In their Commentary “Better Off Not Knowing,” Volk and Ubel1 ask us to consider that harm may be avoided by concealing diagnostic data from the physician's eyes if it is deemed impertinent to the clinical question at hand. This idea and the proposed solutions shift the blame from the interpreter of the data to the data itself.
Before physicians fill out a laboratory slip or radiology requisition, we have sorted through uncountable details from the patient's history, review of systems, and physical examination, carefully choosing the appropriate weight, if any, to assign each bit of information. Every question asked and body part examined is a diagnostic test. And so, even at the early stages of the clinical encounter, the possibility of “incidentaloma” discovery exists.