Misrepresentation of a medical study is unfair to me (and you), the patient.

This is what you see when you click on this well-known, well-read blog. 

"How medication mistakes happen in the hospital"

Here is what you see when you click on the original article.  Same article, just a different title:

When Asked, Patients Can't Tell

By Katrina Woznicki, Contributing Writer, MedPage Today
Published: December 10, 2009
Reviewed by Zalman S. Agus, MD; Emeritus Professor
University of Pennsylvania School of Medicine and
Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner

Now, what does the original study really say?

"Lack of patient knowledge regarding hospital medications^"

I posted a comment (as of yet not approved by the moderator, probably due to the late hour):

The original study report may be found here: http://bit.ly/8Dtzv1
This article by Ms. Woznicki does not clearly identify the nature of the study and the findings. According to the study, these were meds given IN THE HOSPITAL. It clearly indicates a reason for INCLUDING THE PATIENT, not incriminating the patient!

“Without a system to incorporate the patient into hospital medication management, these patients will be disenfranchised from participating in inpatient medication safety. These results are a call to reexamine how we educate and involve patients regarding hospital medications. Mechanisms to allow patients to provide feedback to the medical team on their hospital medications might identify errors or improve patient satisfaction with their care. However, the systems and cultural changes needed to provide education on inpatient medications are considerable. Future research is needed to determine if increasing patient knowledge regarding their hospital medications would reduce medication errors in the inpatient setting and how this could be effectively implemented.”

To me, this also points out why we need to be careful of 2nd/3rd party “interpretations” of studies which are done.

The problems I see (and I'm assuming you are able to read all three, so won't "read" for you):

1. The title of the original Medscape article has been changed on the blog and is misleading
2. The Medscape article did not represent well the original study
3. The original study actually shows the need for further informing/involving of the patient.

How did a decent study get turned around into something I clearly believe it did not show?  And do the authors of the original study realize this has happened?

As a patient, I'm tired of misrepresentation for any reason, and especially to get headlines.  Most of all, things like this from well-known "experts", even inadvertently, have severe repercussions for me, the patient.  It's time we stood our ground on this.  Patients aren't stupid.  We can read.

BTW, this is another reason patients need to read the original studies and have access to them.

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Natural is not the same as "bioidentical"

The Alternative that Isn’t: Bioidentical Hormones

A very brief excerpt from this excellent article:

BHT is the alternative that isn’t. It isn’t safer, it isn’t more effective, and it isn’t based on sound or convincing science. Celebrity advocates and anecdotal evidence are easy to find, but the scientific data to support the broad claims of BHT advocates is absent. Without reassurance about risk or benefit, BHT is not an appropriate or safe option for the overwhelming majority of women.

I’m a patient. What should I know?

BHT therapy means more unknowns than HRT. These risks could have serious long-term health consequences. Despite what you may read on the internet or what you are told by your physician or pharmacist, you must assume the risks of BHT are at least equivalent to that of HRT.

This is a must-read article.  Excellent research with great explanations are included.

Sidenote: I don't like the broad statement about salivary tests for hormones.  There is a lot of peer-reviewed research showing the effectiveness of testing salivary cortisol with approved methods.  However, these are done in combination with OTHER testing, also.

BBC: Low [thyroid] hormone levels in pregnancy linked to hard birth

Expectant mums who are low in a hormone made by the thyroid gland in the neck are more likely to struggle in labour, findings suggest.

Not only are these labours generally longer and harder, they are also more likely to end in an assisted delivery with forceps, ventouse or a Caesarean.

The article talks about abnormal positioning of the infant prior to birth and information on problems for the infant during development, also, if the mother's thyroid hormones are off. 

To read the whole article: Low hormone levels in pregnancy linked to hard birth

Glen Whitman on Medical Innovation

"...don't just fix the parts that are broken; we have to also make sure we don't break the parts that are working very well..."

"We lead the world in medical innovation..."

Severe Childhood Obesity and Missing DNA

Missing Chunks Of DNA Can Promote Severe Childhood Obesity In Rare Cases, Study Suggests

Remember the case of the Columbian baby who was news a little over a year ago?  You can read about it here when I wrote about it then:

Eleven-month-old Colombian baby is the weight of an eight-year-old --Can you say "Zebra"?

I hope someone working with this study saw that video, too.  According to the article, "[t]hey found evidence that several rare deletions [of DNA] may promote obesity, including one kind they studied further and found in less than 1 percent of about 1,200 severely obese children."

Thankfully, Dr. Farooqi also intervened with obese children cases under scrutiny by British child welfare authorities and showed they had the chromosome 16 deletion, taking blame off the parents. 

I realize there are many causes for obesity, and that many are due to overeating and under-exercising.  But I also know that those who really have a valid, medical problem which leads to obesity are most often derided and thrown into that same category.  Not only are there endocrine reasons, but now there are definitely genetic reasons for some.  I predict there will be more and more of this uncovered in the near future.

(Thank you to the Cushings-Help message board member who posted this article!)

Read the Nature article here:  Large, rare chromosomal deletions associated with severe early-onset obesity

Evaluating Thyroid Function: The Clinical Advisor

Laura M. Gunder, DHSc, MHE, PA-C, and Sara Haddow, MSA, PA-C

November 30, 2009

Myxedema is caused by the deposition of hyaluronic acid in patients with thyroid disease.

At a glance

• The serum thyroid-stimulating hormone is the best initial test of thyroid function.
• Abnormal protein levels can have significant effect on the total thyroxine (T₄) results.
• Subclinical hyperthyroidism and subclinical hypothyroidism are exclusively laboratory diagnoses.
• Re-evaluate patients with subclinical hypothyroidism within three months of detection and then every six months.

Read the rest of this excellent article here:  The Clinical Advisor

I would like to point out that measuring TSH only is misleading for many, many patients, especially those who have had or still have a pituitary adenoma.   Also, anyone who has had surgery for a pituitary adenoma cannot rely on TSH values to determine hypothyroidism.