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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com

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martes, 11 de marzo de 2014

Los "Top 5" tests a evitar

BY MIKE MITKA on FEBRUARY 17, 2014
"Diagnostic testing, treatments, and hospitalizations ordered by emergency physicians account for up to 10% of US health expenditures. From 2003 through 2011, the mean cost of an emergency department visit increased about 240%, from $560 to $1354. In an effort to rein in unnecessary and costly activities, an expert panel identified a top 5 list of tests, treatment, and disposition decisions (whether to admit patients to the hospital or discharge them) that they believe are of little value and can be controlled by emergency medicine physicians and avoided for most patients.
The list appears today in JAMA Internal Medicine.
The expert panel considered 64 tests, treatments, and disposition decisions before producing its top 5 list:
• Don’t order computed tomography (CT) of the cervical spine for patients after trauma who do not meet certain criteria
• Don’t order CT to diagnose pulmonary embolism without first determining a patient’s risk for pulmonary embolism
• Don’t order magnetic resonance imaging of the lumbar spine for patients with lower back pain without high-risk features
• Don’t order CT of the head for patients with mild traumatic head injury who do not meet certain criteria
• Don’t order tests to assess blood clotting times for patients without bleeding or unless you suspect they are on anticoagulation therapy or have a clotting disorder"
http://newsatjama.jama.com/2014/02/17/author-insights-top-5-list-of-diagnostic-tests-that-emergency-physicians-can-forgo/