FDA approves first blood test to help diagnose concussions

HM Epstein hmepstein at GMAIL.COM
Fri Feb 16 01:14:39 UTC 2018


This December 2017 article from STAT news identified 289 relatively new patents “that disclosed objective concussion diagnostic technologies or assessments.” They organize them by type of measurement. Their conclusion is that no one method will be the gold standard because, the “concussive threshold” has proven to be elusive and complicated.” 
https://www.statnews.com/2017/12/18/concussion-diagnosis-technology/

My hope was that having a relatively simple blood test would help reduce the number of young athletes going back out onto the field for the next game. Unfortunately, it seems it will be years before sideline assessments can become more reliable.

Best,
Helene


       
Website Twitter LinkedIn​ Facebook

On Feb 15, 2018, at 5:44 PM, Tom Benzoni <benzonit at GMAIL.COM> wrote:

Concussion is a clinical diagnosis, based on history and physical.
CT is a picture.
This test predicts a negative CT.
The only purpose for a CT is to tell the neurosurgeon: "Drill here."
Concussion is found first by history; application of force to head/body causing (hopefully) temporary derangement in function.
Next is skilled physical exam.
In these settings, the CT is likely normal while the neuropshych exam is abnormal.

Tom

> On Thu, Feb 15, 2018 at 1:18 PM, Mosher, Timothy <tmosher at pennstatehealth.psu.edu> wrote:
> ​It will be interesting to see  how this test fits into the clinical pathway.  It sounds as though it will serve as a test to exclude intra-cranial hemorrhage.  If so it will need to have high sensitivity and NPV to avoid additional examination with CT.  A concern is that it will be used in patients with low probability of ICH (i.e. ones that currently would not undergo CT examination) leading to higher cost with relatively little impact on patient outcome.
> 
> From: Grubenhoff, Joe <Joe.Grubenhoff at CHILDRENSCOLORADO.ORG>
> Sent: Thursday, February 15, 2018 2:05 PM
> To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
> 
> Subject: Re: [IMPROVEDX] FDA approves first blood test to help diagnose concussions
>  
> I think if I understand the test correctly, the blood test is a test that suggests that there is actually intracranial bleeding (aka more than an isolated concussion) that would lead a clinician to be more judicious in the use of CT. then if the CT is ultimately negative, the dx of concussion would be made. So in essence the test is not a test to dx a concussion but more along the lines of a test to rule out more serious injury leaving concussion as a dx of exclusion. I think the problem is in the reporting and conflating separate ideas.
> 
>  
> 
> From: Ruth Ryan <ruth at RYAN-GRAHAM.COM>
> Reply-To: Society Medicine <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>, Ruth Ryan <ruth at RYAN-GRAHAM.COM>
> Date: Thursday, February 15, 2018 at 11:57
> To: Society Medicine <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>
> Subject: Re: [IMPROVEDX] FDA approves first blood test to help diagnose concussions
> 
>  
> 
> Helene, Thanks for this, it’s good to keep an eye on new diagnostic developments, which we could certainly use in head injury. And a skeptical eye at that.
> 
>  
> 
> This article is based on a press release from the manufacturer, touting its FDA approval, not much of a gold standard for safety these days.  Caution flags abound.
> 
> The article states concussion may be later confirmed by CT, however CT does not permit diagnosis of concussion; the disruption of neural connections is not visible on imaging.
> 
> CT can show skull fracture and intracerebral bleeding.
> 
> The worst effect of a negative CT is to lull the physician and patient into a false sense of security, permit a missed diagnosis of concussion, and set the patient up for re-injury by returning to activity prematurely.
> 
>  
> 
> Ruth Ryan RN, BSN, MSW
> 
>  
> 
> From: HM Epstein [mailto:hmepstein at GMAIL.COM] 
> Sent: Thursday, February 15, 2018 8:39 AM
> To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
> Subject: [IMPROVEDX] FDA approves first blood test to help diagnose concussions
> 
>  
> 
> The first blood test to help diagnose concussions is both more accurate than current sideline assessment tools and less expensive than CTs. But a positive result still needs to be confirmed by CT and 3-4 hours for results is too long for sideline use. So is this considered an improvement in diagnosis? No information in this article about the accuracy of the test for all concussions or whether it’s limited to just certain types of concussion.
> https://www.statnews.com/2018/02/14/blood-test-concussions/?
> 
>  
> 
> 
> 
> To unsubscribe from IMPROVEDX: click the following link:
> http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1
> 
> or send email to: IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG
> 
> Visit the searchable archives or adjust your subscription at: http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?INDEX
> 
> 
> Moderator:David Meyers, Board Member, Society for Improving Diagnosis in Medicine
> 
> To learn more about SIDM visit:
> http://www.improvediagnosis.org/
> 
>  
> 
> 
> 
> To unsubscribe from IMPROVEDX: click the following link:
> http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1
> 
> or send email to: IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG
> 
> Visit the searchable archives or adjust your subscription at: http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?INDEX
> 
> 
> Moderator:David Meyers, Board Member, Society for Improving Diagnosis in Medicine
> 
> To learn more about SIDM visit:
> http://www.improvediagnosis.org/
> 
> CONFIDENTIALITY NOTICE:  This e-mail, including any attachments, is for the sole use of the intended recipient and may contain confidential and privileged information.  If you are not an intended recipient, or the person responsible for delivering this message to an intended recipient, you are hereby notified that reading, copying, using or distributing this message is prohibited. If you are not an intended recipient, please contact the sender by reply email and destroy all copies of the original message from your computer system. 
> 
> 
> 
> To unsubscribe from IMPROVEDX: click the following link:
> http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1
> or send email to: IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG
> 
> Visit the searchable archives or adjust your subscription at: http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?INDEX
> 
> Moderator:David Meyers, Board Member, Society for Improving Diagnosis in Medicine
> 
> To learn more about SIDM visit:
> http://www.improvediagnosis.org/
> 
> 
> 
> To unsubscribe from IMPROVEDX: click the following link:
> http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1 or send email to: IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG
> 
> Visit the searchable archives or adjust your subscription at: http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?INDEX 
> Moderator:David Meyers, Board Member, Society for Improving Diagnosis in Medicine
> 
> To learn more about SIDM visit:
> http://www.improvediagnosis.org/




To unsubscribe from IMPROVEDX: click the following link:
http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1
or send email to: IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG

Visit the searchable archives or adjust your subscription at: http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?INDEX

Moderator:David Meyers, Board Member, Society for Improving Diagnosis in Medicine

To learn more about SIDM visit:
http://www.improvediagnosis.org/






Moderator: David Meyers, Board Member, Society to Improve Diagnosis in Medicine


HTML Version:
URL: <../attachments/20180215/888ba88e/attachment.html>


More information about the Test mailing list