Diagnostic Tests And Patient Reassurance

Do diagnostic tests reassure patients?  Possibly not, abstract:

OBJECTIVE: This review is a narrative synthesis of the RCTs which studied the efficacy of using diagnostic tests to reassure patients.

METHODS: We searched for RCTs that examined the level of reassurance after diagnostic testing in outpatients. We used PubMed, Psychinfo, Cochrane Central, Ongoing Trials Database and Scopus.

RESULTS: We found 5 randomized controlled trials that included 1544 patients. The trials used different diagnostic tests (ECG, radiography of lumbar spine, MR brain scan, laboratory tests, MR of lumbar spine) for different complaints (e.g. chest pain, low back pain and headache). Four out of 5 RCTs did not find a significant reassuring value of the diagnostic tests. One study reported a reassuring effect at 3 months which had disappeared after one year.

CONCLUSION: Despite the sparse and heterogeneous studies, the results point in the direction of diagnostic tests making hardly any contribution to the level of reassurance. We recommend further studies on the use of diagnostic tests and other strategies to reassure the patient.

PRACTICE IMPLICATIONS: A clear explanation and watchful waiting can make additional diagnostic testing unnecessary. If diagnostic tests are used, it is important to provide adequate pre-test information about normal test results.

Of course, diagnostic tests (that are presumably not necessary) are not only given to reassure patients, but – possibly in some cases - to protect doctors from malpractice liability.

Beets and apples salad

Is your diet too low in fiber? Here is a little unusual combination for a salad to try along with your main dishes.  It delivers lots of fiber even during the winter, when fresh salads may not be easily available.  

Use your imagination and add as many other ingredients as you wish (and have at hand). For example, for more splash of color, vitamins and fiber, add a grated carrot and/or a few slices of a tangerine.

For us, today "the main dish" is composed of a can of salmon with tahini-lemon-onion seasoning and baked chickpea balls. For these recipes, I will post additionally.



Beets and apples salad
Ingredients
1 Tbsp olive oil
1 Tbsp apple cider vinegar
1 Tbsp strawberry preserves (or any other preserves you like)
salt to taste
1 14-oz can of beets (whole or sliced)
1 medium apple, cored and diced (any variety you like)
chopped parsley (optional)

Directions
Mix the first four ingredients well and then combine with the apples and beets. Sprinkle with some parsley.