Classic disease-mongering - maybe 10 million Americans with this underrecognized problem

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An interesting story on a condition called FMD, or fibromuscular dysplasia, soon tumbled into an exercise in disease-mongering. Excerpts:

"I believe that a large number of Americans have FMD," says Jeffrey W. Olin, director of vascular medicine and a professor at the Mt. Sinai School of Medicine in New York City. "It's reasonable to say that many thousands could be saved from complications like heart attack, stroke, ruptured aneurysm and even death, by screening patients."

...Dr. Olin has prepared a top-10 list of doctors' misconceptions and missteps. They include, "Telling patients that the symptoms are all in their head. Telling patients that FMD is a rare disease. Telling patients with severe headaches with FMD that there is nothing that you can do for them."

..."Three to five percent would be a very reasonable estimate in the general population for FMD," says Thom W. Rooke, vascular medicine professor at the Mayo Clinic. That works out to there being possibly 10 million Americans who have FMD, he says. By comparison, an estimated 3 million Americans have epilepsy, 2.5 million have breast cancer, more than 2 million have schizophrenia and 725,000 have melanoma.

Dr. Rooke says many FMD patients might never have symptoms, and only a few are likely to experience severe problems. But, he says, many "vascular catastrophes," such as heart-rhythm deaths and strokes in young people, may stem from FMD.

The screening assertion is never clarified nor challenged. It is just left hanging out there: maybe 10 million Americans with this silent problem. If only we screened for it!

Whom would you screen?

When would you start?

What's the number needed to screen in order to prevent one event?

What evidence is there for effectivness of such screening?

The WSJ reporter in question has done this kind of story before - pro-vascular-screening advocacy without the perspectives of anyone who might challenge the prudence of such screening recommendations.

Dartmouth's Dr. Gil Welch, in response to that previous pro-screening story, wrote me: "Screen many, to find the few -- while many others get labeled at risk in the process. And thus many will be treated "wrong." "

Why isn't that important perspective included in this kind of story?

1 Comment

What needs to be mention is that this disease is often over looked and under diagnosed. Education is the key to preventing problems. If we are willing to find the cause of hypertension in a young person, many medical catastrophes could be prevented. You need to understand that a majority of patients diagnosed with this disease have been misdiagnosed for years, sometimes loosing a kidney which can be prevented. Yes, I agree many diagnostic tests is not the answer, but how about taking a simple blood pressure, listening for bruits.... that is basic assessment skills that each physician and nurse should be doing. If you see hypertension in a young patient how about ordering a renal ultrasound?

About this Entry

This page contains a single entry by Gary Schwitzer published on June 29, 2009 3:05 PM.

There's always another test you can do. We have a problem saying "We're done now." was the previous entry in this blog.

CBS claims exclusive but leaves vital info out of heart stem cell story is the next entry in this blog.

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