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Comment & Response
Less Is More
March 2018

Medical Overuse of Prostate-Specific Antigen Testing and Overprescription of Antibiotics—Reply

Author Affiliations
  • 1Department of Epidemiology and Public Health, University of Maryland School of Medicine & Department of Hospital Epidemiology, Veterans Affairs Maryland Health Care System, Baltimore, Maryland
  • 2Robert Wood Johnson Foundation Clinical Scholars Program, Yale University School of Medicine, New Haven, Connecticut
  • 3Department of Veterans Affairs, West Haven, Connecticut
  • 4Department of Medicine and Center for Health Policy and Outcomes, Memorial-Sloan Kettering Cancer Center, New York, New York
JAMA Intern Med. 2018;178(3):432-433. doi:10.1001/jamainternmed.2017.8534

In Reply Dr Prazeres makes salient points regarding overuse that we would like to emphasize. Despite working within different health care systems, with shared research and medical cultures, many aspects of overuse likely apply across countries.

Dr Prazeres highlights physician emphasis on performing often harmful prostate-specific antigen tests over counseling patients to make highly beneficial behavioral changes such as smoking cessation. This is a great example of the opportunity cost of overuse. The time and energy expended on prostate-specific antigen testing and follow-up tests and treatment can distract from care that is much more likely to help patients lead healthier lives.1

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