Its amazing the number of patients who demand that their doctors perform tests using the newest high-tech equipment in the belief that “the latest is the best”. Come to think of it, even some doctors believe in this too.
In earlier blog postings, When The Latest Need Not Be The Best and Why The Latest Heartscans are Popular…But Not Foolproof, I had highlighted the lack of necessity for doing high-fangled tests and the dangers associated with doing them. So much so, it looks counter-productive in terms of the risks outpacing the benefits.
It may come as a surprise to many that some of the most reliable tests can be low-tech and low-cost as well. Take the measuring tape and the weighing machine, for example. With these, you can obtain the body mass index and the waist-hip ratio, the latter as important as blood tests for cholesterol and sugar in determining a person’s likelihood of developing diabetes, heart disease and metabolic syndrome.
The weighing machine is also useful for patients with heart or kidney failure who have already been put on treatment. Gaining just a couple of pounds can indicate an unhealthy buildup of fluids—a telltale sign that a patient is at risk of serious shortness of breath and other symptoms that could lead to a hospital admission. Information from the scale can lead to adjustments in diet, such as cutting back on salt, or medications to restore fluid balance without necessitating in-hospital treatment, This means extra savings in cost.
Now, a new study suggests cardiologists may want to add a stopwatch to their medical bag. More than half of patients who undergo open-heart surgery in the U.S. and Canada are at least 65 years old and growing numbers of them are in their 80s or even 90s. Timing how long it takes an elderly patient to walk five meters, or about 15 feet, significantly improves a doctor’s ability to predict whether a patient will be able to withstand the stress of surgery.
This test, gait speed, has been used before to predict the frailty of elderly people. Now, it is used to see whether an elderly person can withstand heart surgery. Slow walkers—those who took longer than six seconds to cross the five-meter line—were about three times as likely to die or suffer such complications as a stroke or kidney failure and were twice as likely to have a prolonged hospital stay after heart surgery.(Read more on the study here).
In these days of rising healthcare costs within a recessionary landscape, it is indeed refreshing to note that some of the most useful tests need not be expensive and high-tech..