| Cutting edge |  In today's newsletter there is an item that suggests that actually listening to patients and them examining them carefully may provide more information on the condition of their cardiovascular systems that putting them on a treadmill and looking at their ECG. The study showed that the predictive value of the exercise stress test - in the participants in the study - was no better than a good history and examination. In other words - clinical skills.
This is, to me, an important study. It shows that a well trained and conscientious doctor is at least as useful as a series of expensive investigations. I am sure that exercise stress testing is not the only investigation that may be less useful than people think.
There is an increasing tendency among doctors to go for investigations - at great cost to the patient and their medical schemes - simply because they are available. And, unfortunately patients have latched onto this to such an extent that extensive investigations are regarded as the norm.
My 86-year-old father-in-law is a case in point. An unnecessary admission to hospital resulted in a series of investigations that showed that he has a particular heart condition that can only be treated by surgery - something for which he is not a suitable candidate. The cardiologist suspected the specific condition after a clinical examination and an echocardiogram (a relatively inexpensive and non-invasive investigation) and went ahead and confirmed it by doing a CT scan - expensive and very uncomfortable for the old man. Given my father-in-law's general poor health, the CT scan should probably not have been done. It didn't change the old man's management in any way and has left him fearful of the consequences of his condition and of any future admissions to hospital.
An investigation is only useful if it is going to change management - keep that in mind when you visit your doctor.
Bridget Farham Editor
https://www.bizcommunity.com
| | Today's headlines
MedicalManaging insomnia in shift workers - Jenni Newman Public RelationsSome of the most significant industrial accidents in human history - the Exxon Valdez incident, the Chernobyl disaster, the Three Mile Island accident and the Challenger Space Shuttle crash - were caused by human error as a result of fatigue.
CardiologyWally's back to conquer Kilimanjaro Wally Katzke crept into the hearts and homes of many South Africans on Saturday, 2 August 2008 when he became the first heart patient in the world to be televised live undergoing open heart surgery. Now, the former cardiovascular patient is back on track with some ambitious ‘heart challenges' lined up for 2009, including climbing Mount Kilimanjaro during the year. Talking to patients provides more information on heart disease than testsHeart tests offered to many patients with chest pain are of little value in predicting future heart disease, say researchers.
Chronic diseasesMusic is good for the heartLike laughter, music appears to be good for your heart.
Infectious diseases1918 Spanish flu records could hold key to preventing future pandemicsAustralian researchers hope that 1918 pandemic records may help them prevent a future outbreak. Ghana: meningitis outbreak kills tenTen people have been confirmed dead and two are hospitalised following an outbreak of meningitis in north-central Ghana.
MalariaAirport malariaIn a global world, significant factors affect the spread of infectious diseases, including international trade, air travel and globalised food production.
OncologyTreatment for cancer may result in bone lossTreatment for breast and prostate cancer may cause bone loss.
PaediatricsResearchers identify Achilles heel of common childhood tumourResearchers have, for the first time, found a mechanism for the rapid growth of the benign blood vessel tumour known as infantile haemangiomas, the most common tumour found in children. The findings implicate gene mutations that facilitate the abnormal activity of a hormone called VEGF, and suggest that anti-VEGF therapies - already approved for other conditions - may be an effective treatment. |
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