Using Diagnostics in the Clinic

Out of all the diagnostics tools used for our patients in my clinical practice setting, the following five diagnostic tools are the tools that are frequently used and observed. I will discuss the indication of each of the tools and its pros and cons. Please see table below.

  Pros Cons Indications
Electrocardiogram (ECG) It is cost effective, non-invasive, and easy to perform. (Sharma et al., 2011) Not all heart abnormalities may be detected through ECG.

Rates of false positives on screening could be as high as 40%. (Stein, 2010)

It is used to rule out myocardial infarction, arrhythmias, and many other heart problems. (Colyar, 2015)
Pregnancy test It is accurate if the test is done at the right timing (after the first day of a woman’s missed period). (Heidt, 2014) Not always accurate because early urine pregnancy tests may result in false negative result. (Heidt, 2014) It is used to confirm pregnancy. Urine is being tested to confirm a diagnosis. (Cash & Glass, 2014)
Dipstick urinalysis It is cost-effective and convenient to use that provides a rapid test result. (Nabili, 2015) It is not accurate when it comes to checking for infection if a patient does not know how to catch proper mid-stream urine. (Buttaro et al., 2013) It is a test that evaluates the urine to detect disorders such as urinary tract infection, diabetes, and kidney problems. (Buttaro et al., 2013)
Monofilament test Inexpensive, easy-to-use, and portable. (Dros et al., 2009) It can be unreliable at times especially if the patient does not know how to properly follow the instruction of when to say he/she felt the sensation of the microfilament and when he/she did not feel it. (Dros et al., 2009) It is a test to assess the loss of protective sensation and to diagnose peripheral neuropathy especially to patients diagnosed with diabetes. (Dros et al., 2009)
Rapid Fecal Occult Blood Test (FOBT) It is cost-effective and simple while it produces a rapid result. It also provides an accurate test result when the procedure is done right. (American Cancer Society, 2016) It may produce a false positive or false negative result when the procedure is not done right such as when the provider did not fully insert the finger into the anus to get enough sample or when the provider caused the anus to bleed when finger is inserted into it. (American Cancer Society, 2016) It is used to determine human hemoglobin in feces to diagnose GI bleeding, colorectal carcinoma, colon polyps, diverticulitis, and ulcerative colitis. (Teco Diagnostics, 2012)

References:

American Cancer Society. (2016). Colorectal cancer prevention and early detection. Retrieved from http://www.cancer.org/acs/groups/cid/documents/webcontent/003170-pdf.pdf

Buttaro, T.M., Trybulski, J., Bailey, P.P., Sandberg-Cook, J. (2013). Primary care: A collaborative practice. (4th ed.). St. Louis, MO: Elsevier Mosby

Cash J.C., & Glass, C.A. (2014). Family practice guidelines. (3rd ed.). New York, NY: Springer Publishing

Colyar, M. (2015). Advanced practice nursing procedures. Philadelphia, PA: F.A. Davis Company

Dros, J., Wewerinke, A., Bindels, P. J., & van Weert, H. C. (2009). Accuracy of monofilament testing to diagnose peripheral neuropathy: A systematic review. Annals of Family Medicine7(6), 555–558. http://doi.org/10.1370/afm.1016

Heidt, A. (2014). Early pregnancy tests. Retrieved from http://www.everydayfamily.com/early-pregnancy-tests/

Nabili, S. (2015). Pros and cons of dipstick. Retrieved from http://www.emedicinehealth.com/urinalysis/page4_em.htm

Sharma, S., Ghani,S., & Papadakis, M. (2011). ESC criteria for ECG interpretation in athletes: Better but not perfect. Heart, 97, 1540-1541. Doi: 10.1136/heartjnl-2011-300400

Stein, J. (2010). The pros and cons of heart abnormality screening for athletes. Los Angeles Times. Retrieved from http://articles.latimes.com/2010/oct/01/news/la-heb-ecg-screening-20101002

Teco Diagnostics. (2012). Rapid fecal occult blood test. Retrieved from http://www.tecodiagnostics.com/wp-content/uploads/2012/07/F7351.pdf

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