More articles from Smart Testing
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Serial serum lipase testing after the initial diagnostic workup for inpatients with acute pancreatitis: What is the evidence?
Samantha Jill Magier, MD, MEng, Thiruvengadam Muniraj, MD, FRCP and Naseema Merchant, MBBS, FCCP, FACP, FHM- Cleveland Clinic Journal of Medicine June 2023, 90 (6) 341-343;
- DOI: https://doi.org/10.3949/ccjm.90a.22060
Beyond the initial diagnostic workup, the results of serial testing may be misleading, with the potential for adverse effects on patient care and increases in healthcare spending.
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Does this young adult patient need a hip radiograph?
Christina Stull, MD, MBA and Alejandro Moreno, MBBS, MPH, JD, MACP- Cleveland Clinic Journal of Medicine December 2020, 87 (12) 721-722;
- DOI: https://doi.org/10.3949/ccjm.87a.20011
Hip fractures are uncommon in adults under age 50.
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When does acute pyelonephritis require imaging?
Mary E. Lacy, MD, Navneet Sidhu, MD and Justin Miller, MD- Cleveland Clinic Journal of Medicine August 2019, 86 (8) 515-517;
- DOI: https://doi.org/10.3949/ccjm.86a.18096
Imaging is recommended for those at risk of complications.
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Is neuroimaging necessary to evaluate syncope?
Erika Hutt-Centeno, MD, Robert Wilson, DO and Kenneth A. Mayuga, MD, FHRS, FACC, FACP- Cleveland Clinic Journal of Medicine April 2019, 86 (4) 240-242;
- DOI: https://doi.org/10.3949/ccjm.86a.18016
If the diagnosis is unclear after the history and examination, then electroencephalography during tilt-table testing can help.
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How long should we follow simple ovarian cysts with pelvic ultrasonography?
Megan C. McNamara, MD, MS and Rachel Brook, MD- Cleveland Clinic Journal of Medicine October 2018, 85 (10) 745-747;
- DOI: https://doi.org/10.3949/ccjm.85a.17116
Before menopause, most simple cysts smaller than 5 cm resolve in 2 to 3 menstrual cycles and need no further intervention.
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Is Pap testing still needed after hysterectomy?
Halle G. Sobel, MD, Elise Everett, MD and Laura D. Lipold, MD- Cleveland Clinic Journal of Medicine June 2018, 85 (6) 456-458;
- DOI: https://doi.org/10.3949/ccjm.85a.17063
There is no need to continue Pap testing after hysterectomy for a benign indication.
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Measuring both serum amylase and lipase for acute pancreatitis lowers quality and raises cost
Abdulhadi Akhtar, MD, Ravindra Sarode, MD and Deepak Agrawal, MD- Cleveland Clinic Journal of Medicine September 2017, 84 (9) 670-672;
- DOI: https://doi.org/10.3949/ccjm.84a.16103
Measuring lipase alone is sufficient.
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Is spirometry necessary to diagnose and control asthma?
Mani Latifi, MD and Sumita Khatri, MD- Cleveland Clinic Journal of Medicine August 2017, 84 (8) 597-599;
- DOI: https://doi.org/10.3949/ccjm.84a.16078
Asthma is a clinical diagnosis, but spirometry can improve how we diagnose, assess, and control it.
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What stool testing is appropriate when diarrhea develops in a hospitalized patient?
Sheena K. Ramdeen, MD, MPH and Glenn W. Wortmann, MD, FIDSA, FACP- Cleveland Clinic Journal of Medicine December 2016, 83 (12) 882-884;
- DOI: https://doi.org/10.3949/ccjm.83a.16039
Most cases are not due to infection, but
Clostridium difficile is the most common infectious cause.
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Is a serum TSH measurement sufficient to monitor the treatment of primary hypothyroidism?
Christian Nasr, MD- Cleveland Clinic Journal of Medicine August 2016, 83 (8) 571-573;
- DOI: https://doi.org/10.3949/ccjm.83a.15165
Yes, the TSH level provides the information you need to manage primary hypothyroidism.