Study Finds 21 Percent of Patients are Misdiagnosed

Do I Need A Second Opinion?

A study published in the Journal of Evaluation in Clinical Practice on April 4, 2017, found that more than 20 percent of patients are misdiagnosed. The study titled “Extent of Diagnostic Agreement Among Medical Referrals” looked at the diagnosis originally given to patients and compared that to the diagnosis later given upon the patient seeking a second opinion.

Study Finds 21 Percent of Patients are Misdiagnosed - Austin-TX-Chiropractor-Sciatica-Leg-Pain-Butt-Down-FootThe study reviewed the records of 286 patients who were referred by their primary care doctor to the Mayo Clinic’s General Internal Medicine Division in Rochester, Minn., over a two-year period from Jan. 1, 2009 to Dec. 31, 2010.

Overall, the results showed only 12 percent of those seeking a second opinion at the Mayo Clinic had their diagnoses confirmed. However, 21 percent of the patients had their diagnosis completely changed, while 66 percent of those patients received a refined or redefined diagnosis. Overall, the study showed that almost 88 percent of patients seeking a second opinion at the Mayo Clinic receive a new or refined diagnosis.

Previous research cited in the new study showed that errors in diagnosis “…contribute to approximately 10 percent of patient deaths.” Additionally they “…account for 6 to 17 percent of adverse events in hospitals.”

“Effective and efficient treatment depends on the right diagnosis,” said study co-author James Naessens, a health care policy researcher at the Mayo Clinic, in an April 4th press release in Science Daily. “Knowing that more than 1 out of every 5 referral patients may be completely [and] incorrectly diagnosed is troubling — not only because of the safety risks for these patients prior to correct diagnosis, but also because of the patients we assume are not being referred at all.”

In a Washington Post article, Mark L. Graber, a senior fellow at the research institute RTI International and founder of the Society to Improve Diagnosis in Medicine, who was not involved with the study noted, “Diagnosis is extremely hard. There are 10,000 diseases and only 200 to 300 symptoms.” He added, “Doctors are humans, and they make the same cognitive mistakes we all make. If you are given a serious diagnosis, or you’re not responding the way you should [to medication], a second opinion is a very good idea. Fresh eyes catch mistakes.”

Second opinions are still encouraged, but the concern is that they may be limited due to in-network insurance issues preventing patients from seeking second opinions. In response to the problem of diagnosis error, the National Academy of Medicine has called for dedicated federal funding for improved diagnostic processes and error reduction.

It is obvious that there is an increase in cost both in diagnosis and medical treatment if the first diagnosis is not confirmed by the second opinion. However, Naessens sums up the concerns if a second opinion is not sought saying, “Total diagnostic costs for cases resulting in a different final diagnosis were significantly higher than those for confirmed or refined diagnoses, but the alternative could be deadly.”

If you or anyone you know could benefit from a better functioning nervous system, please call us at 512-452-2525 to schedule a consultation with Dr. Swanson. Austin chiropractor located in north central Austin, TX.


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Being Overweight Does not Affect Outcome of Back Treatments, But Being Obese Does

How Likely Am I To Get Back Pain? Does BMI Play A Role?

A study published on December 12, 2015, in the journal Chiropractic & Manual Therapies showed that being overweight or underweight does not have a significant effect on the outcome of various lower back pain treatments. However, being obese did have a negative impact on the results of care. The study begins by reporting that nearly 30% of the world population reports suffering from back pain while 80% report back pain at some point in their lifetime.

Being Overweight Does not Affect Outcome of Back Treatments, But Being Obese Does - Austin Texas Chiropractor Best Car Accident Injury Doctor Help PainIn this study, 681 people with lower back pain were included. Data was collected from each of the participants about their history of back pain, demographics, occupation history, disability, health status and mental health status. The participants were enrolled into one of four treatment protocols: medical care only, medical care with physical therapy, chiropractic care only, or chiropractic care with the use of physical modalities.

The participants were all treated according to the protocol of the doctor they were assigned to, using one of the four types of care categories. Outcomes of care were measured at 2 weeks, 4 weeks, 6 weeks, and 6 months after the initial treatment. For the purposes of this study, a comparison of the various types of care was not made to see if one type of care was more effective than another. Only the effects of weight as measured by body mass index (BMI) were evaluated to see if it had an effect on the results of whatever type of care the person was receiving.

The results showed that, across all treatment protocols, people who were considered to be obese had a decreased chance of improvement with their lower back pain. This included all times of follow-up as well as all levels of pain. However, being overweight, but not considered obese, did not have a significant effect on the outcome of care for any of the categories of care. Similarly, those who were underweight also did not show any significant decrease in their percentage of recovery.

The study did show that those who were obese and lost weight during care did have a better chance at recovery, and those who gained weight during care reduced their chance even further. All other groups of people showed no statistical difference in their ability to recover based upon their weight, unless they were considered to be obese.

In their discussion the authors wrote,  Results of this study suggest that BMI is a relevant predictor of response to treatment. Obese participants are less likely to show improvement from LBP treatment regardless of the care they receive.  They also stated in their conclusion,  an association between obesity and less favorable treatment outcomes was inferred in this study. There appears to be an association between obesity and disability as well as obesity and subjective most severe pain.

If you or anyone you know could benefit from a better functioning nervous system, please call us at 512-452-2525 to schedule a consultation with Dr. Swanson. We are located in north central Austin, TX.


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Fever Resolved in Child with Chiropractic Care

Is A Fever A Good Thing? Can Chiropractic Care Help the Immune System Fight Infection?

The Journal of Pediatric, Maternal & Family Health published a case study on December 22, 2016, documenting the case of a young boy with acute fever being resolved with chiropractic. Fever is triggered by an activation of the immune system as it fights things such as bacteria and viruses.

Fever Resolved in Child with Chiropractic Care - Austin Texas Chiropractor Pediatric Kids Infants Babies Newborns Spinal CareThe Mayo Clinic states,  “A fever is a temporary increase in your body temperature, often due to an illness. Having a fever is a sign that something out of the ordinary is going on in your body.”  They continue by noting, “Fevers generally go away within a few days. A number of over-the-counter medications lower a fever, but sometimes it’s better left untreated. Fever seems to play a key role in helping your body fight off a number of infections.

This study begins by pointing out that although there are many anecdotal reports of chiropractic being effective for cases of fever, there is little in the way of published studies on this subject. Most of the published evidence for chiropractic care is for musculoskeletal conditions such as back and neck pain. However, additional studies have shown chiropractic being helpful for conditions such as menstrual disorders, asthma, chronic obstructive pulmonary disease, hypertension, colic, ear infections, and bedwetting.

In this case, an 11-year-old boy was brought to the chiropractor. Five days before his chiropractic visit, he developed a fever along with symptoms of general malaise, fatigue, and behavioral changes such as decreased activity, lethargy, and decreased communication. His temperature was monitored by his mother and ranged from 101 degrees to 103 degrees Fahrenheit. The boy’s mother was giving him acetaminophen (such as Tylenol) every 4-6 hours with no change in the fever. After 2 days of the fever, the boy was seen by an MD and prescribed amoxicillin for acute unspecified upper respiratory infection.

A chiropractic examination was performed which showed muscle tightness and swelling. Additionally, spinal range of motion showed restrictions. Specific chiropractic adjustments were administered to the boy based upon the findings.

The boy’s mother checked her son’s temperature upon returning home which was approximately one hour after the chiropractic visit. She reported that her son’s temperature had returned to normal at 98.4 degrees. Additionally, she reported that her son’s energy increased and he returned to his normal behavior of being talkative, active, and had increased ability to focus.

The boy reported that within 60 minutes of the first adjustment he felt  back to normal  and was no longer achy, sore, or having headaches. His mother reported that his temperature remained normal and he continued to be energetic, talkative, and back to his regular level of activity.

In their discussion the study authors stated,  This case report outlined the care of a male child with acute illness resulting in both immunological and musculoskeletal symptom improvement within 60 minutes of treatment and was sustained at follow-up appointments.

If you or anyone you know could benefit from a better functioning nervous system, please call us at 512-452-2525 to schedule a consultation with Dr. Swanson. We are located in north central Austin, TX.


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