> When ordering unproven screening tests for asymptomatic patients without good reason, few consider the low yield, high cost per diagnosis made, and considerable toll of false positives. Anecdotal accounts of unexpected diagnoses discovered on “routine” testing help perpetuate over-testing. But even the best tests yield more false positives than true positives when the prevalence of what one is testing for is low. Others order tests to establish a “baseline,” but this has been shown repeatedly not to improve care for asymptomatic patients and consumes hundreds of millions of health care dollars per year.1, 2 Abnormal results that later prove erroneous engender unnecessary anxiety and needless follow-up testing. Ordering only medically indicated tests reduces our role as instigators of needless worry and, as an added benefit, helps lessen physicians’ workload.
