Sir,

Recently, there is debate raging over the use or abuse of diagnostic facilities like various radiological and pathological investigations. In this regard, the views expressed by the article "overuse of various radiological and pathological investigations: Should we be safe or sorry?" are interesting. [1] This sentiment from a faculty in the diagnostic department is indeed heartening.

True, today clinical judgment and decision making may not be what it used to be in earlier days. There is definitely increase in patient awareness and patient education. [1] The patients are more educated and are the internet friendly. They check and countercheck everything related to their ailments before, during and after visiting clinicians. [2] They often have many queries and don′t spare even the laboratory personals. [3] In this scenario, the need for evidence based medicine is becoming fast popular.

Clinical examination should precede and be the basis for any diagnostic investigation. [1] Each investigation requested by the clinicians should have a proper aim and objective based on the history and a thorough clinical examination of the patient.

And in our Indian setup, judicious use of various tests is essential. Any unnecessary and repeat tests should be avoided. The benefits of the test, as well as its cost-effectiveness, should be kept in mind, before undergoing or requesting any particular test. All said and done, always the patient should remain the priority and one should use and take utmost care to reach a diagnosis with the available resources. To achieve this, some of the measures like regular audits, developing diagnostic investigation protocols, continuous educational programs, and regular patients′ feedbacks should be implemented in the medical services of our country.

We would like to conclude by saying that we should not miss any diagnosis just because of not using an available diagnostic modality. The use of diagnostic modality should be justified and should be of proven utility. On the other hand, clinical and laboratory investigation should be complementary to each other, so as to provide the best possible result. In the end, we feel it′s better to be safe rather than sorry.