Doubtful benefit of most IGeL offers

02/26/2015

Many patients are offered so-called Individual Health Services (IGeL) at a doctor's visit, the costs of which they themselves have to bear. But most IGeL have according to scientific evaluation of the Medical Service of the GKV-Spitzenverbandes (MDS) "no demonstrable benefit or they harm." Patients can get an overview on the Internet portal www.igel-monitor.de, the MDS for three years operates.

According to the MDS, about every second patient is offered individual health care at a doctor's visit. Hardly surprising, because the doctors deserve this quite well. But the medical benefit often remains doubtful. An informed decision-making aid is provided by the website IGeL-Monitor. To date, 37 IGeLs have been evaluated and described by the team of scientists on the Internet portal, ranging from ovarian ultrasound, to cancer screening, to shock wave therapy for heel pain. However, only four self-payers were able to reach a positive rating.

No IGeL rated "positive"
According to the MDS, the overall result of the IGeL evaluation is very sobering. Thus, 16 out of the 37 reviewed examination and treatment methods were rated as "negative or tend to be negative", reports the MDS. 13 IGeL had cut with an unclear result and only four were rated "tends to be positive". Not one achievement received the rating positive. "The majority of IGeL performs poorly and has no demonstrable benefit for the patients or they can even be harmful", says the managing director of the MDS, Dr. med. Peter pick. According to MDS, gynecologists rank number one among IGeL vendors, followed by dentists and third-party ophthalmologists. The development in the booming IGeL market is questionable, the patients are not sufficiently informed about benefits and risks and alternatives, which are paid by the health insurance, are often not mentioned. Pick.

Ultrasound of the ovaries rated "negative"
According to the expert, patients should in any case require time for reflection, information and a written contract. "IGeL are never urgent. There is no reason to be pushed, "continued Pick. In case of doubt, the IGeL-Monitor portal offers the insured a scientifically sound and yet easy-to-understand decision support, so that they can decide with the necessary knowledge for or against an IGeL. According to the MDS, the worst evaluation result ("negative") was the determination of the immunoglobulin G (IgG) against food, the colonic hydro therapy, the toxoplasmosis test in pregnant women (early detection) and the ultrasound examination of the ovaries for cancer screening. The latter are often offered by gynecologists as part of a so-called "gynecological cancer screening", reports the MDS. In any case, the statutory health insurance would pay from the age of 20 years, however, a check-up in the form of scanning.

Numerous IGeL with the rating "tendency negative"
The additional ultrasound examination of the ovaries is, according to the MDS "negative" to evaluate, because on the one hand with ultrasound examination the same number of women die of ovarian cancer as without examination and on the other hand "women often unnecessarily worried by false alarms and even actually healthy ovaries are removed." Also medical societies would now advise against the investigation. Numerous other IGeLs also received a "negative" rating in the evaluation of MDS, including ophthalmoscopy with measurement of intraocular pressure for glaucoma early diagnosis, leech therapy for knee osteoarthritis, genital bleeding therapy for tendinopathy, MRI screening for early detection of Alzheimer's disease and PSA Test for the early detection of prostate cancer.

Individual health services are often counterproductive
According to the MDS, the PSA test is "one of the most frequently offered IGeL", with early detection of prostate cancer being the goal. "Even though the PSA test is presented as a useful precautionary measure in advertising campaigns and by many urologists and general practitioners, there has been intensive discussion in specialist circles about the benefits and harms to the test for years," according to the communication on the portal IGeL-Monitor. To date, the data remains contradictory to the benefit. As before, only indications of a low benefit are to be seen, while the data situation to damage clearly fails. "That's why we continue to see evidence of little damage," report the portal's scientists. No clear statement can be made, among other things, on the effects of acupuncture in the context of tension-type headache prophylaxis, Bach flower therapy, biofeedback therapy in migraine, professional teeth cleaning and breast ultrasound for early detection of cancer.

"Trend positive" was the "Acupuncture for migraine prophylaxis" by IGeL-Monitor, the "laser treatment of varicose veins", the "light therapy for seasonal depressive disorder (Seasonal Affective Disorder) And the "shock wave therapy in heel pain". A clear "positive" rating did not reach any of the individual health services evaluated so far.
(Fp)