A nice article, linked below, from NPR illustrates the complexity in deciding whether to undergo certain health screenings. While some screening tests (colonoscopy for example) are firmly acknowledged to be helpful, others (like those offered by Lifeline screening) are more controversial. At first glance, screening seems to be a no brainer. Finding things early and fixing them, so the thinking goes, can only be beneficial. The problem is that results from certain screening tests (carotid arteries, for example) rarely return with “yes or no” results. Oftentimes (in fact most of the time) these low quality ultrasound tests lead to a “maybe”, leaving the patient in a bind. While most doctors are happy to discuss next steps with their patients, what patients do not realize is that once “Pandora’s box” is open, a more invasive test may be required to sort things out. Without the appropriate studies looking at these confounding factors, who is to say that finding the 1 in 10,000 chance that a carotid artery needed surgey may require 10 people to receive ct scans with contrast that induced a kidney problem just to find out they were “ok”. As always, these decisions need to be individualized between doctor and patient BEFORE undergoing the screening test.