The July 2010 publication of Annals of Internal Medicine included report of a study lead by Dr. Saul Weiner, physician at University of Illinois Medical Center in Chicago. The study investigated errors in diagnoses and treatment choices as an outcome of providers missing contextual information in patient histories. Contextual information includes data such as work and home environments, and is a source for recognizing conditions caused by contact, exposure or engagement with a biological or chemical factor.
One group of patients who would greatly benefit from further contextual questions is those diagnosed with mesothelioma. Mesothelioma is a rare cancer affecting about three thousand Americans each year. Mesothelioma is caused by exposure to toxic chemical asbestos, which is often an occupational hazard. Many mesothelioma patients have no idea they have been developing the disease, particularly if they do not know and are not asked about possible asbestos exposure.
During asbestos exposure, if asbestos fibers are inhaled, a mutation can begin in the lining of abdominal cavities, such as the heart or lungs. This starts a growth process of irregularly patterned malignant tumors. Mesothelioma takes twenty to fifty years to demonstrate symptoms which mimic those of pneumonia and bronchitis; it is very difficult to properly diagnose mesothelioma. There are mesothelioma treatments available, but no known cure.
The study by University of Illinois used 100 participating doctors who were visited by medical-actor patients. These patients presented with bio-medical red flag symptoms. Results showed key information was missed during patient interviews between 62 and 88% of the time.
In cases of mesothelioma and other conditions where environmental factors can be the cause, questioning beyond the standard intake forms is necessary to understand harmful exposure potential.
The President’s Cancer Panel recently presented President Obama with a report entitled,
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