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[Less is more in cardiology and angiology]

G Hasenfuß1, S Schellong2

  • 1Klinik für Kardiologie und Pneumologie, Herzzentrum Göttingen, Universitätsmedizin Göttingen, Göttingen, Deutschland.

Der Internist
|March 2, 2021
PubMed

Insights

This article highlights overdiagnosis and overtreatment in cardiovascular medicine, focusing on chronic coronary heart disease, cervical artery ultrasound, and thrombophilia testing. It details appropriate indications to prevent unnecessary procedures and resource waste.

Area of Science:

  • Cardiovascular Medicine
  • Vascular Medicine

Background:

  • Cardiovascular medicine is a significant healthcare cost driver.
  • Overdiagnosis and overtreatment are prevalent issues within the field.
  • This article examines three specific cases: chronic coronary heart disease, cervical artery ultrasound, and thrombophilia diagnostics.

Purpose of the Study:

  • To identify and detail appropriate indications for specific cardiovascular diagnostic procedures.
  • To reduce overdiagnosis and subsequent overtreatment in cardiology and vascular medicine.
  • To emphasize the judicious use of healthcare resources.

Main Methods:

  • Review of diagnostic criteria and clinical guidelines for coronary intervention.
  • Analysis of indications for Duplex sonography of cervical blood vessels.
  • Evaluation of diagnostic workup for thrombophilia.

Main Results:

  • Chronic coronary heart disease diagnosis requires unequivocal proof of ischemia before intervention.
  • Duplex sonography of cervical vessels and thrombophilia testing are justified only by specific, valid clinical problems.
  • Overdiagnosis leads to unnecessary resource utilization and potential harm from overtreatment.

Conclusions:

  • Strict adherence to appropriate indications is crucial for coronary interventions, cervical artery ultrasound, and thrombophilia testing.
  • Minimizing overdiagnosis is essential to prevent overtreatment and conserve healthcare resources.
  • The article provides detailed guidance on appropriate use cases for these cardiovascular diagnostics.

Keywords:
Coronary heart diseaseCoronary interventionOverdiagnosisThrombophilia/screeningUltrasonography, Doppler, duplex/carotid arteries

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