A patient brought in a flyer for Life Line Screening, where for $129 an individual can have their carotid (neck) and peripheral (leg) arteries screened for blockage, their abdominal aorta screened for aneurysm (swelling), and be tested for osteoporosis. The advertisement claims that “we can help you avoid a stroke,” and their logo notes “Life Line Screening: The Power of Prevention.”
Are these tests worth your money? Short answer: No.
Although the flyer correctly indicates that 80 percent of stokes can be prevented, the National Stroke Assocation does not recommend ultrasound as a screening test. Preventing stroke includes quitting smoking, knowing your blood pressure and cholesterol numbers, drinking alcohol in moderation (if already doing so), exercising regularly, and eating a low-sodium diet. Their is no mention of an ultrasound test. Why? Because there is NO evidence that it helps save lives in individuals who are healthy and have no symptoms (except for the following situations).
The United States Preventive Services Task Force (USPSTF) latest guidelines recommend only screening men between age 65 to 75 years old who have ever smoked to be screened for an aortic aneurysm. If you are in this group, ask your doctor for an ultrasound.
For women, osteoporosis screening should begin at age 65 years old and have a bone density test done. Among the “different bone measurement tests performed at various anatomical sites, bone density measured at the femoral neck by dual-energy x-ray absorptiometry (DXA) is the best predictor of hip fracture.”
It is unclear how accurate or how good ultrasound of the heel or wrist is compared to the bone density test. If you feel you have other risk factors, like family history, use of steroids for a long period of time, then check with your doctor to see if screening should be done sooner. Otherwise at age 65, all women should be evaluated not with an ultrasound but a bone density test.
USPSTF recommends against screening for peripheral artery/vascular disease (PAD) as well as carotid ultrasound.
Worried about either condition? Ask your doctor. For peripheral vascular disease, particularly when significant, individuals commonly have leg pain when walking. The blockage in the arteries decreases blood flow to the leg muscles when active causing pain. When the person stops walking, the pain resolves.
A doctor can determine whether you have PAD by seeing if you have good foot pulses simply by placing fingers on the pedal pulses. If your pulses are normal, then you don’t have significant PAD. If the doctor is concerned about your symptoms, he will order an ultrasound which will be covered by insurance.
There’s a reason why that — in small print — Life Line Screening writes that they do “not partipate in the Medicare program and the cost of [their] screening services is not covered or reimburseable by Medicare” as well as they do “not file insurance claims and the cost of [their] screening services is your responsibility.” There is NO scientific evidence that these tests can make a difference except for the groups noted above. Since insurance companies only want to cover what is proven, Life Line Screening wants you to pay for essentially unnecessary tests.
Better use for your money? Check your blood pressure and your cholesterol. Quit smoking. Cut down alcohol use if you already drink. Maintain a low-sodium diet. To prevent osteoporosis, women should take 1,200 to 1,500 mg of calcium per day as well as 800 to 1,000 IU of vitamin D daily.
For $129? Get a really nice pair of walking shoes. Oh, and don’t spend too much money on multivitamins, because they aren’t worth the money either.
*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*