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(Medical Xpress)   25 medical organizations were asked to list their Top 5 unnecessary medical services. The result: 135 services. Apparently, a Top-5 list was too small for some of them   (medicalxpress.com) divider line 27
    More: Interesting, medical organizations, standard algorithms  
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2892 clicks; posted to Geek » on 10 Apr 2014 at 11:19 AM (1 year ago)   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



27 Comments   (+0 »)
   
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2014-04-10 10:04:29 AM  
And you wonder why they bill you $25 for a Band-Aid.  It's not because they are greedy, per se.  It's because they can't do math.
 
2014-04-10 11:31:35 AM  
DEATH PANELS!
 
2014-04-10 11:32:58 AM  
Missing from that article.

The lists....

unless my pre coffee eyes missed them of course...
 
2014-04-10 11:36:36 AM  
list all the things!
 
2014-04-10 11:36:47 AM  

meat0918: Missing from that article.

The lists....

unless my pre coffee eyes missed them of course...


Yep, and subby missed the fact that each individual place came up with their own lists, so a TOTAL of 136(Out of a potential of 150[25*5]) is nothing odd.
 
2014-04-10 11:40:08 AM  
Nope, no lists.  Article fails.

I wonder if it'll be things known to be more harmful than beneficial like acupuncture, completely useless stuff like homeopathy or rehki (however that's spelled...) or marginally beneficial stuff like chiropractic?

Or CT scans for kids who fell down and bumped their heads on the grass?
 
2014-04-10 11:42:01 AM  
I skimmed the article and didn't see "full body scan," so I guess that was money well spent.
 
2014-04-10 11:42:22 AM  

meat0918: Missing from that article.

The lists....

unless my pre coffee eyes missed them of course...


There's one weird internet trick you can use for getting lists in articles like these.
 
2014-04-10 11:43:02 AM  

Mikey1969: meat0918: Missing from that article.

The lists....

unless my pre coffee eyes missed them of course...

Yep, and subby missed the fact that each individual place came up with their own lists, so a TOTAL of 136(Out of a potential of 150[25*5]) is nothing odd.


You might want to check the batteries on your calculator.

As of August 2013, 25 participating specialty societies had produced 1 or more Top 5 lists containing a total of 135 services
 
2014-04-10 11:45:32 AM  

meat0918: Missing from that article.

The lists....

unless my pre coffee eyes missed them of course...


Iszael: Nope, no lists.  Article fails.

I wonder if it'll be things known to be more harmful than beneficial like acupuncture, completely useless stuff like homeopathy or rehki (however that's spelled...) or marginally beneficial stuff like chiropractic?

Or CT scans for kids who fell down and bumped their heads on the grass?


The article mentioned that a percentage were diagnosis, another percentage were population surveys and some other crap.  But there was no actual 'list' as far as I could tell.

I am guessing things to avoid are vaccinations, colonoscopies, prostate exams, mamograms, pap smears, and things like that.
 
2014-04-10 11:48:03 AM  
 
2014-04-10 11:54:14 AM  
Imaging tests for author to determine mental capacity: When you need a brain scan...
 
2014-04-10 12:01:20 PM  

Mikey1969: so a TOTAL of 136(Out of a potential of 150[25*5]) is nothing odd.


25 * 5 is 125, last time I checked.
 
2014-04-10 12:07:36 PM  

Saiga410: Mikey1969: meat0918: Missing from that article.

The lists....

unless my pre coffee eyes missed them of course...

Yep, and subby missed the fact that each individual place came up with their own lists, so a TOTAL of 136(Out of a potential of 150[25*5]) is nothing odd.

You might want to check the batteries on your calculator.

As of August 2013, 25 participating specialty societies had produced 1 or more Top 5 lists containing a total of 135 services


dittybopper: Mikey1969: so a TOTAL of 136(Out of a potential of 150[25*5]) is nothing odd.

25 * 5 is 125, last time I checked.


Oh, FFS. WTF is wrong with my head today? I saw 5 and thought 6 every single time I looked at that.
 
2014-04-10 12:20:30 PM  

dittybopper: Mikey1969: so a TOTAL of 136(Out of a potential of 150[25*5]) is nothing odd.

25 * 5 is 125, last time I checked.


At least one of those respondents did 15 entries that I saw.
 
2014-04-10 12:30:19 PM  

RoyBatty: Better article in nejm

Lists:
http://www.choosingwisely.org/doctor-patient-lists/


These aren't lists of unnecessary procedures. These are just lists with general advice, e.g.

Don't delay palliative care for a patient with serious illness who has physical, psychological, social or spiritual distress because they are pursuing disease-directed treatment.
 
2014-04-10 12:31:56 PM  

Mikey1969: Saiga410: Mikey1969: meat0918: Missing from that article.

The lists....

unless my pre coffee eyes missed them of course...

Yep, and subby missed the fact that each individual place came up with their own lists, so a TOTAL of 136(Out of a potential of 150[25*5]) is nothing odd.

You might want to check the batteries on your calculator.

As of August 2013, 25 participating specialty societies had produced 1 or more Top 5 lists containing a total of 135 services

dittybopper: Mikey1969: so a TOTAL of 136(Out of a potential of 150[25*5]) is nothing odd.

25 * 5 is 125, last time I checked.

Oh, FFS. WTF is wrong with my head today? I saw 5 and thought 6 every single time I looked at that.


It is like a math version of Skitt's law.
 
2014-04-10 12:44:03 PM  

draypresct: RoyBatty: Better article in nejm

Lists:
http://www.choosingwisely.org/doctor-patient-lists/

These aren't lists of unnecessary procedures. These are just lists with general advice, e.g.

Don't delay palliative care for a patient with serious illness who has physical, psychological, social or spiritual distress because they are pursuing disease-directed treatment.


I got the impression those are the lists that are being talked about. I suspect what happened was a multi-layer game of telephone combined with some craptacular journalism.

If you can find a better set of lists that match the description given in subby's link, please do!
 
2014-04-10 12:58:49 PM  

Tricky Chicken: Mikey1969: Saiga410: Mikey1969: meat0918: Missing from that article.

The lists....

unless my pre coffee eyes missed them of course...

Yep, and subby missed the fact that each individual place came up with their own lists, so a TOTAL of 136(Out of a potential of 150[25*5]) is nothing odd.

You might want to check the batteries on your calculator.

As of August 2013, 25 participating specialty societies had produced 1 or more Top 5 lists containing a total of 135 services

dittybopper: Mikey1969: so a TOTAL of 136(Out of a potential of 150[25*5]) is nothing odd.

25 * 5 is 125, last time I checked.

Oh, FFS. WTF is wrong with my head today? I saw 5 and thought 6 every single time I looked at that.

It is like a math version of Skitt's law.


Yeah, it sucks... At least I got my user name and password right when signing in...
 
2014-04-10 01:07:01 PM  

PIP_the_TROLL: dittybopper: Mikey1969: so a TOTAL of 136(Out of a potential of 150[25*5]) is nothing odd.

25 * 5 is 125, last time I checked.

At least one of those respondents did 15 entries that I saw.


Then it technically wasn't a "Top 5" list, was it?

So when asked to provide their top 5, they gave 15.  Which still doesn't speak well of their math skills (though that would explain the entirety of the overage).
 
2014-04-10 01:20:59 PM  

RoyBatty: draypresct: RoyBatty: Better article in nejm

Lists:
http://www.choosingwisely.org/doctor-patient-lists/

These aren't lists of unnecessary procedures. These are just lists with general advice, e.g.

Don't delay palliative care for a patient with serious illness who has physical, psychological, social or spiritual distress because they are pursuing disease-directed treatment.

I got the impression those are the lists that are being talked about. I suspect what happened was a multi-layer game of telephone combined with some craptacular journalism.

If you can find a better set of lists that match the description given in subby's link, please do!


Whups - didn't mean it as a critique of your post. I agree that you've probably found the lists that TFA was referring to. As you said, a game of telephone + craptacular journalism.
 
2014-04-10 01:36:15 PM  

draypresct: RoyBatty: draypresct: RoyBatty: Better article in nejm

Lists:
http://www.choosingwisely.org/doctor-patient-lists/

These aren't lists of unnecessary procedures. These are just lists with general advice, e.g.

Don't delay palliative care for a patient with serious illness who has physical, psychological, social or spiritual distress because they are pursuing disease-directed treatment.

I got the impression those are the lists that are being talked about. I suspect what happened was a multi-layer game of telephone combined with some craptacular journalism.

If you can find a better set of lists that match the description given in subby's link, please do!

Whups - didn't mean it as a critique of your post. I agree that you've probably found the lists that TFA was referring to. As you said, a game of telephone + craptacular journalism.


Hey, fwiw, I didn't take your post as a critique either. I would like to find the "promised" lists of unneeded medical procedures.
 
2014-04-10 02:03:44 PM  

RoyBatty: Hey, fwiw, I didn't take your post as a critique either. I would like to find the "promised" lists of unneeded medical procedures.


I'm glad I didn't come across as negative (easy to do here). I would also like to see a list of unneeded medical procedures within each field by the doctors of that field.

I've heard doctors in one field claim that the procedures of another field are unnecessary, but I don't really trust those judgments.

/I've been surprised how many doctors don't think much of the entire field of pathology.
 
2014-04-10 04:48:31 PM  

RoyBatty: draypresct: RoyBatty: Better article in nejm

Lists:
http://www.choosingwisely.org/doctor-patient-lists/

These aren't lists of unnecessary procedures. These are just lists with general advice, e.g.

Don't delay palliative care for a patient with serious illness who has physical, psychological, social or spiritual distress because they are pursuing disease-directed treatment.

I got the impression those are the lists that are being talked about. I suspect what happened was a multi-layer game of telephone combined with some craptacular journalism.

If you can find a better set of lists that match the description given in subby's link, please do!


These are the lists that are being talked about. The trouble is that they've broken them down by specialty group, rather than by test/procedure. For something purporting to be patient-friendly, they're not very patient friendly.

Some of them are about unnecessary tests and procedures (e.g., "Don't perform neuroimaging studies in patients with stable headaches that meet criteria for migraine."), others are about common practices that should be avoided (e.g., "Don't use lateral wedge insoles to treat patients with symptomatic medial compartment osteoarthritis of the knee.").

/Writes patient- and provider-facing messaging around a lot of this stuff.
//Not a doctor, but I did play one on TV
 
2014-04-10 05:00:31 PM  

robertus: RoyBatty: draypresct: RoyBatty: Better article in nejm

Lists:
http://www.choosingwisely.org/doctor-patient-lists/

These aren't lists of unnecessary procedures. These are just lists with general advice, e.g.

Don't delay palliative care for a patient with serious illness who has physical, psychological, social or spiritual distress because they are pursuing disease-directed treatment.

I got the impression those are the lists that are being talked about. I suspect what happened was a multi-layer game of telephone combined with some craptacular journalism.

If you can find a better set of lists that match the description given in subby's link, please do!

These are the lists that are being talked about. The trouble is that they've broken them down by specialty group, rather than by test/procedure. For something purporting to be patient-friendly, they're not very patient friendly.

Some of them are about unnecessary tests and procedures (e.g., "Don't perform neuroimaging studies in patients with stable headaches that meet criteria for migraine."), others are about common practices that should be avoided (e.g., "Don't use lateral wedge insoles to treat patients with symptomatic medial compartment osteoarthritis of the knee.").

/Writes patient- and provider-facing messaging around a lot of this stuff.
//Not a doctor, but I did play one on TV


I remember that episode! The murderer would have gotten away if not for his pronation!
 
2014-04-10 09:21:15 PM  
Oh my.   Here's the list of low-value procedures from the American Academy of Orthopaedic Surgeons:

1. Avoid performing routine post-operative deep vein thrombosis ultrasonography screening in patients who undergo elective hip or knee arthroplasty.
2. Don't use needle lavage to treat patients with symptomatic osteoarthritis of the knee for long-term relief.
3. Don't use glucosamine and chondroitin to treat patients with symptomatic osteoarthritis of the knee.
4. Don't use lateral wedge insoles to treat patients with symptomatic medial compartment osteoarthritis of the knee.
5. Don't use post-operative splinting of the wrist after carpal tunnel release for long-term relief.

What is the deal with #2?  Who the hell injects saline in an arthritic knee joint to flush it out?  That isn't going to work!

Obviously, you need to scope that knee to really clean it out and do the job right!

Right?

http://www.ncbi.nlm.nih.gov/pubmed/12110735
http://faculty.fortlewis.edu/burke_b/Criticalthinking/Readings/Mosel ey %20et%20al%20-%20placebo%20surgery.pdf
(Read about how the placebo surgery was done, in the "Methods" section)
 
2014-04-11 09:18:10 AM  

Parthenogenetic: Oh my.   Here's the list of low-value procedures from the American Academy of Orthopaedic Surgeons:

1. Avoid performing routine post-operative deep vein thrombosis ultrasonography screening in patients who undergo elective hip or knee arthroplasty.
2. Don't use needle lavage to treat patients with symptomatic osteoarthritis of the knee for long-term relief.
3. Don't use glucosamine and chondroitin to treat patients with symptomatic osteoarthritis of the knee.
4. Don't use lateral wedge insoles to treat patients with symptomatic medial compartment osteoarthritis of the knee.
5. Don't use post-operative splinting of the wrist after carpal tunnel release for long-term relief.

What is the deal with #2?  Who the hell injects saline in an arthritic knee joint to flush it out?  That isn't going to work!

Obviously, you need to scope that knee to really clean it out and do the job right!

Right?

http://www.ncbi.nlm.nih.gov/pubmed/12110735
http://faculty.fortlewis.edu/burke_b/Criticalthinking/Readings/Mosel ey %20et%20al%20-%20placebo%20surgery.pdf
(Read about how the placebo surgery was done, in the "Methods" section)


Thanks! I'd been using this study in arguments (on Fark and at work) about the ethics of placebo controls, but it's nice to have more examples.
 
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