Can these ultrasound tests save your life?

You may already have seen one of the offers on TV or gotten a brochure in the mail. They're pretty hard-sell, designed to unnerve you. "We can help you AVOID A STROKE in just 10 minutes," one brochure says. The cover letter may be signed by a celebrity, like Peggy Fleming. You're offered "high-quality ultrasound screenings" in a nearby location for a special reduced price. If you choose three different tests (for example, for stroke, abdominal aortic aneurysm, and hardening of the arteries), you can save a bundle. And more important, according to the testimonials in the ads, you can save your own life. They don't mention that insurance seldom pays for this voluntary testing, which costs up to $300 for the whole package. Still, this may sound like a good deal -- but maybe it's not.

The ultrasound tests you'll be urged to get are painless and quick -- the sound waves are safe and there's no radiation, unlike CT scans. They are legitimate tests, used by doctors and hospitals. The usual offerings in such packages are these:

So what could be wrong with this offer?

A lot. We advise against such screenings, for these reasons:

What the Task Force says

The U.S. Preventive Services Task Force is an expert panel that evaluates screening tests in order to protect the public and con- serve medical resources. Here's what it says about the kinds of tests being offered in these packages:

Bottom line: Before you get any test, get medical advice. If you're under 60, you don't need these tests, unless you have symptoms or risk factors. In that case, you should see a doctor rather than referring yourself to some center. These "packages" promise a lot, but deliver little in the way of benefits. They can, however, deliver anxiety and even suffering, instead of the "peace of mind" they promise. The pitch advises you to take charge of your health care. We urge you to do that by saying no to these offers.

This is reprinted from the UC Berkeley Wellness Letter from March, 2005. I agree with their recommendations. I do think that men who smoke or have high blood pressure should have an abdominal ultrasound around age 60 to look for an abdominal aortic aneurysm (though your insurance may not cover the cost of this test if done as a screening test). I am not in favor of general screening for carotid artery narrowing, as I think the data regarding the benefits of surgery in people without symptoms of TIA or stroke is unclear. Bone density tests are routinely offerred in this practice to women over age 65, and to some younger women with certain risk factors for osteoporosis. The best simple screening test for peripheral artery disease is examination of the feet for temperature and pulses (done in this practice routinely).