“Seeing” and “Understanding” are Two Very Different Things

September 27, 2011  |  Category: Physicians

I have no problem with patients seeing their lab results – over the internet (as the Department of Health & Human Services has proposed), or any other way. The problem is most patients don’t know how to interpret their lab results. It takes years of study and experience in order to do so effectively.

Every lab test is subject to the principles of sensitivity and specificity. Sensitivity is how often a test detects disease in a patient that actually has the disease. If you set the sensitivity too high, almost everyone who has a positive test really has the disease but you miss some people who have the disease because they will have a negative test (“false negative”). If you set the sensitivity too low, you pick up a lot of people who have a positive test but don’t have the disease (“false positive”). All tests are subject to this phenomenon one way or another. The general convention in the lab world is to set sensitivity at 95 percent. This means that if you do 20 tests, you expect one test to be abnormal even though the patient is fine.

Specificity is, if you have a positive test, do you really have that particular disease?  Some tests, like a Sed Rate, are very non-specific. They can come back abnormal, but for a variety of different reasons. A Sed Rate can be high because of arthritis, serious infection, or something as simple as a cold.

Many patients panic if they see any abnormal result. Many will continue to worry even when there may be nothing to worry about. It is not even unusual for some patients to seek alternative treatments for diseases they don’t even have because of worry. Many times the unnecessary treatments are expensive and present a health risk themselves.

So even though lab results belong to the patient, I firmly believe it is best that test results be reviewed with a professional – because seeing and understanding can be two very different things.