Ten years ago, President Obama received an unnecessary coronary artery calcium scan.1 Some might argue that a president’s health is more vital than that of the average person but that misses the point. Medical diagnostic tests have consequences. Beyond the anxiety caused by false positive results, incidental findings can result in a cascade of further tests, some of which, if invasive, carry substantial risks.2,3 Whether you are the president or not, medical tests should be performed when there is reasonable evidence that the benefits outweigh the harms, not just because they are available. As Korenstein et al4 reported in JAMA recently, services, such as coronary artery calcium scans with a grade I designation from the US Preventive Services Task Force meaning insufficient evidence, are included in executive physicals.
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Redberg RF, Katz MH. First Physical, Reprised. JAMA Intern Med. Published online January 13, 2020. doi:10.1001/jamainternmed.2019.6612
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