January 3rd, 2011 by KevinMD in Better Health Network, Research
Tags: Absence of Disease, Accuracy in Diagnosis, Archives of Internal Medicine, Diagnosis and treatment, Diagnosis Error, Dr. Kevin Pho, False Negatives, False Positives, General Medicine, Incorrect Diagnosis, KevinMD, Medical Diagnosis, Medical Diagnostics, Medical Malpractice, Misdiagnosis, Overtesting, Patient Death, Presence of Disease, Preventable Death, Too Many Medical Tests, Too Much Testing, Unnecessary Medical Tests, Wrong Diagnosis
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I’ve written in the past that more medicine and tests do not necessarily reflect better care.
There is no test that is 100 percent specific or sensitive. That means tests may be positive, when, in fact, there is no disease (“false positive”), or tests may be negative in the presence of disease (“false negative”).
It’s the latter that often gets the most media attention, often trumpeted as missed diagnoses. But false positives can be just as dangerous. Consider this frightening case report from the Archives of Internal Medicine:
A 52-year-old woman presented to a community hospital with atypical chest pain. Her low-density lipoprotein cholesterol and high-sensitivity C-reactive protein levels were not elevated. She underwent cardiac computed tomography angiography, which showed both calcified and noncalcified coronary plaques in several locations. Her physicians subsequently performed coronary angiography, which was complicated by dissection of the left main coronary artery, requiring emergency coronary artery bypass graft surgery. Her subsequent clinical course was complicated, but eventually she required orthotropic heart transplantation for refractory heart failure. This case illustrates the hazards of the inappropriate use of cardiac computed tomography angiography in low-risk patients and emphasizes the need for restraint in applying this new technology to the evaluation of patients with atypical chest pain. Read more »
*This blog post was originally published at KevinMD.com*
January 2nd, 2011 by Shadowfax in Better Health Network, True Stories
Tags: Adriamycin, Breast Cancer, Breast Cancer Screening, Breast Self-Exam, Caringbridge, Chemotherapy, Cytoxan, Dr. Liam Yore, ED, Emergency Department, Emergency Medicine, Emergency Room, ER, HER2 Positive, Herceptin, Infiltrating Ductal Carcinoma, Mastectomy, Movin' Meat, Oncology, Preventive Health, Preventive Medicine, Radiation, Shadowfax, St. Baldrick's Foundation, Taxol, Triple Negative Breast Tumor
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This year has been a weird one for me and cancer. In the ER, we see cancer patients pretty infrequently. The occasional chemotherapy with fever, but that’s about it. I think the oncologists try hard to keep the patients out of the ER — to everybody’s benefit.
But this year, I’ve had a weird rash of cases where I’ve made primary diagnoses of cancer in the ER — several times over and over and over again. In ten years I don’t think I’ve made as many cancer diagnoses as I have this year alone. Just very strange.
Unfortunately, it came home to roost. My wife was diagnosed with breast cancer last week. Read more »
*This blog post was originally published at Movin' Meat*
January 2nd, 2011 by Glenn Laffel, M.D., Ph.D. in Better Health Network, News
Tags: Alli, Anti-Obesity Drugs, Bupropion, Contrave, Dr. Glenn Laffel, Endrocrinology, FDA, Food and Drug Administration, Lorcaserin, Meridia, Naltrexone, Orexigen, Orlistat, Overweight, Pizaazz, Qnexa, Sibutramine, Weight Loss, Weight Management, Xenical
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The FDA has been tough on diet drugs of late. Three years ago it scuttled an attempt to get the European diet drug rimonabant approved for use in the U.S. More recently it rejected, at least temporarily, applications for Qnexa and Lorcaserin.
But that trend may have been reversed last week, when an advisory committee set the stage for possible FDA approval of Orexigen’s investigational diet drug, Contrave. By a 13-7 vote, the committee said in essence that the somewhat modest beneficial effects of the drug outweighed its tendency to increase blood pressure.
The FDA will make final decision on the matter by the end of January. It is not required to follow the advice of its advisory committees, but as was the case for the three diet drugs mentioned above, it usually does. Read more »
*This blog post was originally published at Pizaazz*
January 2nd, 2011 by Nicholas Genes, M.D., Ph.D. in Better Health Network, True Stories
Tags: Blogborygmi, Doctors and Social Media, Doctors On Twitter, Dr. Guido Majno, Dr. Nicholas Genes, Dr. Thomas Peebles, Healthcare Social Media, Medicine and Social Media
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This year I learned about the death of two physicians that were pretty important to me.
The first was my pathology teacher, Dr. Guido Majno. In addition to being a tremendously kind and curious person, he and his wife wrote the best textbook I’ve ever read.
The second death was that of my pediatrician growing up, Dr. Thomas Peebles. Funny, although he followed me from birth to high school, my family never knew about his incredible research background. We learned it in the many obituaries.
It’s worth reflecting on their accomplishments and the manner in which they conducted their lives and practice — especially in this era, when doctors are encouraged to develop their social media presence and be proactive about online reviews.
Would they have used these new tools? Would they even have needed them? Would they have found the idea of trading links to medical stories on Twitter to be interesting? Stimulating? Or maybe distressing or distasteful?
I never thought to ask them.
*This blog post was originally published at Blogborygmi*
January 1st, 2011 by GarySchwitzer in Better Health Network, Opinion
Tags: Gary Schwitzer, Health News Articles, Health News Coverage, Health News Review, Healthcare Journalists, Healthcare PR, Healthcare Public Relations, Healthcare Reporters, HealthNewsReview.org, Medical Reporting, Reporting Health News, Responsible Health Reporting, Responsible Reporting, Year In Review
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Healthcare journalists are buried under a mountain of public relations material sent to them every day of every week of every month. I don’t even work in a traditional news setting, yet I’ve made it onto the distribution lists of countless PR people.
The picture on the left shows a pile of video news releases sent to one TV health news reporter over a relatively short time span.
Here’s my year end look at just some of what was sent to me this year. Imagine what the New York Times, USA Today, the TV networks, and others receive.
I get countless emails from PR people offering interviews with their experts on:
• Seasonal Affective Disorder (SAD) — including an offer of an interview with a “celebrity trainer” who claims to have trained Julia Roberts, Cindy Crawford, Jennifer Aniston, Claudia Schiffer, and Kim Kardashian. (Were they all SAD?)
• A leading NY dermatologist invited me to “sip on champagne” and sample his new “daily nutrition for skin” cream.
• “For the more than 50 million Americans suffering from frequent heartburn, the thought of Halloween celebrations can truly be scary.” — PR for NYC gastroenterologist who is also consultant to makers of a heartburn drug. One of his tips: “Don’t just stock up on treats, prep your medicine cabinet” with the proton pump inhibitor of the company for whom he consults. Read more »
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
