Tuesday, July 05, 2011

How doctors and labs fool patients



When our patients get pregnant, we refer them to an obstetrician who helps to provide them with medical care during their pregnancy . Most obstetricians now routinely perform a triple marker test for pregnant women, to rule out birth defects. The purpose of this test is to reassure patients that their baby is healthy - as in fact, the vast majority of babies are !

Sadly, some doctors deliberately mis-interpret the test results to scare the patient into doing additional unnecessary testing.

Look at the report above.

It's written it typical medical gobbledygook, which even doctors find hard to understand . Rather than print the report in simple English and explain the result in terms which the patient can make sense of , it seems the lab is going out of its way to scare patients by using unnecessarily complex terms !

For example, the assessment is - The First Trimester Screening for the given sample is found screen NEGATIVE. Now this is reassuring - this means the screening test was negative, which means the patient does NOT need to worry ! However, by highlighting the word NEGATIVE which has a negative ( bad) connotation in most people's mind, the patient gets very worried, and goes running to her doctor for help ( and it seems this report has been designed to do just that !)

In this report, the Prior Risk ( risk prior to doing the test) of the patient having a baby with the chromosomal anomaly called Down syndrome is 1:140. This is considered to be High Risk - the baby has a 1 in 140 chance of being abnormal . Now, after doing the test, the Posterior Risk ( risk calculated after taking the test results into account) has dropped dramatically to only 1:7500 ( which means there is a 7499:7500 chance that the baby does NOT have Down syndrome ! ) This is a very reassuring report, which means the doctor can counsel the patient she does not have to worry.

However , rather than do this, this doctor chose to highlight ( see the black arrow she has drawn with her hand in the right column) the 1:140 printed High Risk figure in this report. She has told her patient that the results of this report shows she is at High Risk, and is now pushing the patient into doing an unnecessary amniocentesis, by scaring her that this test result shows she is at high risk of having a baby with a birth defect ! ( It seems she does this for all her patients :(

What a shame ! No wonder patients no longer have any confidence in doctors anymore !
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