Wednesday, October 03, 2012

When Experts Speak Outside Guidelines

This morning, an article appeared in the Chicago Tribune that "revisits" Sudden Cardiac Arrest.  It is written by a local cardiologist, Dr. Joseph Marek, who advocates for EKG screening of athletes without discussing its downside and the fact that such a recommendation falls outside of our professional associations' guidelines on this issue.

While the intent of Dr. Marek's efforts are probably in the right place, we should all realize that testing (of any kind) that occurs on large segments of the population who are at relatively low risk for an ailment leads to a considerable incidence of false positive tests (in other words, abnormal findings that are ultimately found to be benign).  The cost and anxiety of the evaluation of these tests (consults, echocardiograms, even invasive angiograms) during such an evaluation can be considerable and might lead to real complications of their own.



Dennis said...

All true. However I remember the parable about closing the barn door after the horses have fled. And then nothing is free and profit is king. Its a slippery slope.

Anonymous said...

Or, the obverse, when fools talk about the guidelines but have no idea of what they're talking about... (I'm referring to a popular 'health-related' topic contributor to a popular website comparable to Ladies' Home Journal or Good Housekeeping (definitely NOT a pharmacist author) n the popular press who mentioned a JAMA article published not too long ago. This gossiping no-nothing discussed a matter for which I'm sure only referred to reading an abstract of the JAMA article about rare side-effect of retinal detachment associated with fluoroquinolones.

As a pharmacist, there are several issues of major importance to discuss about these broad-spectrum antibiotics that would be helpful to the average public, especially with regard to the fact that with mandatory employer-mail out prescription programs people do not consult with a pharmacist, or part of 'free' programs for everyone, such as avoiding antacids, milk, iron, aluminum, sucralfate, etc. within 4 hours of a dose, or no taking if a child, or in some, watching for emergence of hallucinations, etc. avoiding sunlight, taking the WHOLE prescription (and not not just a few tablet 'til feel better), even the importance of taking with plenty of water (to avoid yeast infections), but oh, no! This non-expert provides 'medical advice' for a column and doesn't know a thing about the guideline and what people that take antibiotics NEED to know.