With the explosion of medical technology that can detect disease and other health problems earlier and more precisely than ever before, it’s easy to think that more tests and screenings are the keys to getting and staying healthy. This is not necessarily the case, says Antoinette Rose, M.D., an internal medicine doctor at PAMF's Mountain View Center and member of PAMF’s Health Maintenance Committee. Foundation for Health spoke with Dr. Rose about evidence-based guidelines, a set of recommendations for a variety of screening tests that are based on research studies that examine the risks and benefits of screening tests.

Q. What are evidence-based guidelines?

A. Evidence-based guidelines are powerful tools that help doctors ensure that we what do is right for our patients. Many research studies are done to examine the risks and benefits of screening tests. A nationwide taskforce called the U.S. Preventive Service Task Force looks at all of those studies and sifts through the sometimes conflicting results to make recommendations about which screening tests are really worth doing. For the past 15 years at PAMF, a group of doctors has examined these recommendations to make sure they are appropriate for our patients. The final product is evidence-based guidelines.

Q. I’m confused. I thought screening for disease was a good thing?

A. Yes, but all screening tests carry risks, and your doctor needs to know that the benefits of performing a test would outweigh any potential risk the test may carry. In fact, it is almost more important to know the risks and benefits of screening tests than to know those of a treatment for illness. Why? Because screening tests are generally done on a healthy person who should not be made less healthy by, for example, being put through a preparation for a colonoscopy or the discomfort and fear of a mammogram, unless your doctor has good proof that the benefits of these tests outweigh the risks. Let me give you another example: Performing annual chest X-rays on a patient does not reduce the risk of death from lung cancer, but X-rays do cause unnecessary exposure to radiation.

Q. If my doctor follows evidence-based guidelines, does this mean I won’t get individualized care?

A. Absolutely not. As their name suggests, they are simply guidelines. You and your doctor can still decide that a different set of tests – or a different frequency of tests – is needed depending on your individual medical history and health needs.
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