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Mark Favaloro
Mark Favaloro
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Government Panel Questions Safety of Mobile Screenings

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A recent report by Kaiser News and the Washington Post raises concerns about the reliability and safety of mobile health screenings. Many hospitals and other health-care facilities have partnered with medical-screening companies in order to promote tests that are aimed at consumers who are concerned about serious medical conditions, such as heart disease and strokes.

But the U.S. Preventive Services Task Force (USPSTF) recommends against using many of the tests on people without symptoms or risk factors. The USPSTF says these screenings find too few problems to outweigh their drawbacks, which include false positive results, follow-up procedures and potentially unnecessary surgery. These drawbacks could needlessly drive up the cost health-care spending.

Routine screenings, such as the ones for blood pressure and diabetes found at local malls, fairs or other community events, are not the type of mobile screenings that have caught the attention of the USPSTF. What is raising the concerns of many medical experts are “packages” that offer screenings for “life-saving tests for heart disease and stroke.” The tests, which usually are not covered by insurance, are performed in specially equipped buses that travel to different locations. These screening services are being offered in dozens of cities across the county, including Richmond, Washington D.C., Tyler, Texas, Marin, Calif. and the suburbs of Chicago. The fees for these screenings range between $100 to 150.

Tests such as ultrasound tests for blockages of the carotid artery and weak spots in the abdominal aorta; a resting electrocardiogram or EKG; elasticity of the arteries; and blockages in arteries serving the legs (for peripheral arterial disease) are part of many package screenings.

The USPSTF recommends against routine use of four of those five tests in adults who don’t have symptoms or risk factors. It does recommend the ultrasound looking for abdominal aortic aneurysms but only for men age 65 to 75 who have smoked.

EKGs and ultrasounds for blocked carotid arteries are among dozens of procedures that many physician organizations say are overused and should be questioned by both patients and their doctors.

Steven Weinberger, executive vice president and chief executive of the American College of Physicians, calling hospital involvement without disclosing potential downsides to mobile screenings, “unethical.” “A lot that ends up being found is clinically of no importance at all,” said Weinberger, and added the screenings, “not only can raise [health care] costs, but also can lead to additional testing that is harmful.”

False-positives, or results that erroneously indicate disease, are more likely when screening widely for a condition that affects only a small percentage of people. The USPSTF cited the example of testing for the narrowing of the carotid artery. Stream says this is a risk factor for stroke estimated to affect only about one percent of people over age 65. According to the panel, 4,348 people would need to be screened with both ultrasound and a follow-up magnetic resonance imaging test to prevent a single stroke.

Glen Stream, board chairman of the American Academy of Family Physicians, said the test “is potentially selling false reassurance to some people and at the same time, it’s really frightening others. ” Yet this is one of the more common tests offered in these mobile screenings.

Mobile screening bus