Tests advertised in newspaper
Section titled “Tests advertised in newspaper”This week we've been questioned by several patients about a newspaper ad. This ad suggests that you protect yourself and your loved ones by getting screened for vascular disease and osteoporosis.
My advice in most cases is not to engage in such tests unless you have symptoms. There may be times when such tests are worthwhile, but if so, you are far better off getting the test at an established facility.
In the best of hands, such tests are difficult to perform. This particular lab says that they use registered or "registry eligible" sonographers. An experienced ultrasound technician told me that "registry eligible" means that they have a pulse.
Here are more details on the specific tests mentioned
Osteoporosis- The screening test offered is to measure bone density in the heel. This would be helpful if bone density were the same in every bone. It is not. This is why the bone density test we recommend (which costs about $150) measures bone density in the hip and the spine. Often one of those is low, and the other is not. Measuring bone density in the heel tells us nothing. It is not worth even $10.
Peripheral vascular disease- The screening test offered is an ultrasound test to look for blocked blood vessels. Now, if you have symptoms of peripheral vascular disease, such as pain when you've walked a bit, AND you were considering surgery OR you were not sure what was causing the pain, THEN such a test might help your doctor decide on the best treatment. No doctor, however, is going to make any decisions influencing your health based on this test advertised in the newspaper.
My concern is that the fuzzy images and color (which you can influence by the twist of a dial on the machine) are going to suggest you might have vascular disease and cause you to spend much more money on more tests and physician visits to find out if the first test was right or not. If you are feeling fine, no careful physician or surgeon is going to suggest any kind of treatment for peripheral vascular disease, regardless of what the test shows.
Carotid Artery Narrowing- The issues are the same as for peripheral vascular disease. If you have no symptoms, then many physicians would suggest no treatment. Some do, if the narrowing is severe enough, but again they are going to repeat the test on their own equipment.
Abdominal Aortic Aneurysm- This one might be worthwhile if you have a personal or family history of heart disease and are in your sixties or over. What they are measuring is a bit easier to measure. If you are thick in the middle and they get the measurement right, they might find an abdominal aneurysm that we'd miss on physical examination. They might not find it, though, as ultrasound cannot pass through bowel gas.
3/28/04