2002
DOI: 10.1146/annurev.publhealth.23.092101.134534
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Cascade Effects of Medical Technology

Abstract: Key Words technology, adverse effects, quality-of-care, diagnostic tests s Abstract Cascade effect refers to a process that proceeds in stepwise fashion from an initiating event to a seemingly inevitable conclusion. With regard to medical technology, the term refers to a chain of events initiated by an unnecessary test, an unexpected result, or patient or physician anxiety, which results in ill-advised tests or treatments that may cause avoidable adverse effects and/or morbidity. Examples include discovery of … Show more

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Cited by 178 publications
(148 citation statements)
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“…Imaging may detect abnormalities unrelated to the pain, leading to additional tests, interventions, and referrals that do not improve outcomes. 8,9 Cumulative low-level radiation exposure is associated with an increased risk of cancer, with about 1,200 additional future cases of cancer anticipated for the 2.2 million lumbar CT scans performed annually in the US. [10][11][12] Medical societies recommend against imaging for acute low back pain.…”
Section: Introductionmentioning
confidence: 99%
“…Imaging may detect abnormalities unrelated to the pain, leading to additional tests, interventions, and referrals that do not improve outcomes. 8,9 Cumulative low-level radiation exposure is associated with an increased risk of cancer, with about 1,200 additional future cases of cancer anticipated for the 2.2 million lumbar CT scans performed annually in the US. [10][11][12] Medical societies recommend against imaging for acute low back pain.…”
Section: Introductionmentioning
confidence: 99%
“…Rigorous processes and evidentiary standards for causality are important because a positive genomic finding for a child with unexplained sudden death may lead to a costly and potentially harmful cascade of follow-up tests and screening for biological relatives (Deyo 2002).…”
Section: Discussionmentioning
confidence: 99%
“…This phenomenon, termed the cascade effect, is well recognized in health policy literature, with most experts recommending that the best way to curtail the cascade effect is to avoid unnecessary testing in the first place. 26,27 The fourth statement in this year's ASH Choosing Wisely Âź campaign recommends against testing or treating for heparin-induced thrombocytopenia (HIT) in patients with a low pretest probability of HIT (score of 0-3). 28 The 4 Ts score is a clinical scoring system that estimates the pretest probability of HIT using readily available clinical and laboratory parameters.…”
Section: Discussionmentioning
confidence: 99%