The Law of Diminishing Returns in Clinical Medicine?

           The law of Diminishing Returns in economic state that when a factory add more units of variable input to fixed inputs, the marginal product of the variable input declines beyond some point.

But there is a article title by ‘The Law of Diminishing Returns in Clinical Medicine: How much Risk Reduction is Enough?’

     This phenomenon also applies in the variety of clinical situation. Johnson discussed the law of diminishing returns as it relates to the diagnostic process more than 15 years ago.

      "In the quest for diagnostic certainty, one can be led into a false sense of accomplishment by the results of sensitive, specific, and well-executed diagnostic tests that provide little or no diagnostic information. This is a consequence of the fact that as one approaches diagnostic certainty the useful information returned by diagnostic tests and observations approaches zero." State by Johnson, who is an economy Professor. 

For example, this was the case happened.

Mr. Martin is a fictional, 65-year-old, African-American man who was diagnosed a year ago with type 2 diabetes mellitus.

           He leads a sedentary life but does not smoke or drink alcohol to excess. So far, he has had no clinically apparent end organ complications from his diabetes. However, he has recently noticed fatigue, polyuria, and polydipsia. He currently takes no medications. His past and family histories are otherwise unremarkable.

          At the insistence of his wife he agreed to see his primary care physician, who finds that his body mass index is 30.5, his blood pressure is 200/100 mm Hg, his haemoglobin A1c (A1c) is 10%, his low-density lipoprotein (LDL) cholesterol is 140 mg/dL, his high-density lipoprotein cholesterol is 40 mg/dL, and his total cholesterol is 260 mg/dL.

AND

            Actually, Mr. Martin should, according to American Diabetes Association guidelines, be advised to lose weight, exercise moderately, take low-dose aspirin, lower his blood pressure to below 130/80, lower his LDL level to below 100 mg/dL, reduce his A1c to below 7%, take an angiotensin-converting enzyme inhibitor, and possibly take a β-blocker to reduce his risk of a myocardial infarction (MI).

           In the context of an enlarging armamentarium of interventions providing both benefits and harms and escalating health care costs, the law of diminishing returns could provide a framework for rational prioritization.

Referene:

1. www.economyprofessor.com/economictheories/law-of-diminishing-returns.php.

2. http://www.medscape.com/viewarticle/722769

By Chin Kar Man 0314683