Diagnostic test (medical)

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Reporting accuracy of tests

Psychological effects of diagnostic tests

Medical tests can have value when results are abnormal by explaining to a patient the cause of their symptoms[1]. In addition, normal test results can have value by reassuring patients that serious illness is not present and even reduce the rates of subsequent symptoms [2]. Understanding the meaning of a normal test in advance of learning the test results may also reduce the rates of subsequent symptoms [3].

Lack of adequate education about the meaning of test results (especially relevant to tests that may have incidental and unimportant findings) may cause an increase in symptoms[4] or anxiety[5]. In addition, the possible benefits must be weighed against the costs of unnecessary tests and resulting unnecessary follow-up and possibly even unnecessary treatment of incidental findings [6].

References

  1. Ward B, Wu W, Richter J, Hackshaw B, Castell D (1987). "Long-term follow-up of symptomatic status of patients with noncardiac chest pain: is diagnosis of esophageal etiology helpful?". Am J Gastroenterol 82 (3): 215-8. PMID 3826028.
  2. Sox H, Margulies I, Sox C (1981). "Psychologically mediated effects of diagnostic tests". Ann Intern Med 95 (6): 680-5. PMID 7305144.
  3. Petrie K, Müller J, Schirmbeck F, Donkin L, Broadbent E, Ellis C, Gamble G, Rief W (2007). "Effect of providing information about normal test results on patients' reassurance: randomised controlled trial". BMJ 334: 352. PMID 17259186.
  4. Kendrick D, Fielding K, Bentley E, Kerslake R, Miller P, Pringle M (2001). "Radiography of the lumbar spine in primary care patients with low back pain: randomised controlled trial". BMJ 322 (7283): 400-5. PMID 11179160.
  5. Hoefman E, Boer KR, van Weert HC, Reitsma JB, Koster RW, Bindels PJ (2007). "Continuous event recorders did not affect anxiety or quality of life in patients with palpitations". Journal of clinical epidemiology 60 (10): 1060–6. DOI:10.1016/j.jclinepi.2007.01.014. PMID 17884602. Research Blogging.
  6. Jarvik J, Hollingworth W, Martin B, Emerson S, Gray D, Overman S, Robinson D, Staiger T, Wessbecher F, Sullivan S, Kreuter W, Deyo R (2003). "Rapid magnetic resonance imaging vs radiographs for patients with low back pain: a randomized controlled trial". JAMA 289 (21): 2810-8. PMID 12783911.