Diagnosis and Medication

Art Papier MD apapier at LOGICALIMAGES.COM
Tue Nov 26 23:21:24 UTC 2013


Ilene,

Medications can interact with each other, typically referred to as drug-drug
interactions and cause adverse events by causing either an "over dose" or an
"under dose".   These interactions can go unnoticed until there is obvious
harm (eg bleeding from an increased blood level of Coumadin as an example).
Medications can also just induce or cause disease directly without
interaction.  These reactions are often missed and can be quite delayed in
being recognized.     Part of our work  in developing VisualDx clinical
decision support is to focus on this problem area, drug induced disease or
drug induced adverse events.  A typical elderly patient can be on 10
medications or more.  Often a medication is causing the problem.  We started
our work looking at drug induced diseases that manifest on the skin, and
then broadened to the mucosa and eye.  We are eventually going to cover all
medication induced diseases.  Systemic diseases like lupus can be drug
induced, and many other diseases have medications as a predisposing or
causative factor.  Though we call this "drug eruptions" the idea is much
broader than "rashes".  The results are ranked by the number of citations
linking the drug to the diagnosis in the literature that you can click into.
The results can be scanned by a physicians and shared with patients since
all of the knowledge is visual and easily understandable by the patient.

 

This system is used in over 1500 hospitals and large clinics, please reply
off the list and we can send you a video link showing how it works and also
temporary access if you would like.   

 

 

Art Papier MD

Chief Executive Officer

3445 Winton Place . Suite 240 . Rochester NY 14623 

(585) 427-2790 x230 .  <mailto:apapier at logicalimages.com>
apapier at logicalimages.com 


 www.visualdx.com

www.skinsight.com

Logical Images

 

 

 

-----Original Message-----
From: robert bell [mailto:rmsbell at ESEDONA.NET] 
Sent: Tuesday, November 26, 2013 4:12 PM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: Re: [IMPROVEDX] Diagnosis and Medication

 

Yes, this and renal failure with ARB's and hypovolemia. 

 

One of the things that comes to mind with the example Dr. Graedon provides
is that a computer with frequency data (if it can be obtained) as part of a
diagnostic program should be able to pick up these "misses" very quickly.

 

We have to start more readily acknowledging that the average physician's
single brain is inadequate for many prompt accurate diagnoses. We need
computers.

 

We need money and research. 

 

Rob Bell

 

 

 

On Nov 26, 2013, at 10:26 AM, Teresa Graedon <
<mailto:terry.graedon at GMAIL.COM> terry.graedon at GMAIL.COM> wrote:

 

> One very specific example that we hear about time after time on our
website is the patient with a chronic cough who undergoes many tests and
even several trials of antibiotics, asthma inhalers or reflux prescriptions,
to no avail. Then at some point some provider (usually not the prescriber)
says, but isn't this due to the ACE inhibitor you are taking? Diagnostic
problem solved...but why did it take so long?

> 

> 

> Terry Graedon, PhD 

> The People's Pharmacy  

> 

> 

> On Nov 26, 2013, at 12:15 PM, "Hamm, Robert M. (HSC)" <
<mailto:Robert-Hamm at OUHSC.EDU> Robert-Hamm at OUHSC.EDU> wrote:

> 

>> Suggestion: though we academics can appreciate a general idea such as
that medication use can affect diagnosis, to be useful for communicating
with patients, and even for changing physicians' vigilance, it should be
specific examples that are communicated about. 

>> 

>> Rob

>> 

>> Robert M. Hamm, PhD

>> Clinical Decision Making Program

>> Department of Family and Preventive Medicine

>> University of Oklahoma Health Sciences Center

>> 900 NE 10th Street

>> Oklahoma City OK 73104

>> 405 271 5362 ext 32306       Fax 405 271 2784

>>  <mailto:robert-hamm at ouhsc.edu> robert-hamm at ouhsc.edu

>> ________________________________________

>> From: Wu, Albert [awu at JHSPH.EDU]

>> Sent: Tuesday, November 26, 2013 10:43 AM

>> To:  <mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>
IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG

>> Subject: Re: [IMPROVEDX] Diagnosis and Medication

>> 

>> A very obvious starting point is that almost any set of symptoms could be
caused by medication, with either appropriate or inappropriate use

>> 

>> So knowing about medication use can be very important

>> 

>> Albert W. Wu, MD, MPH, FACP

>> Professor and Director

>> Center for Health Services & Outcomes Research

>> Johns Hopkins Bloomberg School of Public Health

>> Baltimore MD 21230

>> (410) 955-6567 / fax (410) 955-0470

>> Mobile (410) 978-1539

>> 

>> 

>> From: " <mailto:PULSE516 at AOL.COM%3cmailto:PULSE516 at AOL.COM%3e>
PULSE516 at AOL.COM<mailto:PULSE516 at AOL.COM>" <
<mailto:PULSE516 at AOL.COM%3cmailto:PULSE516 at AOL.COM>
PULSE516 at AOL.COM<mailto:PULSE516 at AOL.COM>>

>> Reply-To: Society to Improve Diagnosis in Medicine <
<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG%3cmailto:IMPROVEDX at LIST.IMPROVED
IAGNOSIS.ORG>
IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.O
RG>>, " <mailto:PULSE516 at AOL.COM%3cmailto:PULSE516 at AOL.COM%3e>
PULSE516 at AOL.COM<mailto:PULSE516 at AOL.COM>" <
<mailto:PULSE516 at AOL.COM%3cmailto:PULSE516 at AOL.COM>
PULSE516 at AOL.COM<mailto:PULSE516 at AOL.COM>>

>> Date: Tuesday, November 26, 2013 11:20 AM

>> To: "
<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG%3cmailto:IMPROVEDX at LIST.IMPROVED
IAGNOSIS.ORG%3e>
IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.O
RG>" <
<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG%3cmailto:IMPROVEDX at LIST.IMPROVED
IAGNOSIS.ORG>
IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.O
RG>>

>> Subject: [IMPROVEDX] Diagnosis and Medication

>> 

>> Can you share with me your thoughts on how medication use might affect a
diagnosis?

>> 

>> Thanks

>> 

>> ilene

>> 

>> Ilene Corina, President

>> PULSE of NY

>>
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>> (516) 579-4711

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