“Some Heart Disease Screens May Be Unnecessary” – topic of a health consumer column in the New York Times. Excerpts:
Avoid: Several studies have suggested that expensive tests for biomarkers that are sometimes indicative of heart disease — such as C-reactive protein, a sign of systemic inflammation — are not cost-effective in generally healthy patients. More sophisticated testing should be done only in patients with known heart risks.
Some sophisticated, expensive heart disease screening tests may pose risks to the patient and may not be effective. For example, patients who receive CT angiography — in which multiple CT scans are used to produce a three-dimensional image of the heart — are exposed to amounts of radiation. According to a study published last month in The Archives of Internal Medicine, patients at low risk of heart disease who got this test were more likely to be treated aggressively with invasive and potentially risky procedures, but in the end were not less likely to have a heart attack or other coronary problem.
Addendum: Alain Braillon left this comment on my LinkedIn page:
“In 1923, Jules Romains wrote a comedy: “Knock or the Triumph of Medical Science” in which, thanks to frightening graphs, an inventive village doctor succeeds in turning the robust inhabitants into confirmed hypochondriacs.
In 1673, Molière pictured Fleurant, a money-hungry apothecary, as the supplier of unicorn’s horn to the “Imaginary Invalid”.
Now, who will write the “Healthy unwitting”?
We must recognize the discrepancy between the expected and the actual impact of screening in real life settings. Disease mongering and overdiagnosis are a source of harm.