Less health care may be better health care. Health care based on clinical testing is a logical approach, but if there is a “bad” result it may be only temporary. The clinician would not know about this though unless there is follow-up testing. To study the notion that a clinical test finding may improve over time, without any treatment, the author measured his autonomic nervous system with heart rate variability on 30 different days, twice per day to see how well the paired readings might agree. Results showed substantial improvement in the second reading compared to the first, and this difference was statistically significant (p < 0.0001) with a large effect size (of 2.0). This finding is an example of why it may be prudent to perform follow-up testing prior to clinical decision-making to avoid the problem of unnecessary treatment.

Heart rate variability, spontaneous improvement, unnecessary treatment