Do You Really Need That Medical Test?

Medical tests may not help reassure people when they have health concerns

(RxWiki News) If someone has a nagging health concern, a verdict of "all clear" after a round of extensive blood tests or imaging studies should make them feel better, right? Maybe not.

A recent review of published studies found that medical tests may not actually be reassuring. For patients who were not likely to have a serious condition, getting medical tests did not lower their level of worry and anxiety.

The authors concluded that costly and unnecessary testing may not be the best way to reassure patients. More research is needed to know what will really make people worry about their health less.

"Talk to a doctor about your health concerns."

Past research showed that doctors commonly believed that patients were reassured by having tests done for health issues that caused them worry.

So Alexandra Rolfe, MBChB, and Christopher Burton, MD, at the University of Edinburgh in Scotland, reviewed published studies to see if medical tests were actually reassuring to patients.

They found 14 trials with a total of 3,828 people who had had tests to rule out serious medical conditions related to their symptoms. Studies that were included in the review compared patients who had tests to patients who didn't.

The studies asked patients about their illness concern and general anxiety symptoms. Some studies asked about worry and anxiety just after the test, and others asked these questions again between four and 18 months later.

People in the studies were unlikely to have a serious medical condition, meaning they did not have risk factors or did not display the kind of symptoms that would seem to signal a serious condition.

Most of the patients in the studies were seeing their primary care doctor. Five of the studies looked at people visiting specialists.

Patients in the studies underwent imaging or other tests for symptoms related to indigestion, headache, heart function and back pain.

The authors of the review said the idea of reassurance for patients has two parts. One is short-term relief of not having a serious condition. The other is a change in the way a person sees the symptoms once they know that the symptoms are not part of a bigger health problem.

In the studies reviewed, patients did not experience short-term relief. Three studies showed that having tests did not lower the level of worry about illness. And two studies showed that tests did not lower anxiety in general.

Ten studies showed that testing did not reassure patients that the symptoms were nothing to worry about.

The authors concluded that, when people were at low risk for a serious illness, having tests did not help reassure them. They suggested that researchers and doctors need to find ways to avoid unnecessary testing while also reassuring patients.

Imaging tests can cost up to $5,000 or more. Other lab work and tests of heart function can cost many hundreds of dollars.

This review was published February 25 in the Journal of the American Medical Association (JAMA) Internal Medicine. The authors report no conflicts of interest.

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Review Date: 
February 25, 2013