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Smart Testing tackles chief culprits of wasted care: unnecessary imaging procedures and diagnostic tests
Peer-reviewed series of patient vignettes focuses on clinical value of selected tests in specific scenarios in an evidence-based and common-sense way
Philadelphia, August 4, 2014 -- The American College of Physicians (ACP) and Cleveland Clinical Journal of Medicine (CCJM) have collaborated to create a new series, Smart Testing, to help physicians provide High Value Care by presenting clinical scenarios in which diagnostic tests are commonly ordered in the absence of supporting data. The articles use evidence-based recommendations to clarify when testing is appropriate.
"The Institute of Medicine has estimated that $765 billion is wasted annually in the United States on care that provides no value to patients," said Dr. David Fleming, president of ACP. "Smart Testing clinical vignettes and discussions illustrate the appropriate use of imaging tests and other diagnostic procedures, of which overuse and misuse account for an estimated $210 billion of our wasted health care dollars."
Dr. Patrick Alguire, senior vice president for medical education at ACP, notes in an introduction to the periodic CCJM series that spending on imaging procedures and diagnostic tests has "skyrocketed, with a cumulative increase of approximately 90% from 2000 to 2009. Despite our extensive use of diagnostic imaging and other testing, the US population does not benefit from better health or longer life than other industrialized nations."
Dr. Brian Mandell, CCJM editor in chief, admits in a commentary about the series that he "may bristle when someone, often for cost reasons, questions the necessity of a diagnostic test that I have ordered to help me understand a clinical problem in a specific patient. Nevertheless…the frequent use of sophisticated and expensive testing in the United States has not resulted in better clinical outcomes."
The appropriateness of cardiac stress testing in low-risk patients and strategies for avoiding malpractice litigation while providing evidence-based care are among the initial topics in the Smart Testing series, which is part of ACP's High Value Care initiative.
About ACP's High Value Care Initiative
ACP's High Value Care initiative is designed to help doctors and patients understand the benefits, harms, and costs of tests and treatment options for common clinical issues so they can pursue care together that improves health, avoids harms, and eliminates wasteful practices. ACP defines High Value Care as the delivery of services providing benefits that make their harms and costs worthwhile. Value is not merely cost. Some expensive tests and treatments have high value because they provide high benefit and low harm. Conversely, some inexpensive tests or treatments have low value because they do not provide enough benefit to justify even their low costs and might even be harmful.
About the American College of Physicians
The American College of Physicians is the largest medical specialty organization and the second-largest physician group in the United States. ACP members include 141,000 internal medicine physicians (internists), related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow ACP on Twitter and Facebook.