5 questions to ask your Doctor…
An important conversation about unnecessary tests, treatments and procedures.
Overdiagnosis happens when you get a diagnosis that ends up causing you more harm than good. It can happen when a healthy person is diagnosed with a very early form of a disease, but that disease would never have developed to cause you any symptoms.
While this might sound surprising, overdiagnosis does happen and there is evidence people are being overdiagnosed across a lot of conditions. Health researchers and practitioners like us at universities in Australia are trying to find out more about the problem, how it is caused, and how to reduce it.
Overdiagnosis is an unnecessary diagnosis, and it can lead to unnecessary tests and treatments. Because all treatments have side effects, being overdiagnosed means you might be harmed by a treatment, even though it was not needed. It can also mean unnecessary costs. And you may also feel worried about a disease without needing to.
• NPS MedicineWise, Pain: what is going on?
• NPS MedicineWise, Lowering your opioid dose
• NPS MedicineWise, Chronic pain explained
• NPS MedicineWise, Opioid medicines and chronic non-cancer pain
• NPS MedicineWise MedicineWise app
• Painaustralia – Provides a list of support groups and helplines for people experiencing chronic pain.
. https://www.nps.org.au/news/if-not-opioids-then-what
“Tests, treatments, and procedures for healthcare providers and consumers to question.”
Australia's peak colleges, societies and associations have developed lists of recommendations of the tests, treatments, and procedures that healthcare providers and consumers should question. Each recommendation is based on the best available evidence.
Importantly, they are not prescriptive but are intended as guidance to start a conversation about what is appropriate and necessary.
As each situation is unique, healthcare providers and consumers should use the recommendations to collaboratively formulate their own appropriate healthcare plan together.
Lists of recommendations for YOU to ask your Doctor:
Use the 5 questions to make sure you end up with the right amount of Care - not too much and not too little.
1. Do I really need this test or procedure?
A. Tests may help you and your doctor or other healthcare provider determine the problem. Procedures may help to treat it.
2. What are the risks?
A. Will there be side effects? What are the chances of getting results that aren't accurate? Could that lead to more testing or another procedure?
3. Are there simpler, safer options?
Sometimes all you need to do is make lifestyle changes, such as eating healthier foods or exercising more.
4. What happens if I don't do anything?
Ask if your condition might get worse - or better - if you don't have the test or procedure right away.
5. What are the costs?
Costs can be financial, emotional or a cost of your time. Where there is a cost to the community, is the cost reasonable or is there a cheaper alternative?
Adapted from material developed by Consumer Reports.
--------------------------
Wiser Healthcare is a research collaboration involving The University of Sydney, Bond University, Monash University and international colleagues. It is funded by the Australian National Health and Medical Research Council, through both its Centres for Research Excellence scheme and its Program Grant scheme. It aims to conduct research that will reduce overdiagnosis and overtreatment in Australia and around the world.
Overdiagnosis and overtreatment occur when routine medical tests and treatments do more harm than good. Wiser Healthcare will investigate the cause and size of the problem and test new solutions, in the areas of cancer, cardiovascular disease and musculoskeletal disorders. We will particularly focus on overdiagnosis caused by imaging (like CT scans and MRI scans), testing biomarkers (for example, blood tests like the Prostate Specific Antigen test), and genetic tests.
Here you can find out about their plans, read their work, see the evidence about overdiagnosis, and get help to make decisions, whether you are a clinician, a policymaker, or a citizen considering your own healthcare.
See also:
The Royal Australian College of General Practitioners (RACGP) has released its top five recommendations of medical tests, treatments and procedures clinicians and consumers should question.
'Most guidelines and textbooks cover useful new treatments, but we also need to make sure we have effective ways of disseminating the evidence that recommends against a test or treatment.'
The RACGP's list forms part of an overall 61 recommendations released by 14 Australian colleges, societies and associations involved in the Choosing Wisely campaign.
The five RACGP recommendations for your GP are:
'The RACGP is a proud first-wave member of Choosing Wisely Australia, a valuable initiative that can assist GPs to start conversations about appropriate medical tests and procedures,' Dr Jones said.
'The RACGP wants to keep improving the system wherever we can and sometimes that means supporting GPs when they chose not to use a medical intervention,' he said.
'Therefore our Choosing Wisely working group have put a lot of effort into collating the evidence into a succinct, easy format that offers the local GP practical advice for common situations.'
Full copies of the recommendations are available on the Choosing Wisely website.
with Many Thanks for such a well written site. When Caring for your loved one, BOTH of you need all the help your GP can give you... It makes the life of the Carer that much easier, and gives Great Confidence to your loved one that they are being listened to, and understood.
written with great Understanding.
---------------------------------------------------------------------------------------------------------------------=
https://vimeo.com/124597870
A 90 second online video showing what happens behind the scenes after your Pathology sample is taken.
GUIDELINE ON PATHOLOGY TESTING IN THE EMERGENCY DEPARTMENT
Pathology is the study of disease, or any condition that limits the quality, length, or enjoyment of life. From the time a new life is created to the time it ends pathology is involved. Pathology touches every facet of medicine and, therefore, society.
Pathology consists of eight main disciplines:
Anatomical Pathology – the study of organs and tissues to help in determining the causes and effects of particular diseases. An anatomical pathologist’s findings are fundamental to medical diagnosis, patient management and research.
Sub specialities include:
• histopathology – microscopic examination of tissues, taken either as biopsy samples or resection specimens, for the purpose of diagnosis, prognosis and directing appropriate treatment;
• cytology – the study of individual cells to detect abnormal cells; and
Chemical Pathology or Biochemistry – involves the study and investigation of the biochemical basis of disease processes, with particular emphasis on metabolic diseases, which include diabetes, bone disease, inborn errors of metabolism and lipid disorders. Work covers the common investigations of electrolyte and diagnostic enzyme changes and plasma proteins seen in routine clinical practice, as well as endocrine testing, tumour markers, therapeutic drugs and toxicology.
Forensic Pathology – investigating unexpected deaths, including the analysis of criminal cases and assisting the police in a range of investigations.
Genetics – includes two main branches – cytogenetics (microscopic analysis of chromosomal abnormalities) and molecular genetics (uses DNA technology to analyse mutations in genes). It involves tests on chromosomes and DNA from cells in body fluids and tissues to diagnose genetic diseases.
Haematology – deals with many aspects of diseases which affect the blood, such as anaemia, leukaemia, lymphoma and clotting or bleeding disorders. It also encompasses the subspecialty of transfusion medicine, which includes blood typing and compatibility testing and the management and supply of a large range of blood products.
Immunology – deals with immunological tests for allergic reactions, diagnostic markers for autoimmune disorders such as lupus, rheumatoid arthritis, diabetes and thyroid conditions, and tests to monitor tissue injury due to inflammation.
Microbiology – deals with diseases caused by infectious agents such as bacteria, viruses, fungi and parasites through tests on blood, body fluids and tissue samples. Additional areas involve control of outbreaks of infectious disease and dealing with the problems of infections caused by antibiotic-resistant bacteria.
General Pathology – covers all areas of pathology and is a wonderfully diverse career option.
Your My Health Record is an online summary of your health information, such as your medicines, any allergies you may have, and your medical history.
Once your My Health Record is created your doctor, hospitals and other healthcare providers involved in your care can automatically access your health information, unless you set up your privacy controls.
Using these privacy controls lets you decide which healthcare providers can access your My Health Record and what they can view. You can also ask a provider not to upload certain information. If you decide you don’t want a My Health Record you can cancel it at any time.
Click on Frequently Asked Questions: https://www.oaic.gov.au/s/myhealthrecord/privacy/
23 July 2019
An important conversation about unnecessary tests, treatments and procedures.
Overdiagnosis happens when you get a diagnosis that ends up causing you more harm than good. It can happen when a healthy person is diagnosed with a very early form of a disease, but that disease would never have developed to cause you any symptoms.
While this might sound surprising, overdiagnosis does happen and there is evidence people are being overdiagnosed across a lot of conditions. Health researchers and practitioners like us at universities in Australia are trying to find out more about the problem, how it is caused, and how to reduce it.
Overdiagnosis is an unnecessary diagnosis, and it can lead to unnecessary tests and treatments. Because all treatments have side effects, being overdiagnosed means you might be harmed by a treatment, even though it was not needed. It can also mean unnecessary costs. And you may also feel worried about a disease without needing to.
• NPS MedicineWise, Pain: what is going on?
• NPS MedicineWise, Lowering your opioid dose
• NPS MedicineWise, Chronic pain explained
• NPS MedicineWise, Opioid medicines and chronic non-cancer pain
• NPS MedicineWise MedicineWise app
• Painaustralia – Provides a list of support groups and helplines for people experiencing chronic pain.
. https://www.nps.org.au/news/if-not-opioids-then-what
“Tests, treatments, and procedures for healthcare providers and consumers to question.”
Australia's peak colleges, societies and associations have developed lists of recommendations of the tests, treatments, and procedures that healthcare providers and consumers should question. Each recommendation is based on the best available evidence.
Importantly, they are not prescriptive but are intended as guidance to start a conversation about what is appropriate and necessary.
As each situation is unique, healthcare providers and consumers should use the recommendations to collaboratively formulate their own appropriate healthcare plan together.
Lists of recommendations for YOU to ask your Doctor:
- 5 questions to ask your doctor or other healthcare provider before you get any test, treatment, or procedure
- the above as a handy one page handout.
- Question Builder: https://www.healthdirect.gov.au/question-builder
Use the 5 questions to make sure you end up with the right amount of Care - not too much and not too little.
1. Do I really need this test or procedure?
A. Tests may help you and your doctor or other healthcare provider determine the problem. Procedures may help to treat it.
2. What are the risks?
A. Will there be side effects? What are the chances of getting results that aren't accurate? Could that lead to more testing or another procedure?
3. Are there simpler, safer options?
Sometimes all you need to do is make lifestyle changes, such as eating healthier foods or exercising more.
4. What happens if I don't do anything?
Ask if your condition might get worse - or better - if you don't have the test or procedure right away.
5. What are the costs?
Costs can be financial, emotional or a cost of your time. Where there is a cost to the community, is the cost reasonable or is there a cheaper alternative?
Adapted from material developed by Consumer Reports.
--------------------------
Wiser Healthcare is a research collaboration involving The University of Sydney, Bond University, Monash University and international colleagues. It is funded by the Australian National Health and Medical Research Council, through both its Centres for Research Excellence scheme and its Program Grant scheme. It aims to conduct research that will reduce overdiagnosis and overtreatment in Australia and around the world.
Overdiagnosis and overtreatment occur when routine medical tests and treatments do more harm than good. Wiser Healthcare will investigate the cause and size of the problem and test new solutions, in the areas of cancer, cardiovascular disease and musculoskeletal disorders. We will particularly focus on overdiagnosis caused by imaging (like CT scans and MRI scans), testing biomarkers (for example, blood tests like the Prostate Specific Antigen test), and genetic tests.
Here you can find out about their plans, read their work, see the evidence about overdiagnosis, and get help to make decisions, whether you are a clinician, a policymaker, or a citizen considering your own healthcare.
See also:
- http://www.choosingwisely.org.au/recommendations
- Under the List of Recommendations
- Click on “Expand All” for a fuller explanation
The Royal Australian College of General Practitioners (RACGP) has released its top five recommendations of medical tests, treatments and procedures clinicians and consumers should question.
'Most guidelines and textbooks cover useful new treatments, but we also need to make sure we have effective ways of disseminating the evidence that recommends against a test or treatment.'
The RACGP's list forms part of an overall 61 recommendations released by 14 Australian colleges, societies and associations involved in the Choosing Wisely campaign.
The five RACGP recommendations for your GP are:
- Don't order colonoscopy as a screening test for bowel cancer in people at average or slightly above average risk. Use faecal occult blood screening (FOBT) instead.
- Don't order chest x-rays in patients with uncomplicated acute bronchitis.
- Don't routinely do a pelvic examination with a Pap smear.
- Don't treat otitis media with antibiotics, in non-Indigenous children aged 2-12 years, where reassessment is a reasonable option
- Don't test thyroid function as population screening for asymptomatic patients.
'The RACGP is a proud first-wave member of Choosing Wisely Australia, a valuable initiative that can assist GPs to start conversations about appropriate medical tests and procedures,' Dr Jones said.
- 'For example, chest x-rays involve radiation exposure, cost, time and effort on the part of the patient and we need to reserve them for situations where an x-ray is likely to change the treatment.
- 'Our recommendation suggests various situations where chest x-ray may be entirely appropriate but for most people walking through the GP's door with a cough, it does not really change what the doctor would do anyway.'
- Dr Jones encouraged both general practitioners and patients to join in conversation and recognize the occasions when it might not necessarily be best to undertake certain tests, treatments or procedures.
'The RACGP wants to keep improving the system wherever we can and sometimes that means supporting GPs when they chose not to use a medical intervention,' he said.
'Therefore our Choosing Wisely working group have put a lot of effort into collating the evidence into a succinct, easy format that offers the local GP practical advice for common situations.'
Full copies of the recommendations are available on the Choosing Wisely website.
with Many Thanks for such a well written site. When Caring for your loved one, BOTH of you need all the help your GP can give you... It makes the life of the Carer that much easier, and gives Great Confidence to your loved one that they are being listened to, and understood.
written with great Understanding.
---------------------------------------------------------------------------------------------------------------------=
https://vimeo.com/124597870
A 90 second online video showing what happens behind the scenes after your Pathology sample is taken.
GUIDELINE ON PATHOLOGY TESTING IN THE EMERGENCY DEPARTMENT
Pathology is the study of disease, or any condition that limits the quality, length, or enjoyment of life. From the time a new life is created to the time it ends pathology is involved. Pathology touches every facet of medicine and, therefore, society.
Pathology consists of eight main disciplines:
Anatomical Pathology – the study of organs and tissues to help in determining the causes and effects of particular diseases. An anatomical pathologist’s findings are fundamental to medical diagnosis, patient management and research.
Sub specialities include:
• histopathology – microscopic examination of tissues, taken either as biopsy samples or resection specimens, for the purpose of diagnosis, prognosis and directing appropriate treatment;
• cytology – the study of individual cells to detect abnormal cells; and
Chemical Pathology or Biochemistry – involves the study and investigation of the biochemical basis of disease processes, with particular emphasis on metabolic diseases, which include diabetes, bone disease, inborn errors of metabolism and lipid disorders. Work covers the common investigations of electrolyte and diagnostic enzyme changes and plasma proteins seen in routine clinical practice, as well as endocrine testing, tumour markers, therapeutic drugs and toxicology.
Forensic Pathology – investigating unexpected deaths, including the analysis of criminal cases and assisting the police in a range of investigations.
Genetics – includes two main branches – cytogenetics (microscopic analysis of chromosomal abnormalities) and molecular genetics (uses DNA technology to analyse mutations in genes). It involves tests on chromosomes and DNA from cells in body fluids and tissues to diagnose genetic diseases.
Haematology – deals with many aspects of diseases which affect the blood, such as anaemia, leukaemia, lymphoma and clotting or bleeding disorders. It also encompasses the subspecialty of transfusion medicine, which includes blood typing and compatibility testing and the management and supply of a large range of blood products.
Immunology – deals with immunological tests for allergic reactions, diagnostic markers for autoimmune disorders such as lupus, rheumatoid arthritis, diabetes and thyroid conditions, and tests to monitor tissue injury due to inflammation.
Microbiology – deals with diseases caused by infectious agents such as bacteria, viruses, fungi and parasites through tests on blood, body fluids and tissue samples. Additional areas involve control of outbreaks of infectious disease and dealing with the problems of infections caused by antibiotic-resistant bacteria.
General Pathology – covers all areas of pathology and is a wonderfully diverse career option.
Your My Health Record is an online summary of your health information, such as your medicines, any allergies you may have, and your medical history.
Once your My Health Record is created your doctor, hospitals and other healthcare providers involved in your care can automatically access your health information, unless you set up your privacy controls.
Using these privacy controls lets you decide which healthcare providers can access your My Health Record and what they can view. You can also ask a provider not to upload certain information. If you decide you don’t want a My Health Record you can cancel it at any time.
Click on Frequently Asked Questions: https://www.oaic.gov.au/s/myhealthrecord/privacy/
23 July 2019