgery, cardiac catheterization with angioplasty or bypass surgery, and swallowing studies with stomach surgery.

Usage, Medical care, Medical care utilization, Diagnosis, Laboratory, Laboratory diagnosis

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Avoiding the Unintended Consequences of Growth in Medical Care: How Might More Be Worse?

Article Abstract:

One of the unintended consequences of the growth in medical care is that more medical care may be harmful. Most physicians probably believe that more medical care leads to better outcomes. However, the law of diminishing returns assures that additional growth in medical care will be associated with progressively smaller returns until no benefit is derived from the treatment. One example of this is increased attention to risk factors for diseases. If more people are diagnosed with a condition, more will be offered treatment. But how many will actually need the treatment or benefit from it?

Ethical aspects, Medical ethics

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