of what's wrong with health care in the U.S. From NYTimes stenographer -- perhaps voice recognition software connected to a word processing program, although ostensibly a human being -- Gina Kolata. A consensus panel on Alzheimer's disease is about to recommend new guidelines for diagnosis:
Under the new guidelines, for the first time, diagnoses will aim to identify the disease as it is developing by using results from so-called biomarkers — tests like brain scans, M.R.I. scans and spinal taps that reveal telltale brain changes.
The biomarkers were developed and tested only recently and none have been formally approved for Alzheimer’s diagnosis. One of the newest, a PET scan, shows plaque in the brain — a unique sign of Alzheimer’s brain pathology. The others provide strong indications that Alzheimer’s is present, even when patients do not yet have dementia or even much memory loss.
Earlier, we have been told:
If the guidelines are adopted in the fall, as expected, some experts predict a two- to threefold increase in the number of people with Alzheimer’s disease. Many more people would be told they probably are on their way to getting it. The Alzheimer’s Association says 5.3 million Americans now have the disease.
This sounds like a great advance, right? The idea is that people in their 50s will routinely be given PET scans and spinal taps, and then their doctors will tell them that they have "pre-clinical Alzheimer's disease" and can expect to start forgetting stuff in ten years or so. Meanwhile, presumably, they will periodically see neurologists who will give them assessments to see if it's happening yet.
There's only one teensy weensy little reason why this might not be such a great idea after all. Doctors can do absolutely nothing about it. The knowledge will be completely useless. However, it will represent a whole lot of income for radiologists and neurologists, as well as a whole lot of anxiety and pain for 5 or 10 million people who will now be officially diagnosed with a disease which is causing them no symptoms whatsoever and which nobody can do anything about.
Sounds like a plan.
3 comments:
The biomarkers were developed and tested only recently and none have been formally approved for Alzheimer’s diagnosis.
Um, so why are they recommending it when it hasn't been approved for diagnosing Alzheimer's? Furthermore, any doctor who recommends a spinal tap for no effing reason should be shot.
I like this wording though: If the guidelines are adopted in the fall, as expected, some experts predict a two- to threefold increase in the number of people with Alzheimer’s disease. They don't say that 2- to 3-fold increase is in diagnoses; it's in the disease's occurrence. Funny how that works.
there isn't any clinical benefit to the patient -- quite the opposite. and i worry about the side-effects of insurance and/or employers hearing about this kind of "pre-diagnosis." etc. sounds like a good way to wreck your life, based on something unproven, and about which nothing can be done.
what really matters is the functioning of the patient, and how to alleviate problems. there is far too little attention being paid to that end of things already, without condemning people who are currently doing just fine.
so we can stew about it for some years and then we'll forget about it when it matters anyway.
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