2017 Update on Medical Overuse: A Systematic Review

Area of Science:

• Health Services Research
• Medical Economics
• Clinical Practice Improvement

Background:

• Overuse of medical care is a recognized issue impacting patient outcomes and healthcare costs.
• Identifying and understanding medical overuse is crucial for improving healthcare efficiency and effectiveness.

Purpose of the Study:

• To identify and highlight original research from 2016 relevant to understanding medical overuse.
• To examine strategies for reducing the overuse of medical services in adult patients.

Main Methods:

• A structured review of English-language articles on PubMed published in 2016.
• Examination of tables of contents of high-impact journals for articles on medical overuse.
• Appraisal of identified articles for originality, methodologic quality, and clinical relevance.

Main Results:

• 122 of 1224 reviewed articles were deemed most relevant to medical overuse.
• Examples of overuse include unnecessary transesophageal echocardiography for cryptogenic stroke and increased computed tomography use in emergency departments.
• Services with potential harms outweighing benefits include early-stage prostate cancer treatment and oxygen for moderate chronic obstructive pulmonary disease.

Conclusions:

• Empirical work on medical services for inappropriate or uncertain indications is expanding.
• Shared decision-making with patients and clinician audit with peer feedback are effective strategies to reduce overuse.
• These strategies can lead to significant reductions in unnecessary medical interventions and procedures.