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More medical tests, bigger margin of error in diagnosis

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Diagnostic errors may be the biggest threat to patient safety in New Jersey and throughout the country today. Many people cannot reconcile how this possible in this age of modern medicine, as technology has advanced to provide medical screenings for almost every known disease. But, as we discussed previously, part of the problem is that technology driven medical tests are getting in the way of the clinical assessments performed by physicians.

What this means is that many doctors are performing a staggering number of diagnostic lab and technology-based tests, relying less and less on cues from their own knowledge and patient interaction. Take, for example, the case of a young girl that was recently covered by the Poughkeepsie Journal.

At the age of 4, the girl was experiencing fevers and her mother took her to see a doctor. After basic blood work failed to lead to a diagnosis, the girl was directed to a genetic testing center in another state to be tested for Familial Mediterranean Fever, an inflammatory disorder for which there is no cure. She tested positive and started a painful series of treatment.

Later, it turned out that the lab had mixed up the girl's results with those of another patient. She did not have Familial Mediterranean Fever. She just had the same problem many kids have when they suffer from a sore throat and fevers--she needed to have her tonsils removed.

While this child's 1 ½-year ordeal resulted in prolonged physical and emotional pain, lab mix-ups and misread test results can lead to far worse outcomes in some cases.

Many medical tests are legitimately necessary, but unfortunately a vast number of tests are the results of defensive medicine; a doctor trying to cover all of the bases to avoid lawsuits rather than do what he or she knows is best for the patient. Of course, defensive medicine is ironic because each test involves the introduction of a new chance of error.

As both statistical evidence and this Poughkeepsie case suggest, more testing is not always better for the patient. What is better are skilled medical assessments and care focused on patient safety.

Source: Poughkeepsie Journal, "Medical test mistakes pose serious risk," Lisa Lannucci, May 25, 2014

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