Medical organizations release list of 90 tests and procedures that often are not needed

By Liz Kowalczyk, Globe Staff

Medical organizations have released a new list of tests and procedures that are routinely performed by doctors even though patients often don’t need them. I was surprised to spot at least one test on the roster that I’ve had -- apparently unnecessarily -- in the past year.

I respect my primary care providers and consider myself fairly clear-eyed about medicine. So the fact that my caregiver ordered a blood test for Vitamin D deficiency -- even though I’m not at risk -- during a recent physical shows that we can all learn something from these well-researched lists. I certainly never thought to question the test, which seemed simple enough since I was having blood drawn anyway.

But the American Board of Internal Medicine Foundation, a nonprofit organization that is overseeing the “Choosing Wisely’’ campaign, said the cost of unneeded tests adds up, and can harm patients by exposing them to radiation and more unnecessary medical procedures.

Seventeen leading medical specialty societies identified 90 specific tests and procedures in this recent round, in addition to 45 others flagged last year.

Vitamin D testing is generally unnecessary, according to the American Society for Clinical Pathology, because over-the-counter vitamin D supplements and summer sun exposure are sufficient for most otherwise healthy people. Laboratory testing is appropriate in higher risk patients -- those who are obese or have chronic kidney disease, for example -- when results will be used to decide whether to order more aggressive therapy.

Also on the list:

-- Don’t induce labor or schedule cesarean deliveries before 39 weeks of pregnancy -- unless it is medically necessary. Delivery prior to 39 weeks is associated with increased risk of learning disabilities and respiratory problems.

-- Don’t use feeding tubes in patients with advanced dementia. Studies show that feeding tubes do not improve outcomes for these patients.

-- Don’t perform routine annual Pap tests in women 30 to 65 years of age. In women with average risk for cervical cancer, routine annual Pap tests offer no advantage over screenings performed at three-year intervals. Personally, I’ve seen confusion around this recommendation among medical office staff.

The campaign’s list released least year advises against annual electrocardiograms, CT scans for low back pain, and chest X-rays before surgery.

Recent estimates suggest that nearly 30 percent of the money Americans spend on health care is wasted. The purpose of the campaign is to spark conversations between patients and physicians about what care is really necessary.