The Most Useless Routinely Ordered Tests

What are tests that we frequently order that are frankly... pointless? In this video we'll take a look at some of the biggest offenders!
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[@LongFingeredEgalitarian]

Great information!
Thank you.

[@asong5328]

Agree that unnecessary tests contribute to skyrocketing healthcare costs! Please do not order imaging stress tests if patient is a candidate for a simple treadmill stress rest, which saves cost and prevents unnecessary radiation exposure to patients.

[@amberkluga8949]

I agree on your rant on cost of healthcare. US healthcare is expensive, and less effective....

[@user-ir9vz3bl5z]

7:44-8:26 spiel was gold! I never understood why doctors order daily labs for BMP/CBC and blood draws at 5am just to present on rounds at 9am only to find out the labs hasn't changed from yesterday. Get labs only when you have questions that can change management. Don't do it just to have something to present, it hurts patients physically, and ruins their sleep.

[@deborahrippe5641]

Ok so urinalysis on everyone that comes to ER. They come in for something muscular in nature or broken arm, etc… their dip causes a urinalysis and they get treated for a uti too. I’m a pharmacist and do the call backs and it drives me crazy

[@rickshay4656]

DRE very helpful in cases of undifferentiated shock w/ concern for possible hemorrhagic shock and assessing for source in patients that can't provide reliable history. Or any patient w/ AMS and anemia of unclear acuity and other signs that might be pointing to a bleed but nothing slam dunk. If you see brown stool on the DRE thats reassuring.

[@rickshay4656]

I understand the FOBT is useless in terms of specificity, but I am curious about the sensitivity. Like.. if clinical suspicion for a bleed isn't super high but maybe the patients Hgb is low and you don't have slam dunk overt bleeding, can a negative test provide negative predictive value similar to a D-dimer?

[@anonymous-user-2024]

Hey, I like your channel. Do you have an approach to reading CXR? Thanks

[@jingcliu]

I would love to see a hospitalist that will admit for hepatic encephalopathy without an ammonia 😂

[@ConanLiuMD]

They are behind the times if they are relying on it! HE is a clinical diagnosis and I don’t ever rely on ammonia to determine whether pt needs to be admitted and started on lactulose. Mainly because the test is so inaccurate - a patient could have HE but a negative ammonia, or they could have elevated ammonia but not have HE. So either way it doesn’t change any treatment decisions
www.emlitofnote.com/?p=4477
journals.lww.com/ajg/fulltext/2020/05000/ammonia_levels_do_not_guide_clinical_management_of.20.aspx

[@aldriksimpsonjimenez2331]

Hi! Link to the ICU reddit guide?

[@Valcreee]

Agreed, Guaiac test is useless