Category: Diagnostic tests & procedures

Mast Cell Activation Disorder – Yes, It’s Real

Mast Cell Activation Disorder is real, but there are a large number of fake diagnoses out there. How do you tell the difference?

/ May 31, 2017

FDA issues warning letter to “holistic” practitioner offering thermography for breast cancer detection

Thermography for breast cancer detection is one of more than 65 products the FDA just announced it is going after for fraudulently claiming to prevent, diagnose, treat or cure cancer.

/ April 27, 2017

How Do Doctors Learn to Diagnose, and Can Machines Learn to Do It Too?

Siddhartha Mukherjee weighs in on how doctors arrive at a diagnosis and how computers can assist but not replace them.

/ April 11, 2017

How accurately do physicians estimate risk and benefit?

A new study suggests that physicians tend to overestimate the benefits of treatments, tests, and screening tests, while also underestimating harms.

/ January 26, 2017

Chiropractic Internist: A “specialty” to avoid

The "chiropractic internist" is the creation of an industry association which promotes chiropractors as "primary care physicians." After 300 hours of instruction in a hotel conference room, they claim they can treat "anything that a medical doctor can."

/ January 5, 2017

Precision Medicine and Uncertainty

Precision medicine is a development that promises to tailor treatments to the individual patient based on genetic and other molecular and cellular analyses. In his 2015 State of the Union address, President Obama announced the Precision Medicine Initiative. A website for Precision Medicine claims to offer “perfect care for every individual.” Much of what we read about precision medicine gives the impression...

/ November 15, 2016

When science- and evidence-based guidelines conflict with patient wishes: What’s a doc to do?

We use the term "science-based medicine" (SBM) because medicine isn't a science. The best medicine, however, is based in science. Patient values are also important, but what is a science-based doctor to do when SBM conflicts with what a patient or family wants?

/ October 3, 2016

Genetic Testing: Does Knowing Risk of Disease Make a Difference?

The complete sequencing of the human genome by the Human Genome Project was a remarkable accomplishment and a cause for celebration. Several companies including 23andMe, Navigenics, and deCODE have capitalized on that scientific achievement by offering genomic testing directly to the public. They promise more than they can deliver, and consumers don’t understand the limitations of the test results. The subject has...

/ August 23, 2016

The ROCA Screening Test for Ovarian Cancer: Not Ready for Prime Time

Ovarian cancer is relatively rare but deadly. The lifetime risk of ovarian cancer is 1.5% compared to 12% for breast cancer, but it is the 5th most common cause of cancer death for women. Since the ovaries are hidden deep in the pelvis and the symptoms of ovarian cancer are non-specific, the cancer is often advanced by the time it is diagnosed...

/ June 21, 2016

Is the Annual Physical Unnecessary?

I was approached by The Wall Street Journal to write an article for their Big Issues in Health Care debate series. The subject was “Is the annual physical unnecessary?” I was to take the “yes” side and an internist was to take the “no” side. I wrote the following article. The editor wrote me a couple of times with questions. The internist...

/ April 26, 2016