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John Beasley, M.D.
When patients start walking into my office with test results I didn't order, I know something isn't quite right.
The latest fad is ultrasound scanning of arteries. A few of my patients, and those of my colleagues, have seen direct-to-consumer fliers that claim these scans can detect plaque (hardening of the arteries) in the neck and elsewhere, and thereby prevent strokes and heart attacks. Unfortunately, the evidence isn't so clear.
Yes, ultrasound scanning can detect the presence of plaque. But that's not particularly enlightening. Atherosclerosis or hardening of the arteries with the development of plaque, is present years before a heart attack or stroke. Plaque develops very slowly over time. We all know this. The fact that an ultrasound scan confirms it, doesn't change our approach to heart disease and stroke prevention.
We need to reduce cholesterol, increase exercise and avoid smoking. Very rarely will surgery be the recommendation after a patient gets his or her ultrasound results back.
To me, it's unwise to do testing without evidence that this will be beneficial. On the other hand, I don't believe the tests themselves are harmful. But they are costly. So why should patients spend their money on tests that probably will not offer any additional benefit? It is also unclear if the diagnostic or possible surgical procedures that follow a test will help or perhaps will even harm the patient.
When patients come in with results from these ultrasound scans, all I can really say is that the test did identify some plaque and we're already dealing with it. Marketing such a service to the general public borders on unethical because we simply don't know whether ultrasound tests offer any actual benefit to patients on a mass scale. Save your money, and when necessary, invest it in the tests that may really help you.