Originally published July 8 2009
Lethal Consequences Result for One in Four Patients Not Shown Test Results
by Michael Jolliffe
(NaturalNews) As many as one in four patients are not informed of abnormal medical results, with potentially fatal consequences, according to a new study published in the Archives of Internal Medicine.
Research headed by Dr Lawrence Casalino, chief of the Division of Outcomes and Effectiveness Research in the Department of Public Health at Weill Cornell Medical College, reviewed more than 5000 patient records randomly selected from across the US to assess the effectiveness of test result communication and follow-up care in general medical practice.
Findings revealed that physicians were commonly at fault for patients failing to be notified of even clinically significant medical issues such as abnormal mammography and smear tests, and blood work with results definitively outside of the normal reference range. Mismanaged results included both health issues that presented an immediate danger and those with potential long-term implications for the health of the patient.
These findings occurred despite the researchers allowing what they considered to be a generous follow-up period of 90 days for most of the records examined. Dr Casalino and co-colleagues measured their results across three failure criteria: no record of the patient being informed, the physician stating in the study survey that patients had been informed but this not being documented, and the physician admitting in the survey that the patient was yet to be informed. For all criteria, as many as one in four and an average of one in fourteen patients had not been informed of their abnormal health results, according to the study guidelines. Unexpectedly, the study also found that records kept electronically were the most poorly managed.
"We found that very few physician practices had explicit rules for managing test results" wrote Dr Casalino in 'Frequency of Failure to Inform Patients of Clinically Significant Outpatient Test Results'.
"Failure to report abnormal test results can lead to serious, even lethal consequences for the patient." [1]
The current research is the third such multi-site study to expose problems in the effectiveness with which patients are informed of important health findings. In a 2004 study published in the Journal of General Internal Medicine close to one third of patients with abnormal mammogram results did not discuss them with their physician. [2] Similarly a patient survey carried out in 2006 revealed that more than one in ten patients had experienced long delays in receiving significant test results within the last year. [3]
Public health experts are calling for tighter control of test result management in order that all patients with abnormal laboratory results receive proper follow-up care.
[1] Casalino et al. Frequency of Failure to Inform Patients of Clinically Significant Outpatient Test Results. Archives of Internal Medicine. 2009; 169(12):1123-1129.
[2] Poon EG et al. Communication factors in the follow-up of abnormal mammograms. J Gen Intern Med. 2004;19(4):316-323
[3] Schoen C et al. Toward higher-performance health systems: adults' health care experiences in seven countries, 2007. Health Aff (Millwood). 2007; 26(6):717-734.
About the author
Michael Jolliffe is a freelance writer based in Oxford, UK.
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