Signs and symptoms

Twest54973 twest54973 at YAHOO.COM
Fri Sep 12 12:58:08 UTC 2014


You are essentially suggesting the creation of a patient registry which would be a good start but there are also some problems...

Irb issues
Data entry and maintenance and analysis issues
Referral bias (it would need to be a regional population based registry to avoid only entering those pts referred to a certain team or those with certain patterns of symptoms)
Etc etc 

Thomas Westover 
Asst Professor Mfm
Cooper Medical School NJ

Sent from my iPhone

On Sep 12, 2014, at 1:37 AM, Peggy Zuckerman <peggyzuckerman at GMAIL.COM> wrote:

> How about starting with a review of what is considered to be "classical symptoms" and determining the percentage of diagnosed patients with the associated disease truly have those symptoms?  Too often patients are told that the failure to have the symptoms historically found with the disease precludes the patient from having that disease. 
> 
> Not being in the risk group, too old, too young, wrong ethnicity,wrong gender, lack of response to some medication, lack of some symptom, failure to report the same..the list goes on.
> 
> Peggy Zuckerman
> 
> On Thu, Sep 11, 2014 at 1:56 PM, robert bell <rmsbell at esedona.net> wrote:
>> More regarding the Probabilities discussion.
>> 
>> As mentioned there are the treatment issues as they pertain to diagnosis.
>> 
>> But there are also the problems of symptomatology and signs.
>> 
>> What are the effects of of our genes on ”standard” signs and symptoms? What is the range that one can expect?  Is there any extensive work in this area? I have often wondered for example if certain patients have less or more pain receptor density in various parts of their bodies - is that known.
>> 
>> Also, what are the effects of other diagnoses (known or unknown) on signs and symptoms.
>> 
>> Just think of a 65 year old women who is wheezing and has an unknown Factor V Leidin deficiency, and also an unknown Lady Windermere syndrome. Both of these conditions are not too uncommon and are often initially missed with sometimes dire consequences.
>> 
>> Don’t we need far more database trolling to uncover the breadth of signs and symptoms expression for different conditions/diseases?
>> 
>> As I have said before, let’s get back to the basics - and first evaluate the accuracy of the stethoscope in different hands!
>> 
>> If we are to make significant progress in the diagnostic area, in a reasonable time frame, we need a national and coordinated strategy run by the government or recognized national body.
>> 
>> Rob Bell, M.D.
>> Retired
>> 
>> 
>> 
>> 
>> 
>> 
>> Moderator: Lorri Zipperer Lorri at ZPM1.com, Communication co-chair, Society for Improving Diagnosis in Medicine
>> 
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>> </p>
> 
> 
> 
> -- 
> Peggy Zuckerman
> www.peggyRCC.wordpress.com
> 
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