A new study by researchers from the University of Maryland School of Medicine (UM SOM) has sought to find the most unnecessary and overused medical treatments used in 2016 in the US.
Their findings were recently published in JAMA Internal Medicine. The researchers studied over 2,252 articles, more than half of which specifically addressed medical overuse. The purpose of the study was not to shame any practitioners, the researchers say. Instead, they hope their findings will be used to develop strategies to make healthcare more effective. Many of the most overused techniques were found to be very complex and in-depth procedures, however, the same results can be achieved using cheaper, safer, and simpler methods.
"Too often, health care practitioners do not rely on the latest evidence and their patients don't get the best care," said lead author Daniel Morgan. "Hopefully this study will spread the word about the most overused tests and treatments."
So, without further ado, these were the top 10 most overused medical procedures in 2016:
Transesophageal Echocardiography: This procedure uses high-frequency sound waves to produce detailed images of the heart. Although it has a reputation for being more sensitive than other methods, doctors can reach the same conclusions with images obtained from much simpler tests. It’s also more invasive, requires sedation, and entails more potential risk.
Computed Tomography Pulmonary Angiography (CTPA): Over recent years, this test has been used more and more in emergency departments to help diagnose pulmonary embolism, the blockage of a blood vessel in the lung. However, there are many other tests you can use that are less risky, less expensive, and don’t expose the patient to radiation and contrast dye.
Computed Tomography (CT) in Patients with Respiratory Symptoms: The study found that this was overused in patients who had non-life-threatening respiratory symptoms. In these cases, CT does not enhance the outcome of the patient and can cause false positive results. It also poses risks to patients by exposing them to radiation.
Carotid Artery Ultrasonography and Stenting: Over 90 percent of the time, this treatment is performed under uncertain or inappropriate indications, suggesting that it is often unnecessary. As both stenting and surgery pose risk to the patient, both the test and the procedure are probably used too much.
Aggressive Management of Prostate Cancer: Just 1 percent of men who had their prostate removed died of the cancer. That’s the same rate as the men who did not receive the operation. Prostate cancer treatments can also significantly increase the risk of erectile dysfunction and other problems. The researchers argue that aggressively treating prostate cancer is often not worth the risk in many scenarios.
Supplemental Oxygen Does Not Help Patients with COPD and Moderate Lack of Oxygen: Giving extra oxygen to patients with the lung illness chronic obstructive pulmonary disease, who had only mild oxygen deficit, did not improve either their quality of life or functioning of their lungs.
Surgery for Meniscal Cartilage Tears in the Knee: Having surgery for a meniscus tear did not improve symptoms. There are, however, other strategies that can be more effective, which entail fewer risks and lower costs.
Little Benefit to Nutritional Support in Medical Inpatients: This study looked at 3,376 patients with malnutrition or a risk of malnutrition. The researchers found that "nutritional support therapy," whether received orally or administered straight into the gastrointestinal tract, didn't reduce the patient's chances of dying, becoming infected with a hospital-acquired infection, or their length of stay.
Antibiotics: Nearly half of all antibiotic use is inappropriate. Not only is this costing money and time, it’s also contributing to antibiotic resistance, perhaps one of the biggest problems set to hit the world in the coming years. However, according to a study used in this research, making doctors compare the antibiotics that they prescribe with their peers could lower inappropriate prescriptions from 20 percent to less than 4 percent.
Reducing the Use of Unnecessary Cardiac Imaging: Using advanced cardiac imaging on patients suffering from chest pain has more than tripled over the past 10 years. Many low-risk patients could be given noninvasive tests that lead to unnecessary hospitalization and intervention. A study has previously shown that if doctors and patients make decisions together, the number of tests used decreases.