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Nuclear medicine thyroid scanning does not conclusively determine whether thyroid nodules are benign or malignant.
The main identifiable risk associated with reducing or discontinuing acid suppression therapy is an increased symptom burden.
Asymptomatic, low-risk patients account for up to 45% of unnecessary “screening.” Testing should be performed only when the following findings are present: diabetes in patients older than 40 years; peripheral arterial disease; or greater than 2% yearly risk of coronary heart disease events.
Coronary artery calcium scoring is used for evaluation of individuals without known CAD and offers limited incremental prognostic value for individuals with known CAD, such as those with stents and bypass grafts.
Currently there are no formal practice protocols to address deactivation; fewer than 10% of hospices have official policies.
Advance care planning discussions should include the option of deactivating the implantable cardioverter-defibrillator when it no longer supports the patient’s goals.
Tests whose results will not alter management should not be ordered.
Protocol-driven testing can be useful if it serves as a reminder not to omit a test or procedure, but should always be individualized to the particular patient.Skin or serum-specific Ig E testing for inhalants or foods is not indicated, unless there is a clear history implicating an allergen as a provoking or perpetuating factor for urticaria.There is little evidence that detection of coronary artery stenosis improves health outcomes in asymptomatic patients at low risk of coronary heart disease.It follows that the decision regarding the need for (and dosage of) maintenance therapy is driven by the impact of those residual symptoms on the patient’s quality of life rather than as a disease control measure.Antireflux therapy has been demonstrated to have no effect in reducing the symptoms of gastroesophageal reflux disease (GERD) in children.False-positive test results are likely to lead to harm through unnecessary invasive procedures, overtreatment, and misdiagnosis.