But then again Osler was a known practical joker and died in 1919 when the
most advanced piece of medical laboratory technology was the microscope.
Whether evidence will support the notion that history and examination are
the best diagnostic tools I doubt. If we take an analogy from astronomy, it
is clear that the Sun moves across the sky while we remain stationary......
Trevor Tickner
-----Original Message-----
From: Alter, David N. [mailto:[log in to unmask]]
Sent: 22 January 2003 12:55
To: [log in to unmask]
Subject: Re: sensitive CRP and CHD
for the same reason that Sir Edmund Hillary climbed Mount
Everest.....because it was there. But seriously, clinicians are a funny lot
despite claims that an unexpected lab result or one that they don't know how
to lump into a differential diagnosis must be lab error and
despite Osler's aphorism that stated:
Let me take the history,
Let the medical student perform the physical exam,
Throw the lab results away,
And I'll give you the diagnosis
and despite the fact that the history and physical are the best diagnostic
test available,
Clinicians still want more and more lab tests to make there job easier (or
more precise?)
David Alter, MD
Clinical/Chemical Pathologist
Spectrum Health
Grand Rapids MI
-----Original Message-----
From: Paul Masters [mailto:[log in to unmask]]
Sent: Wednesday, January 22, 2003 5:07 AM
To:
Subject: Re: sensitive CRP and CHD
Irrespective of the practical difficulties of using hsCRP in individuals I
would ask why the world needs another cardiac risk factor? We don't exactly
have a good record in treating the traditional ones, or indeed the patients
who have IHD already.
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