2016 Update on Medical Overuse: A Systematic Review.

Area of Science:

• Clinical Medicine
• Health Services Research
• Medical Economics

Background:

• Overuse of medical care is a significant and increasing problem in contemporary clinical practice.
• This issue encompasses excessive testing, overtreatment, and the utilization of questionable medical services.
• Identifying and addressing medical overuse is crucial for improving patient outcomes and healthcare sustainability.

Purpose of the Study:

• To identify and summarize original research articles published in 2015 that offer insights into reducing the overuse of medical care.
• To categorize these articles into key areas: overuse of testing, overtreatment, and questionable use of services.
• To interpret the importance of these findings for clinical medicine and guide evidence-based practice.

Main Methods:

• A structured review of English-language articles indexed in PubMed published in 2015.
• Supplemented by reviewing tables of contents of relevant medical journals.
• Focused on identifying articles related to medical overuse in adult populations.

Main Results:

• 821 of 1445 reviewed articles addressed medical overuse; 112 were selected for relevance, originality, and quality.
• Key findings include increased advanced imaging for headaches, unnecessary hospital admissions for syncope, and frequent colonoscopies.
• Overtreatment was prevalent, with examples including inappropriate anticoagulation for atrial fibrillation, off-guideline testosterone therapy, and suboptimal diabetes management.

Conclusions:

• The volume of research on medical overuse nearly doubled between 2014 and 2015, indicating growing attention to the problem.
• The review of top articles encourages critical evaluation of current medical practices.
• Promoting reflection on these influential studies can help question and modify non-evidence-based medical practices.