Amir Qaseem, MD, PhD, MHA; Timothy Wilt, MD, MPH; Thomas D. Denberg, MD, PhD
Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M12-3186.
Qaseem A, Wilt T, Denberg TD. Screening, Monitoring, and Treatment of Stage 1 to 3 Chronic Kidney Disease. Ann Intern Med. 2014;161:83-84. doi: 10.7326/L14-5013-5
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Published: Ann Intern Med. 2014;161(1):83-84.
Dr. Dhar states that the only harm of screening tests for CKD is financial; we disagree. Screening is a process, not just a simple test, that results in a cascade of additional diagnostic and treatment events. In addition to the expense of the screening test (which may be low), there are costs associated with follow-up evaluation of abnormal results, unnecessary treatment and complications, and adverse effects of treatment. The overuse of screening tests is an important component of unnecessary health care costs in the United States (1). Recommending against CKD screening for asymptomatic patients without risk factors provides clinicians with guidance in that more judicious use of such tests will improve the quality of care and reduce costs.
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