Many Canadians undergoing potentially unnecessary medical tests

Many Canadians undergo potentially unnecessary medical tests and procedures that add delays to hospital wait times and cause unneeded anxiety for patients, according to a new report.

The report, released Thursday by the Canadian Institute for Health Information (CIHI) and Choosing Wisely Canada, zeroed in on several medical treatments and highlighted areas of concern.

In Alberta, 30 per cent of patients with lower-back pain who didn’t show serious “red flag” symptoms had at least one unnecessary X-ray, CT or MRI, according to the analysis. In Manitoba, Saskatchewan and B.C., doctors increasingly prescribed low doses of an atypical antipsychotic medication to children and young adults under 24, despite some experts warning against such prescriptions.

Overall, researchers found that up to 30 per cent of the procedures they analyzed were potentially unnecessary. That translates to more than 1 million potentially unnecessary tests and treatments every year.

Dr. Laurent Marcoux, a family physician and president-elect of the Canadian Medical Association (CMA), says he’s “worried” by the findings.

“If we use resources doing things that are not necessary, what will happen for people waiting for necessary care? It’s a reason why the waiting lists are so long and it’s a reason why it’s so costly for the healthcare system now,” Dr. Marcoux told CTV News.

In the report, researchers assessed eight recommendations from various Canadian medical organizations on different types of care, from mammograms to the treatment of insomnia. They then compared those guidelines to relevant data across the provinces.

In several cases, researchers found significant discrepancies between the guidelines and how doctors ordered tests and treatments.

The report found that one in 10 Canadian seniors use benzodiazepine, a sedative-hypnotic that may increase the risk of falls, fatigue and vehicular accidents. Benzodiazepine and similar drugs shouldn’t be the first choice of treatment for older adults with insomnia, agitation and delirium, according to a recommendation from the Canadian Geriatrics Society and the Canadian Society of Hospital Medicine.

Increases in benzodiazepine prescriptions were recorded in 2014-2015 in Newfoundland, P.E.I. and New Brunswick, compared to numbers recorded three years prior.

The report also looked at screening mammography for average-risk women between 40 and 49 years old. According to the CMA, the tests aren’t necessary for average-risk women within that age group.

But 22 per cent of Canadian women within that age bracket received a screening mammogram, according to the analysis. Researchers warn that such tests can lead to patient anxiety and, in more serious cases, false positives.

Researchers also found that, in Ontario and Alberta, nearly one in three low-risk patients with minor head trauma underwent a CT head scan in a hospital emergency department. Such testing isn’t considered necessary, according to the Canadian Association of Radiologists and the Canadian Association of Emergency Physicians.

Unnecessary CT scans can expose patients to radiation that could increase their risk of cancer, while also lengthening wait times for those who need the important test, according to the report. Unnecessary CT scans are also a drain to provincial health care budgets, since they require highly-trained teams of medical experts and expensive equipment.

“Many Canadians experience care that may be unnecessary,” said David O’Toole, president and CEO of CIHI, in a statement. “This report is another step toward ongoing standardization of measures and improved data to identify gaps, track improvements and ultimately improve the quality of — and access to — care for Canadians.”

The cost of unnecessary testing may be a burden to taxpayers, but Dr. Marcoux says the harm to patients should not be dismissed.

“Saving money and doing things correctly is important, but doing things that aren’t necessary and harming our patients is worse,” he said.