Many tests on patients a waste of time: study

TORONTO — Nearly one third of Canadian patients may be having tests that are unnecessary to diagnose or treat their health conditions, a new report suggests.

The study from the Canadian Institute for Health Information, published Thursday, examined eight specific types of treatment by drawing on data from across the country.

Based on the data, the institute says it estimates up to 30 per cent of low-risk patients are undergoing potentially needless medical tests.

The report was prepared in partnership with Choosing Wisely Canada, a clinician-led movement advocating for reductions in procedures that put a strain on the health care system and can lead to patient harm.

Since its inception two years ago, the CWC has identified about 200 areas in which, it says, patients are having excessive or needless testing.

The Canadian Institute for Health Information said the report, coupled with CWC’s recommendations, should make patients reconsider the notion that more screening is always best.

“This kind of a report can give patients and clinicians an opportunity to ask: ‘Do I really need this test? What are the downsides of it? Are there safer, simpler options? And what happens if I do nothing,” said Tracy Johnson, CIHI’s director of health systems, analysis and emerging issues.

The report examined eight kinds of tests for a variety of different health care settings, culling data from the provinces and analysing the results, Johnson said.

In one category, the study examined the number of patients who had some form of imaging in response to simple lower-back pain.

The CWC recommended people forgo X-rays, MRI’s and CT scans if they experience lower back pain without any other symptoms.

Other categories the report looked at were: the use of “atypical antipsychotics” among children and youth; reliance on types of drugs known as benzodiazepines among seniors as a treatment for insomnia; preoperative tests conducted on patients undergoing low-risk surgery; mamography screenings among younger women at lower risk for breast cancer; imaging for minor head trauma; patients receiving blood transfusions in preparation for hip or knee replacement surgeries, and those receiving CT scans if showing signs of delirium.

Johnson said a complex analysis of the categories, which make use of data sets from different provinces, suggested that an average of 30 per cent of patients would undergo tests that CWC advises against.

The needless procedures increase wait times and put additional financial strain on the nation’s health care system, Johnson said, adding that the institute has not yet determined exactly how much these additional procedures might cost.