THE "WOW FACTOR"
Anecdotal reports are another reason for the sudden emphasis on wellness testing in veterinary medicine. Every veterinarian
can tell a story of a patient with subclinical disease identified on routine wellness testing. It is what I call the wow factor: "Wow, I would never have found this if I had not run all of these tests." And for many veterinarians, these positive anecdotes
are reason enough to do wellness testing. But what about dogs and cats having invasive procedures (e.g. liver biopsy, bone marrow aspirate) or expensive follow-up tests (e.g. further blood tests, imaging studies) that were found to be normal? How did these patients benefit from wellness testing?
I think veterinary medicine is where human medicine was 20 years ago with respect to wellness testing. Now, doctors are realizing
that wellness testing on every patient is not good medicine. As our profession continues to evolve, we must also take a critical
look at wellness testing. Without better studies on which to base wellness testing recommendations, efforts to prevent disease
may do more harm than good. It's hard to hold off on strategies as seductive as wellness testing to detect early disease in
our patients. But if we don't, then we must be prepared to accept the consequences of going to war with the data we have,
instead of the data we really need.
David Robbins, DVM
VCA West Bernardo Animal Hospital
11605 Duenda Road, Suite D
San Diego, CA 92127
1. Grimes DA, Schulz KF. Uses and abuses of screening tests. Lancet 2002;359:881-884.
2. Munro J, Booth A, Nicholl J. Routine preoperative testing: a systematic review of the evidence. Health Technol Assess 1997;1(12):i-iv;1-62.
3. Schein OD, Katz J, Bass EB, et al. The value of routine preoperative medical testing before cataract surgery. N Engl J Med 2000;342(3):168-175.
4. Sommerville TE, Murray WB. Information yield from routine pre-operative chest radiography and electrocardiography. S Afr Med J 1992;81(4):190-196.
5. Bouillot JL, Fingerhut A, Paquet JC, et al. Are routine preoperative chest radiographs useful in general surgery? A prospective,
multicentre study in 3959 patients. Eur J Surg 1996 Aug;162(8):597-604.
6. Alef M, von Praun F, Oechtering G. Is routine pre-anesthetic haematological and biochemical screening justified in dogs? Vet Anaesth Analg 2008;35(2):132-140.
7. Joubert, KE. Pre-anaesthetic screening of geriatric dogs. J S Afr Vet Assoc 2007;78(1):31-35.