Articles Posted in Testing

medtest-300x169Medical over-screening and over-testing not only adds hundreds of billions of dollars in unnecessary costs to U.S. health care, it also may be skewing researchers’ understanding of what causes disease and imposing harsh burdens on older Americans.

Stat, an online health and medical news service, has highlighted an intriguing study from the Dartmouth Institute for Health Policy and Clinical Practice, whose researchers are well-respected for their work on their Atlas Project, which “documents glaring variations in how medical resources are distributed and used in the United States.”

Dartmouth researchers recently examined screening, especially for breast, prostate, and thyroid cancers, and found that over-testing, as Stat reported, may be “misleading doctors and the public about what increases people’s risk of developing cancers,” especially “the types of cancer that matter.”

precise-223x300Although billions of dollars and lots of positive public attention have been lavished on the promise of genetic-based “precision medicine,” this therapeutic approach to treating cancer and other serious diseases may need more scrutiny for basics of quality control.

National Public Radio deserves credit for airing some less-heard experts’ worries about the roles of at least two groups of little-seen and often-ignored medical specialists — pathologists and med techs — and how their common practices may undercut the potential of efforts to target disease treatments to individual patients based on maps of their genes.

Despite its powerful and progress-promising name, precision medicine relies on some old-fashioned, unchanged, and possibly problematic medical techniques, experts told NPR. Blood and tissue samples, which later will be analyzed with costly and supposedly state-of-the-art equipment, still get taken by med techs with limited training. Little attention typically gets paid to how they collect samples and how carefully they get handled before arriving in labs. They may sit on carts for hours, and they may be dragged through different parts of hospitals where temperatures vary widely and can hit extremes.

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The new year is bubbling with numerous reports about  “raw water.” Enthusiasts are flocking to outlets — in Oregon, Maine, San Diego, San Francisco, and the Silicon Valley — for unfiltered, untreated, and unsterilized H2O from springs. They’re paying dearly, for example $36.99 for a 2.5-gallon glass orb of “off the grid” Live Water from a West Coast vendor.

Devotees insist “raw water” tastes better. They contend it’s healthier when free of chemicals, like purifying chlorine and tooth- and bone-protecting fluoride, and replete with “probiotics,” bacteria and microscopic life such as algae that they claim are beneficial.

Such claims fly in the face of at least a century of public health experience and progress, a period in which science-based hygiene has helped to rid the nation of epidemics due to water-borne bacteria, viruses, and parasites. Cholera, typhoid fever, dysentery, and hepatitis A no longer flourish in water supplies, killing thousands annually as these banes once did. It goes without a thought for most Americans that they can turn the spigot at home or the office, drink freely and deeply and not end up getting deathly ill — risks that may be posed by “raw” water.

bp-300x169Did you feel yourself just get less well? U.S. heart experts have just issued new guidelines on what Americans’ optimal blood pressure should be—effectively and suddenly shifting just under half of the adults in the nation younger than 45 into an unhealthful status as hypertensive.

Doctors say there’s no doubting data that shows that blood pressure readings exceeding 130 over 80 can be detrimental to patients’ health. That’s down from the previous warning level of 140 over 90.

But what exactly has the medical establishment wrought with this sweeping metric? Have they deemed so many of us unwell in this way that we’re about to see public doubt and confusion—even profiteering—as has surrounded the description of tens of millions of Americans as “prediabetic?”

urine-sample-cup-263x300With opioid drugs now the leading cause of death for Americans 50 and younger and killing more than 64,000 people last year, was it inevitable that some shady characters are profiteering off the miseries of those struggling to get off potent painkillers?

And is it predictable that key politicians keep talking big but still haven’t backed up their boasts with the money and means to attack a public health crisis that is claiming more lives than cars or guns and at a faster pace than HIV-AIDS did at the peak of that epidemic?

Americans have plenty cause to be — forgive the vulgar word play — pissed off at the doctors and labs that are raking in profits on urine testing for drugs. This business has exploded but with little or no oversight. As reporters Fred Schulte and Elizabeth Lucas have written:

heart-300x190Hospitals and heart doctors may need to rethink their common test to determine if their patients have suffered a heart attack, and whether a newer alternative open-heart procedure carries with it more risks than benefits.

Health News Review, a health information watchdog site, has raised interesting questions as to why mainstream media outlets haven’t paid much attention to the recommendation by the High Value Practice Academic Alliance (HVPAA), a blue-chip group of medical scientists and institutions (including Johns Hopkins), for the phase out of the creatine kinase-myocardial band. CK-MB is the “go-to blood test doctors used to determine if a patient’s heart muscle had been damaged by a heart attack (or myocardial infarction).”

To the tune of $400 million or so annually, doctors turn to CK-MB tests millions of times each year to distinguish, along with patient symptoms and EKGs, if the person before them has suffered a heart attack, HVPAA members write in the medical journal JAMA Internal Medicine.

spinning-300x200Although many sports enthusiasts relish the summer as a peak time to train hard to get especially fit, wise athletes for safety’s sake may wish to build their way up to exhausting workouts, and to ensure they’re staying hydrated in healthful ways, while also recognizing that endurance competitions may alter their bodies in ways that they should at least be aware of.

The New York Times has posted an eyebrow-raising story on the perils to hard-driving jocks, male and female, of “rhabdo,” aka rhabdomyolysis, a “rare but life-threatening condition often caused by extreme exercise. It occurs when overworked muscles begin to die and leak their contents into the bloodstream, straining the kidneys and causing severe pain.”

Two doctors say they treated three recent, severe rhabdo cases brought on when novices in not great shape leaped into intense spinning classes, demanding exercise regimens lasting around an hour and involving specialized stationery bicycles. They found in medical literature 46 other, documented rhabdo cases, with 42 tied to novices’ spinning.

ExpiredDrug-300x225Americans each year needlessly toss hundreds of millions of dollars in costly, valuable, and still potent drugs, a wasteful practice driven by a “myth,” the mistaken belief in and scrupulous adherence to already debunked product expiration dates.

Drug discards, including of medications that may be in short supply nationwide, occur all along the distribution chain, from corner druggists up to giant health system pharmacies.

The practice flies in the face of known evidence, much of it developed, verified, and shared by the same force that presses for expired meds to get tossed: Uncle Sam.

dna-208x300Pathologists are the medical specialists whom few patients ever meet, but they play increasingly important roles in treatment decisions. Some new reports raise concerns about systematic errors in the path lab.

The New York Times painted a surprisingly distanced picture of the work of pathologists in a recent report on these medical doctors who are trained to interpret an array of laboratory tests and often microscopic materials to determine the care for complex diseases.

The paper found that the specialists and their labs mislabeled and mixed up patient samples and results, as well as sometimes contaminating them—yes, rarely, but with potentially significant harms. Erroneous results could lead to misdiagnoses, resulting in patients getting wrong or ineffective treatment, especially for cancers, experts say.

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