Friday, September 29, 2006  Take Your Lumps  What to do with a
patient referred for a finding that you can't interpret on a
test you'd never have ordered? It's a tough one, and not as rare
as you might think, especially in the area of breast lumps. As a
topic for posting, the subject comes up in a roundabout way. A
couple of other medical bloggers picked up on my mammorable
patient" post, and a comment on Orac's site raised the issue of
the morbidity of medical screening. It's a fruitful object of
scrutiny: false positives, for example, (a finding that requires
further evaluation, possibly invasively, that turns out to be
nothing) add up on the other side of the ledger. If a person
suffers harm -- or even death -- from investigation arising from
some sort of routine screening (for whatever...), when the issue
raised turns out to be harmless, well, that's not a good thing.
There's lots to say about it. I won't, exactly, now. It's just
that it reminded me of something that used to drive me crazy.  I
could rant