II. Definitions
- Cascades of Care
- Tests beget more tests
- Broad, non-focused evaluation may results in False Positives and unexpected incidental findings
- These findings trigger escalating levels of testing and evaluation
- The added testing often increases risk, cost and anxiety without patient benefit
III. Diagnostics: Examples
-
Incidentalomas (e.g. CT findings)
- Small Pulmonary Nodules
- Small Adrenal Adenomas
- Incidental findings on tests done without indication
- Electrocardiogram prior to Cataract surgery (and other low risk surgeries)
- Urinalysis during routine physical exam (without other indications)
IV. Precautions
- Avoid testing done to exclude every possible diagnosis (often for medicolegal protection)
- Use Patient Communication and Informed Consent to direct a reasonable testing strategy