Column: Why not all tests are necessary

Dr Mary Wren
Dr Mary Wren
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I think a lot of people like tests. Something about getting a definite answer or a sense of security that we are well.

We read stories in the magazines of people advocating we should all have certain tests – because it saved their life, and it can be confusing knowing what to believe

When I was training, the big emphasis was not on testing; many tests we do today were not even available then.

The emphasis was on the history or the story of the problem.

It is estimated that 80 per cent or more of the diagnosis comes from taking a good history.

You could say that is about asking the right questions and, thinking out of the box, covering a broad range of options and not focusing in too quickly.

Then the examination is the next most important thing, followed by any tests that are done. So we need to think wisely about what test we really need to do and why.

Some tests have implications if positive. For example, a positive HIV test will then change the course of that person’s life in all sorts of ways they don’t think of – life insurance for example.

Sometimes tests suggest problems that are not of any consequence and this raises stress levels and can cause worry for months about something that actually isn’t a problem.

Recently, medical experts from different specialities were asked to name five tests that were not helpful or necessary.

These then formed part of something called the Choose Wisely Campaign which highlights that doctors and patients should talk openly about how conditions should be treated.

You can access the full report online, but some things included are “Women over 45 do not need a blood test to diagnose the menopause and X-rays are no real help to those with lower back pain.

Also “Routine screening for prostate conditions using a test known as a Prostate Specific Antigen, or PSA test, does not lead to longer life and can bring unnecessary anxiety.”

So not all testing is good.

When your doctor tells you that a test isn’t helpful, they are not trying to deprive you of something, rather they are saving you from unnecessary exposure to something that wouldn’t add to your care and may even be negative for you.

Next time your doctor suggests a test, don’t be frightened to ask them if it is really necessary.