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Including the screening adds little extra cost and can identify emerging problems in almost all patients.
Adding ultrasound screening to routine annual visits for older patients can potentially catch more emerging chronic conditions or other problems in nearly all cases.
In an article published this week in the Journal of Ultrasound in Medicine, a team of investigators from Allina Health in Minnesota showed that including ultrasound as a preventive measure in regular wellness checks can be beneficial for older individuals.
Currently, a blood pressure check is the only required physical examination under the Standard Medicare Wellness checkup, but the team, led by Terry K. Rosborough, M.D., an internal medicine specialist with Northwestern Memorial Hospital’s graduate medical education department, showed doctors could perform more assessments with little additional cost for follow-up testing.
“One or more abnormalities were found in 94 percent of our participants, the great majority of which would have been undetected by a traditional physical exam,” the team said. “Many participants benefited from the information and harm was rare and only economic.”
For their study, the team launched a program where experienced physicians used ultrasound to screen 108 adults between ages 65 and 85 during their annual Medicare Wellness appointments. Based on these exams, providers detected 283 abnormalities and made 172 new diagnoses, resulting in 30 ordered follow-ups.
Of the results, new diagnoses of liver steatosis (19 percent of patients) and kidney cysts (10 percent of patients) were the most common abdominal findings. Among the cardiovascular outcomes, the physicians pinpointed new cases of carotid plaque (44 percent of patients), left ventricular diastolic dysfunction (14 percent of patients), and tricuspid value regurgitation (22 percent of patients) the most.
Alongside the added benefit of these new findings, most patients (76 percent) saw no added cost. The price tag for most visits ranged from $5 to $50, the team said. But, those medical bills could have been higher later down the road had these findings not been identified.
While not every patient qualifies for or needs an added ultrasound screening during their routine annual check-up, Rosborough’s team contended such a program still does provide benefit overall. Additional work is needed on how best to design and use these initiatives, though.
“The assessed benefit of these abnormalities was rarely negative and often mild to moderately positive, with important new chronic conditions identified,” the team said. “We continue to investigate how to implement an ultrasound screening exam for select patients having periodic health visits.”
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