Articles Posted in Misdiagnosis

chartgfrresults-300x197Medical specialists and researchers have taken a big step in recognizing that how they diagnose black patients with kidney disease may be racially biased and harmful to a group that already and disproportionately suffers the illness’s harms.

Doctors now should jettison race-based adjustments in equations used in a crucial and fundamental test to assess kidney function, according to studies and editorials published in the New England Journal of Medicine, the American Journal of Kidney Diseases, and the Journal of the American Society of Nephrology.

As the New York Times reported, this step will “affect hundreds of millions of kidney function tests performed yearly in hospitals and outpatient settings, both for acutely ill patients and as part of routine screening blood tests. By one estimate, one million Black Americans might be treated earlier for kidney disease if the diagnostic equation were not adjusted for race.”

portalmedrecord-300x124As doctors and hospitals switch to electronic medical record systems and try to amp up the business efficiency of their enterprises by opening online consumer portals, more patients may access their caregivers’ files on them, including  doctor notes that may be shocking in their inaccuracy.

Heather Gantzer, a doctor practicing at Methodist Hospital in St. Louis Park, Minn., and immediate past chair of the American College of Physicians’ Board of Regents, told Cheryl Clark, a contributor to the MedPage Today medical news site:

“100% of medical records have errors. Some of them are nuisances, but some are really impactful and might make a huge difference for [example for] the person who was said to be on antibiotics” but was not.”

drugselderly-150x150The nation’s nursing homes, battered by the coronavirus pandemic, are under more fire for their resurgent reliance on powerful and risky psychiatric drugs and shaky diagnoses of mental illness to treat elderly residents, as well as for the institutions’ inability to safeguard the old, sick, and injured in their care by ensuring their staff are vaccinated against Covid-19.

Facilities across the country have recorded a 70% spike in dubious designations of elderly residents as schizophrenic. This means they may be dosed with potent antipsychotic drugs, which, critics say, act akin to pharmaceutical restraints and can reduce the vulnerable to near vegetative states, the New York Times reported, based on its investigation of the issue.

The newspaper noted that federal regulators and mental health professionals have campaigned for years to get nursing homes and other long-term care facilities to stop using certain medications, which once were more routinely administered and pack more than a wallop for the old:

colorectalcancerhotspotmap-300x230While technological advances may help provide crucial warnings to young men, especially those who are black, about their heightened risk of early-onset colorectal cancer, the rise of other high-tech diagnostic aids may only worsen built-in, harmful racial biases in an array of medical practices.

Researchers at the University of Chicago, to their credit, have sought the assistance of health providers across the country to inventory and assess increasingly common medical software and the algorithms on which they rely to ensure whiz-bang decision-making tools don’t discriminate against patients of color.

The early results are distressing, showing how well-intentioned experts inject prejudices into programs that can lead to racially unfair choices about patient care. Ziad Obermeyer, an emergency medicine physician and co-author of the Chicago research, told Stat, the science and medical news site, this about algorithms used in many diagnostic tools:

surgerylown-300x196When it comes to hospitals performing low-value tests or procedures and putting older patients at increased risk, Dixie may have little to whistle about.

The Lown Institute, a respected and nonpartisan think tank that says it “believes a radically better American health system is possible,” has published a new hospital index that puts dozens of southern institutions in a dubious light.

That’s because institute researchers scrutinized federal Medicare records on more than 1.3 million fee-for-services provided to older patents at more than 3,300 hospitals nationwide. They reported in findings published in an online part of the Journal of the American Medical Association that “hospitals in the South, for-profit hospitals, and nonteaching hospitals were associated with the highest rates of overuse” of health care services.

demeter-300x261It’s not an invitation to pile on the ice cream, cake, and candy. But older adults may get to say pshaw to the finger-wagging they may have endured from doctors and loved ones about their raised blood sugar levels and the condition that specialists ginned up to caution them about it: prediabetes.

As the New York Times reported, a newly published study by researchers at Johns Hopkins and elsewhere looked at data over six years on almost 3,500 older patients with elevated blood sugar measurements and found they “were far more likely to have their blood sugar levels return to normal than to progress to diabetes. And they were no more likely to die during the follow-up period than their peers with normal blood sugar.”

This is an important finding, the newspaper reported, quoting Elizabeth Selvin, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health in Baltimore and the senior author on the study:

docnotes-300x154Millions of Americans may be finding that their doctors routinely refer to them with terms like SOB and BS. But patients will be better off with this knowledge, once they learn how to translate medical abbreviations.

The Associated Press reported that hospitals and health care systems nationwide quietly are complying with deadlines, and, under a 2016 federal law, are opening up convenient, fast access to patients to not only view and access their electronic health records but also physicians’ notes about their care. As the AP wrote:

“If you already use a patient portal such as MyChart to email your doctor or schedule an appointment, you may soon see new options allowing you to view your doctor’s notes and see your test results as soon as they are available. You may get an email explaining where to look, how to share access with a caregiver and how to keep other eyes off your information. Many people won’t notice a change. About 15% of health care systems already are letting patients read doctor notes online without charge. That means about 53 million patients already have access to their doctor’s notes.”

colorscreen-300x168An important federal advisory group has joined with medical specialists in recommending a change in the age at which patients should start screening for colorectal cancer, to age 45 and not the current 50 years old.

Earlier detection of bowel issues could save lives, the U.S. Protective Services Task Force (USPSTF) has decided, with the influential medical group issuing a draft screening guidance and posting it online for public and expert comment.

Clinicians have reported for a while now that they are seeing more cases of colorectal cancers in younger patients, and their treatment might have better outcomes if it could be started earlier, too. As the New York Times reported:

javaid-300x169A Virginia criminal case, while focusing on claims of fraud against the federal government, also has exposed a long-running and nightmarish pattern of what prosecutors assert has been a Chesapeake gynecologist’s rampant mistreatment of his patients, many of them women of color and poor.

Dr. Javaid Perwaiz is on trial because authorities say he “manipulated records to cover crimes that enriched him but endangered pregnancies, sterilized women unnecessarily, and pressured them into needless procedures to finance his lavish lifestyle,” the Washington Post reported.

The newspaper’s articles, as well as the efforts by the FBI and federal prosecutors to develop the charges against the jailed specialist, raise disturbing questions about not only Virginia medical regulators but also the hospitals where the gynecologist practiced and colleagues who have described a “frenzied environment in which hospital staff struggled to keep pace with Perwaiz as he rushed from procedure to procedure.”

covidtestswab-282x300The federal agency that regulates nursing homes and other long-term care facilities not only has cracked down on them with tough new requirements for coronavirus testing of their staff. The Centers for Medicaid and Medicare Services also has flogged its plan to provide facilities with testing equipment and sample tests.

While owners and operators have grumbled about the whole process, the state of Nevada has gone a step further: Enough, its health officials have decided. They briefly halted as unacceptable the CMS tests for the virus because they say they are flawed and may put nursing home residents at risk.

Besides casting yet more doubt on CMS’s poor pandemic response with long-term care facilities,  Nevada’s balk — rescinded abruptly after federal threat — may offer an important take-away to members of the public, already flooded with findings about the novel coronavirus:

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