No news can be bad news with medical test results


By Shara Yurkiewicz

"No news is good news" is what most patients assume when they’re waiting to receive test results. But "no news" actually meant "bad news" for one out of 14 patients with troubling labs, according to a study published Monday in the Archives of Internal Medicine.

The study, led by Dr. Lawrence P. Casalino of Weill Cornell Medical College in New York City, examined more than 5,000 records of randomly selected middle-aged patients from 23 primary care practices.


The patients had received common blood and screening tests, including mammograms, pap tests, cholesterol tests and red blood cell counts. Almost 35% of the patients had abnormal results that fell well outside the normal range. But in 7.1% of those cases, practices did not inform — or document that they had informed — the patients.

Such communication failures could have serious, even lethal, consequences, said Casalino, a family practice physician whose research focuses on patient safety.

Some patients weren’t informed of total cholesterol levels as high as 318 milligrams per deciliter, well above the 200 mg/dL threshold that is considered worrisome. If left untreated, such levels could eventually result in a stroke or a heart attack for some patients.

Seeing those numbers "would clearly require a doctor at the very least to have a discussion with the patient" about lifestyle changes, medication or other forms of intervention, said Dr. David Meltzer, a physician and health economist at the University of Chicago, who also worked on the study.



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