Physicians should reconsider using electrocardiography routinely in healthy patients without symptoms of heart problems, according to the latest recommendation from the U.S. Preventative Services Task Force.
The "incremental information" garnered from an EKG, whether testing at rest or during exercise, isn’t likely to produce data that would help a physician better understand a patient’s risk of coronary heart disease, according to the panel.
USPSTF gave EKG testing a "D" recommendation in use for healthy patients, which means the panel recommends against its use because "there is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits."
The panel noted that there was not enough evidence to make a strong determination either way for patients with medium or high risk of coronary heart disease.
EKG testing, sometimes called ECG, records the electrical activity of the heart via electrodes attached the skin. For patients with low risk of CHD, the leading cause of death in the U.S., "the information from an ECG probably won’t change the actions your doctor or nurse will suggest you take to reduce your risk for CHD," according to the USPSTF consumer notice.
The researchers worried that the tests would instead lead to unnecessary testing or excess treatment for healthy patients, and advised patients to consider their own health, lifestyle and preferences for health care in discussing with physicians wether or not an EKG test is in their bests interest.
The panels’ recommendation, which is independent of the U.S. government and not the official position of the Dept. of Health & Human Services, refers strictly to the use of EKG as a means of diagnosing CHD in low-risk patients.
It’s not yet clear whether this latest recommendation will cause a furor among physicians as past USPSTF findings occasionally have.
Earlier this year the panel advised against PSA screening, a commonly used prostate cancer test, over concerns about the dangers of aggressive treatment in patients who are asymptomatic and whose cancer may have remained neutral without intervention.
That guidance created outrage among several groups, including the Large Urology Group Practice Assn., which warned that "failing to detect cancer early will create a public health catastrophe in 5-10 years."
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