Even excellent tools can be mis-used. Here are seven “sins” of medical testing:
1. Ordering the wrong test for the right condition.
If I had a nickel for every time a doctor ordered a carotid artery test in a patient with a fainting spell, I could fund my retirement several times over. And this is despite the fact that problems with the carotid arteries (the pulsating blood-vessels in the front of the neck) are incapable of generating fainting spells! Narrowed or blocked carotid arteries are capable of generating many other symptoms — including paralysis on one side of the body or loss of speech — but not unconsciousness. Yet this test is frequently ordered in a knee-jerk fashion for people with fainting spells. Moreover, when the artery is found to be narrowed, it sometimes triggers a needless and risky operation on the affected artery. All because of a test that shouldn’t have been ordered in the first place!
2. Treating the test instead of the patient.
There are situations in which a tool gets confused with a goal. One example of this is in the treatment of people with epileptic seizures. Most people...
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