Wasteful Diagnostic Testing Situations Listed by ACP

An ad hoc group of internists convened by the American College of Physicians has identified a series of clinical situations that frequently lead to wasteful diagnostic tests.

By consensus, the group identified some 40 situations, which include the following:

• Assessing brain natriuretic peptide in the initial evaluation of typical heart failure findings

• Ordering imaging studies for nonspecific low back pain

• Utilizing MRI instead of mammography to screen for breast cancer in women at average risk

• Conducting serologic testing for suspected early Lyme disease

The Annals of Internal Medicine's editor invites readers to comment on or add to the list by taking a survey on the journal's website. She remarks that "unnecessary testing abounds," and cites a Congressional Budget Office estimate that "up to 5% of the nation's gross national product is spent on tests and procedures that do not improve patient outcomes."