The reassuring value of diagnostic tests: a systematic review

Area of Science:

• Medical Diagnostics
• Patient Reassurance
• Evidence-Based Medicine

Background:

• Patient anxiety often drives demand for diagnostic testing.
• The effectiveness of diagnostic tests in providing reassurance is not well-established.

Purpose of the Study:

• To synthesize evidence from randomized controlled trials (RCTs) on the efficacy of diagnostic tests for patient reassurance.
• To evaluate the impact of diagnostic testing on patient reassurance levels.

Main Methods:

• A narrative synthesis of RCTs was conducted.
• Searches were performed across multiple databases including PubMed, Psychinfo, Cochrane Central, Ongoing Trials Database, and Scopus.
• Studies examining reassurance levels after diagnostic testing in outpatients were included.

Main Results:

• Five RCTs involving 1544 patients were analyzed.
• Various diagnostic tests (e.g., ECG, MRI, laboratory tests) for diverse complaints (e.g., chest pain, low back pain) were examined.
• Four out of five RCTs found no significant reassuring effect; one study showed a temporary effect.

Conclusions:

• Diagnostic tests contribute minimally to patient reassurance.
• Clear explanations and watchful waiting may suffice, reducing the need for further testing.
• Adequate pre-test information is crucial when diagnostic tests are employed.