Things Patients and Physicians Should Question

It would seem that there is significant amount of interesting material in the news. This is my 4rth post in two days. I subscribe to ‘MedPage Today’- an online source for hot topics. This hot topic appeared in the Indianapolis Star yesterday. It is of note and it is comforting to see in print efforts to look very closely at tests and procedures in order to help with what is worthwhile, cost-effective, valuable, and direct in making a difference in patient care. People want tests. Tests have problems with sensitivity, specificity, positive predictive values, and negative predictive values.

Things Patients and Physicians Should Question is worth looking at. Various specialties made contributions. Listed below are those from the American Academy of Allergy, Asthma, and Immunology.

  • IgG and IgE testing for allergies – the only proven diagnostic blood test is IgE for specific allergens based on the patient’s clinical history. Indiscriminate IgE batteries should be avoided.
  • Sinus CT scans and antibiotics for uncomplicated acute rhinosinusitis – the condition is almost always caused by viruses and usually resolves without treatment.
  • Routine diagnostic testing for chronic urticaria – definite causes are rarely identified and extensive testing is unproven to improve outcomes or to be cost-­‐effective.
  • Replacement immunoglobulin therapy for recurrent infections – such treatment is warranted only when antibody responses to vaccines are clearly impaired.
  • Diagnosing or managing asthma without spirometry – symptoms alone are not sufficient for a diagnosis and may overestimate as well as underestimate asthma control in treated patients.

Some of these are frequent themes in my postings. It is nice to see them critically reviewed and posted.

FEL 4-5-2012

April 5, 2012 · fleickly · No Comments
Tags: , ,  · Posted in: Allergies, Allergy Testing