90 (More) Medical Tests You Might Not Need

CT scans should be used sparingly for kids

Remember last year when the Philly-based ABIM Foundation made a huge splash with a list of 45 medical tests many of us don’t need? The group is at it again, releasing a list of 90 new tests and treatments that you maybe, probably, totally don’t actually need.

Since the first release last year, ABIM signed on more than a dozen new physicians groups, who provided lists of tests and treatments within their specialties that are often necessary—and sometimes unsafe. The new recommendations include the following:

Unless it’s medically necessary, don’t schedule a C-section or induce labor before 39 weeks of pregnancy.
Why? >> Delivery prior to 39 weeks is associated with increased risk of learning disabilities, respiratory problems and other risks, according to the American College of Obstetricians and Gynecologists and the American Academy of Family Physicians.

Don’t use feeding tubes in patients with advanced dementia.
Why? >> Studies show that percutaneous feeding tubes (those inserted through the skin into the stomach) do not result in better outcomes for dementia patients. The assistance American Academy of Hospice and Palliative Medicine; American Geriatrics Society agree that assistance with oral feeding is a better approach.

Don’t perform routine annual Pap tests in women between 30 and 65 years of age.
Why? >> In average-risk women, routine annual Pap tests offer no advantage over screenings performed at three-year intervals, says the American College of Obstetricians and Gynecologists.

Don’t automatically use CT scans to evaluate children’s minor head injuries.
Why? >> About half of children who visit hospital emergency departments with head injuries are given a CT scan, a test that involves radiation exposure that may escalate future cancer risk. The recommendation from the American Academy of Pediatrics calls for clinical observation prior to making a decision about needing a CT.

Don’t screen for ovarian cancer in asymptomatic women at average risk.
Why? >> In population studies, there is only fair evidence that screening of asymptomatic women can detect ovarian cancer at an earlier stage than it can be detected in the absence of screening. Because of the low prevalence of ovarian cancer and the invasive nature of the interventions required after a positive screening test, the potential harms of screening outweigh the potential benefits, according to the American College of Obstetricians and Gynecologists.

Don’t perform EEGs for headaches.
Why? >> Electroencephalography (EEG) has no advantage over clinical evaluation in diagnosing headache, does not improve outcomes and increases cost, according to the American Academy of Neurology.

Don’t routinely treat acid reflux in infants with acid suppression therapy.
Why? >> Anti-reflux therapy, which is commonly prescribed in adults, has no demonstrated effect in reducing the symptoms of gastroesophageal reflux disease (GERD) in infants, says the Society of Hospital Medicine. Moreover, there is emerging evidence that it may in fact be harmful in certain situations.

The recommendations were developed by the specialty groups, who looked current evidence about treatment options and outcomes. Together, the groups represent 725,000 physicians. ABIM says 15 groups will release new lists later this year.

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