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<text id=90TT0630>
<title>
Mar. 12, 1990: Unbelievable Blood Tests
</title>
<history>
TIME--The Weekly Newsmagazine--1990
Mar. 12, 1990 Soviet Disunion
</history>
<article>
<source>Time Magazine</source>
<hdr>
MEDICINE, Page 79
Unbelievable Blood Tests
</hdr>
<body>
<p>Laboratory reports are often misleading or downright mistaken
</p>
<p> Medical testing centers have plenty of business these days--perhaps more than they can properly handle. Prompted by fears
of everything from AIDS and Lyme disease to high cholesterol,
record numbers of people are lining up to give a blood sample
and get back the good news, or bad. Too frequently, though, the
news is just plain wrong. Several recent studies have revealed
disturbing sloppiness or simple error in the way some blood
tests are conducted and interpreted.
</p>
<p> Among the worst offenders are public cholesterol-screening
programs. Such centers, already a familiar sight in supermarkets
and shopping malls in some parts of the U.S., may become even
more common in the wake of a Government report issued last week.
The report recommended a low-fat, low-cholesterol diet for
everyone, not just those at risk for heart disease.
</p>
<p> In a study of four public cholesterol-screening programs,
published last week in the Journal of the American Medical
Association, researchers found that only one produced accurate
results consistently. The worst program was off the mark in
almost 25% of the tests. A recent survey by the Department of
Health and Human Services of such mass operations found that the
"technicians" conducting the tests often had little or no
training. More than half the people screened at 71 sites had
their fingers squeezed, or "milked," to draw blood. This is
known to dilute the blood with other fluids and produce an
artificially low cholesterol reading. Says HHS inspector general
Richard Kusserow: "Sometimes these operations looked more like
a sideshow at a carnival." When blood is drawn in a medical
setting by trained personnel, such error is less likely.
</p>
<p> Lyme-disease tests can be inaccurate, even if carried out by
experienced professionals. In a study reported in J.A.M.A.,
blood from the same 101 people was taken to three testing
centers. One lab found 23 cases of Lyme, but the second
discovered 31 cases, and the third came up with 43. The main
problem is a failure to standardize Lyme tests from lab to lab.
</p>
<p> Tests for AIDS are more accurate, but problems have arisen
in reporting the results. In a study of 13 labs in the Western
U.S., researchers discovered that written test results often
contained misleading information. Several lab forms incorrectly
stated that a positive result meant only that one had been
"exposed" to the virus. In fact, it means that one is infected.
The authors of the report said such imprecision could confuse
doctors, particularly those having little experience with AIDS.
</p>
<p> Stricter U.S. regulations on laboratory procedures are
scheduled to go into effect this year, and the Government will
increase the number of labs being inspected nationwide from
12,000 to 300,000. But the task is enormous, and many labs may
still escape the enhanced surveillance. So anyone troubled by
the results of a cholesterol test or other blood exam might be
smart to follow that age-old advice applying to medicine in
general: get a second opinion.
</p>
<p>By Andrew Purvis.
</p>
<table>
SLOPPY SCREENING
A U.S. study of public cholesterol testing found widespread
unacceptable procedures:
% OF PEOPLE
PROBLEM CITING PROBLEM
Patient's finger was improperly
"milked" to obtain blood 58%
Staff did not change gloves with each new patient 50%
Staff did not wear gloves 35%
Work area was dirty 11%
</table>
</body>
</article>
</text>