The problem of overuse of medical services is receiving increasing attention, in our Less Is More series and other venues, as well as many thoughtful programs sparked by the Choosing Wisely campaign. In this issue of JAMA Internal Medicine, Fenton et al1 describe an innovative and novel intervention to reduce use of low-value imaging tests, such as screening dual-energy x-ray absorptiometry in low-risk women or spinal magnetic resonance imaging for subacute back pain. Calling these tests “low-value” may be generous because it is more likely that in these clinical scenarios, the tests were actually harmful. The possibility of benefit was tiny and remote, while the possibility of triggering a cascade of further diagnostic tests and treatments incurring further risks was substantial.
Covinsky KE, Redberg RF. An Intervention to Reduce Use of Low-Value Imaging Tests. JAMA Intern Med. 2016;176(2):198. doi:10.1001/jamainternmed.2015.6941