Cascades of care--stop doing unnecessary investigations

Do you get infuriated when members of the team say ‘they did the baseline bloods’ ? Have you ever sent off a screening test or diagnostic test and found something you weren’t expecting and had to launch into further investigations and uncomfortable discussions with families? Ganguli I et al. [JAMA Netw Open 2019;2(10):e1913325. Doi10.1001/jamanetworkopen.209.13325] describe this process as a ‘cascade of care after incidental findings’ which have gone on to require an intervention and treatments which may be of uncertain value. Anecdotally this has been described in the literature but no study has examined physician perception and experiences of this phenomenon. This is an American study of adult physicians but I think it highlights a potential issue for paediatrics and the paper is well worth examining. The authors asked the following three questions: How common are cascades of care after incidental findings? What occurs during these cascades? What are...

from Archives of Disease in Childhood current issue https://ift.tt/2Pn8LFf