Another over-testing over-diagnosis article effectively illustrating issues endemic to our current medical culture.
They do a retrospective national database review regarding the impact of the introduction of CTPA protocol for rule-out PE, and note that we’ve diagnosed three times as many PEs in 2006 as we did in 1998. And, by detecting more PEs, we managed to reduce mortality attributed to PE…along the same gradually decreasing trendline that was present prior to the introduction of CTPA.
Figure 2 is the truly damning graphic – look at all those extra PEs we’re finding and treating for effectively no substantial benefit. Their secondary analysis was in-hospital anticoagulation complications on patients with any diagnosis of PE, which has jumped 71%. Thank goodness we can put them on dagibatran now instead of coumadin and not be able to reverse their life-threatening bleeding episodes….
Again, we are testing people who shouldn’t be testing, finding disease of uncertain clinical significance, and harming them with overtreatment – and let’s not even start with the costs.