Principles-based approach to test selection

SLOW begins with understanding and awareness. Knowing where we are is one way to get an idea of where we are heading (and asking ourselves whether we want to go there). Some of this is soul searching and other forms of personal discovery. Some of this is just opening our eyes and looking at our relationships, our environment, our food and our activity, as though these choices actually matter.

But some things we can’t see: at least, not until it may be too late to make a difference. For these issues we need to perform regular tests, measures or other evaluations of our health. Such tests can play a useful role in maintaining our health by:

  • Identifying modifiable risks for disease or decline.
  • Enabling us to detect problems early. Even before symptoms are recognized or increased risks are identified, screening tests help detect disease in its early and most treatable stages.
  • Providing the opportunity for customized interventions based on our individual needs, rather than generic (one-size fits all) solutions.
  • Identifying and reinforcing successful activities. The ability to quantify allows positive intervention with measurable results (the diet that reduces cholesterol and is shown to do so, or the gym program that improves BMI and reduces percentage of body fat).
  • Improving resource allocation. Identifying non-essential or superfluous activities, seeing where the biggest gains can be made and where to allocate our limited time, energy and money.
  • Providing an impetus and a focus for change. Even healthy individuals guard their health more closely when a test reveals the risk of a high cholesterol level, an abnormal Pap smear, a high level of oxidative stress or a glimpse of mortality. Test results will often be the best stimulus for people to take steps to reduce their risk of disease and disability. The most important part about testing is the act of looking, regardless of what we find.

To be most effective in our testing, we need to keep track of all our investigations. We should aim to know more about ourselves than our doctor or health care provider, not the other way around, so we can more easily monitor and refine our progress and use it to ask more questions.

There are now an enormous number of tests available to measure every aspect of physical and mental function. To undertake them all is not only financially costly, but also unfocussed. Each will be more or less important in certain situations and in certain individuals. We must work our way through what is most important to us first, not those things that are most important to our healthcare provider. Get help to take the first steps. The best help comes from those who are willing to coach and guide us through our options, and who will listen and respond to our questions. Avoid falling to the latest fad that claims to have all the answers.

 

Last Reviewed 02/Mar/2014

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Dr Merlin Thomas

Professor Merlin Thomas is Professor of Medicine at Melbourne’s Monash University, based in the Department of Diabetes. He is both a physician and a scientist. Merlin has a broader interest in all aspects of preventive medicine and ageing. He has published over 270 articles in many of the worlds’ leading medical journals
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