An InteMedica seminar for medical doctors, acupuncturists, and holistic practitioners in Miami this past weekend (February 24th, 2007), promoted products that push the edge of the medical envelope. If we’re exploring in space, it’s a good thing to push the envelope, but whether it’s a good thing with health care we will see.
The sales rep for InteMedica, Dena, is an honest, helpful person who believes in the company’s products. InteMedica markets Chinese herbs, nutritional supplements, and homeopathic medications. The products can be used singly or in combination. To assist the practitioner in choosing the right products, a computer-generated list of recommendations is prepared by a software program that interprets data from the patient’s palm. The patient rests either hand on a metal pad and the pad transmits information to a computer. The data generated by hand contact with the metal plate allows the software to recommend a list of products. This is not a laboratory test and no fluids are removed from the patient. These are data generated by the palm and analyzed by a computer in order to recommend InteMedica’s herbs, homeopathics and supplements. Because veterinarians were invited, I’m hypothesizing there will be a day when a sensor is available to accept data from a dog or cat.
Using a testing device to arrive at a recommended treatment is well established in human and veterinary medicine. For example, blood tests suggest who is anemic and needs blood. Blood tests tell us who needs a bone marrow transplant. X-rays tell us who has bladder stones and needs surgery. MRIs suggest who has spinal compression and needs surgery. Although the use of testing devices is well established, interpreting test results is not a straightforward matter. In fact, interpretation is fraught with difficulties—so many that it takes years of medical training to interpret tests correctly. If it did not take years of training, a lab technician could write a script as soon as blood was taken and run through the analyzer.
Even with medical training, test misinterpretation is common. Here’s an example that occurred with a colleague’s hospitalized Chihuahua this month. Bella, who weighs about three pounds, developed anorexia, dehydration and diarrhea that required hospitalization. One of the abnormalities in Bella's blood tests was an elevated level of urea in the blood (BUN or blood urea nitrogen). Urea is primarily a waste product, so the blood level is carefully regulated by the kidneys. Healthy kidneys selectively pull urea from the blood and toss it out in the urine. When Bella’s veterinarian saw the elevated BUN test results, he interpreted it as a kidney problem—a misinterpretation. What Bella had was an elevated BUN due to dehydration.
Although the clinic veterinarian suggested further diagnostic tests and a change to a special diet, I advised Bella’s family to wait. What happened within 24 hours? Bella began to eat and drink; fluids rehydrated her cells and returned the proper amount of liquid to her blood. Blood pressure returned to normal. Blood of a normal viscosity pumped through her kidneys at a normal rate. Bella’s kidneys tossed out the urea and brought BUN levels back to normal.
What would have happened if test misinterpretation had lead to a series of diagnostic tests and a feeding regimen for pets with suspected kidney failure?
1. A major stress for Bella and her family.
2. A waste of money.
3. A diversion from the real problem, which is either food allergy or dietary indiscretion.
Tomorrow, we’ll have another example of test misinterpretation—this one of a cat the veterinarian wanted to put on insulin. Then, we’ll return to the idea of InteMedica’s diagnostic computer.
No comments:
Post a Comment