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What Do Lab Tests Really Mean?

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Lab Test Analysis
All forms of health care practice have made great advances in the last thirty years. Laboratory testing has also improved, both in the range of tests available and the rapid turnaround-time of results.

But no lab test is perfect. Tests may miss the presence of the disease or may falsely suggest a patient has a particular disease. Either situation may create serious problems.

For example, MRIs are an important tool. They reveal more information than ever before. But this comes with a price. Not every suspicious shadow on an MRI means something. Experience in interpreting MRI images is gained over time. Often technology becomes available well in advance of our ability to accurately interpret the results.

Lab tests need to be interpreted with caution. Accurate diagnoses need supporting evidence - in terms of patient history, physical signs, and symptoms - in addition to lab results.
You're at the doctor's office because you think something might be wrong. Rationally, you know tests are probably necessary, but getting the tests done sometimes provokes a lot of anxiety in all of us. We want to know the results, but are very concerned about the outcome."You need blood work" your doctor remarks casually. Your insides do an immediate flip-flop and you feel as if you've just begun hurtling down a very steep roller-coaster.

And when the results come back,  it's tough to understand the medical jargon, particularly if the tests are "positive". We've all had the experience of "going south" and not listening to another word that's said after the initial "your test results are positive". Our minds are racing ahead, imagining all the awful possibilities.

Rarely, a considerate physician will be able to put the lab results in a less-worrisome perspective for the patient. For patients, it's important to know some key facts - facts that will empower you any time you need lab tests done.

First, statistically one out of every 20 tests performed will be reported as "abnormal" - even though the result is "normal" for the person being tested. If you are perfectly healthy and have 20 tests done on your blood sample, one of those 20 test results will be "out of the normal range" based on statistics alone.1

This is because a normal test range is calculated by eliminating the top 2.5% and the bottom 2.5% of results for a large group of  normal people. This leaves the "normal range" as 95%. So if 20 tests are done, statistically one will be "abnormal", because its results fall in the top or bottom 2.5%. The result is normal for you, but reported as "abnormal".

Other factors to consider are the sensitivity and specificity of the lab test.2 Sensitivity relates to the test's precision in detecting the disease when the disease is present. If a test for colon cancer was 90% sensitive, it would miss ten cases of the disease out of every 100 cases. Specificity relates to whether a positive test actually indicates the presence of the disease you're being tested for. If a test is 90% specific, in ten cases out of 100 positive results, the patient does not actually have the disease.

So if a test has low sensitivity, actual cases of the disease may be missed. If a test has low specificity, test results reporting the presence of the disease may be wrong. All these factors need to be considered in accurately interpreting test results. Things are not always as they seem.3

Bottom line - test results always need to be evaluated in the specific context of the patient. An isolated lab result - or set of results - needs to be related to the patient's condition and circumstances. An accurate diagnosis is not based on lab results alone. That could be a big mistake. Similarly, x-ray, ultrasound, or MRI results need to be interpreted in context also.
Trying to interpret an x-ray without any clinical information is likely to lead to a wrong conclusion. Context is everything. If you have questions, we will be able to explain why certain tests are necessary.

1Thomas SL, et al: How accurate are diagnoses for rheumatoid arthritis and juvenile idiopathic arthritis in the general practice research database? Arthritis Rheum  59(9):1314-1321, 2008
2Friston KJ, et al: Classical and Bayesian inference in neuroimaging: theory. Neuroimage 16(2):465-483, 2002
3Kobayashi M, et al: Intraindividual variation in total and percent free prostate-specific antigen levels in prostate cancer suspects. Urol Int 74(3):198-202, 2005


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We value our patients' experience at Stamford Sports & Spine. If you are currently a patient, please feel free to complete the following Client Experience Questionnaire. The Questionnaire is in Adobe Acrobat format, and requires the free Acrobat Reader to view.

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Dr. Andrew Zomick & Dr. David Avallon

I have been coming to Stamford Sports and Spine for almost 10 years. I am active and have unfortunately been in a few car accidents. The care and treatment offered at Stamford Sports and Spine is world class and without them I would be living with an inordinate amount of pain and discomfort. Going to Stamford Sports and Spine has made my injuries manageable.

--James


Very good team of therapists. Flexible and available schedule. They helped get my teenage athletes back on the field in half the time.

--Shawn


I was experiencing some pain in my right shoulder and numbness down my arm to my hand. The range of motion in my shoulder was limited and I could not participate in volleyball. Dr. Z came to our office offering a free chair massage and a chance to come in for an evaluation. I did this and we worked out a treatment plan that included therapy and adjustments. I noticed in the first few weeks the pain subsided greatly in my shoulder. The numbness in the arm and hand were present but noticeably better. After three weeks, the range of motion in my shoulder was back to normal and the pain was gone. Now after one month of therapy the numbness in the arm is extremely better and I do not notice the symptoms as often as I used to. Coming into the office has helped tremendously. I can now play volleyball pain-free.

--Mary


After moving from London to the USA, two weeks into living in Stamford and having carried and unpacked a lot of heavy boxes my shoulder froze and I was in a great deal of constant pain. After finding Stamford Sports & Spine on the internet I made an appointment and the corrective programme S.S.S. put together for me meant that I immediately had some pain relief, and over the next few weeks the pain left completely. The programme is also ensuring that I am not only pain free but fully corrected so as this problem should not occur again. Very friendly staff and very detailed assessment programme that has ensured my full recovery.

--Laura


From my first visit to Stamford Sports & Spine I was extremely impressed and pleased with their service. Everyone including staff and doctors were very knowledgeable with their chiropractic services. I learned a great deal about my symptoms and overall care more than I expected. I have visited a few other chiropractors but none were as thorough as Stamford Sports & Spine. I was experiencing severe pain in my shoulder and arm and after a few visits my pain decreased substantially. I really appreciate all the services from the adjustments, rollers and even exercise room. I would highly recommend this facility to everyone. The entire staff are friendly, professional and just simply great!

--Sherri


Everyone was incredibly professional and helpful.  The staff is friendly and goes beyond what was expected to meet my needs and education me about my condition.

--Jon


Came in with severe and constant numbness and tingling in my legs and feet. The treatment worked quickly and resolved all of my symptoms. Thanks!

--Erik


My arms were falling asleep every night and had numbness and tingling during the day. I no longer have any of those symptoms during the day and have very rare episodes of pain at night due to my treatment here at Stamford Sports & Spine

--Eric


I came in for hip pain and stiff neck that also affected my right arm and hand. Using the relaxing rolling / traction bed and electrical muscle stimulation along with stretching and the adjustments my hip pain is gone. I can walk without sharp pains running up and down my legs. My neck range of motion has improved and my muscles are more flexible and less spastic.

--Karen


I had severe neck pain which was aggravated by a recent move. I have been coming to be adjusted for a few weeks now and not only has it helped with the neck pain I had been experiencing, but it has also made me feel better overall. I feel like I am able to sit up straighter, and my muscles are looser and less tense. I no longer have the intense pain I had once been experiencing

--Kim


When I came in my pain was a 10 out of 10. After just one week of care my pain went down to a 4 and has been improving ever since. The staff are very friendly and great educators. I learned a lot about my body and how to take better care of myself.

--Heidi


After a car accident,  I had to seek help for my upper back and neck pain. Slowly but surely I started to feel better, not immediately, but by keeping up with my visits with Dr. Q & Dr. Z. Now I can tell you that I feel leaps and bounds better, and am now looking forward to a pain-free summer.

--Rudy


I have been with Stamford Sports & Spine for more than a year now. I still remember how much pain I was in during my first session. I can now walk in and out without any aches or pains.

--Rick


When I first started going to Stamford Sports & Spine, my back had been seizing up with alarming regularity. After just a few months of working with Dr. Z and Dr. Q, I feel much more confident in my daily activities and have even been able to return to the gym.

--Dan


Thank you to Dr. Z, Dr. Q and the whole Stamford Sports & Spine team! For many years, I have been suffering from severe back pain that would sometimes keep me from going to work. The recurring pain would come and go and I couldn't figure out what I was doing to cause it. When I came to the office, Dr. Z took x-rays, did a complete examination and educated me as to what was happening and why. I began treatment and was given exercises to prevent these injuries from happening in the future. Since starting the treatment, I have seen a great improvement in my back. The pain is gone and I have an increased range of motion. Thanks again to the entire staff who are very friendly and always willing to accommodate my hectic schedule when I make appointments.

--Ron


The strabismus in my eyes caused a vertical deviation in my eye placement.  This resulted in my head naturally tilting to the right and throwing my muscular structure in my neck and shoulders off.  I had accepted the tilt and tightness as a way of life and a natural dis-figuration of my spine.  I almost didn't sign on for initial treatment.  After 3 visits I have already noticed a difference in the position of my head, my posture and regular comfort levels.  There is still a ways to go to rid that area of  a lifetime of dysfunction, but what a relief to know it's treatable and already improving.

-Jenn


I found Dr. Z and Dr. Q earlier in the week after experiencing some back pain and sciatica. After the consultation and x-rays I began therapy. After just 2 treatments I felt much better and had a significant reduction in discomfort in the area of concern. I am looking forward to continuing my treatment in an effort for long term recovery and a return to my heavy exercise routine.

--Tom


FANTASTIC. When I leave I feel like a whole new woman. I have been going there for my neck pain and headaches for about 1 year now; off and on and ever since I started treatment there my headaches have been reduced to one every few months instead of a few every month. The intensity of of my pain has also been reduced to almost nothing. The doctors seem to have a very friendly relationship with all of the patients and I feel very welcomed by the staff as well. Not to mention I love how they incorporate therapeutic massages into my treatment. I have since sent over many of my colleagues and family, who also share the same feelings. Thank you.

--Bri


I had a great experience. My low back pain is completely gone. I found the staff extremely knowledgeable, accommodating and friendly. I would highly recommend them.

--Jay F.

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