When faced with medical tests, patients and their families can feel overwhelmed by the many questions running through their minds. These range from the most basic questions -- such as "Why is the test needed?" "How does the test work?" and "Is it okay to eat first?" -- to those arising from fears or concerns about what a
procedure may involve.
Answers to these and many other questions are provided in a new book, "The Yale University School of Medicine Patient's Guide to Medical Tests," which is designed to inform readers about common and not-so-common diagnostic procedures.
The 620-page book, just published by Houghton Mifflin Co., includes detailed descriptions of various medical tests, written in language understandable to the lay person, as well as easy-to-scan charts and illustrations. Each of the book's 29 chapters is written by a full-time faculty physician at the School of Medicine who specializes in the field being covered.
"There's an enormous amount of uncertainty about testing," says Dr. Barry L. Zaret, the Robert W. Berliner Professor of Medicine and the book's senior editor. "The book helps patients through the diagnostic process; it lets them and their families know what the process is, what to expect, how to prepare," he says. "We want to demystify the process and help patients to be a greater part of that process."
This is the second book that Zaret has worked on that provides comprehensive information to patients and the public. Also chief of cardiovascular medicine at the medical school, he was an editor of the "Yale University School of Medicine Heart Book," which was published five years ago.
The new book, he explains, "looks critically at the advantages and disadvantages of each procedure and lets people know the next step." It also gives people a basis for asking questions, making decisions and getting exactly what they need -- at a time when some critics argue that doctors order too many tests, while others say that with managed care, not enough testing is done in some cases, Zaret says.
The first section of "The Yale University School of Medicine Patient's Guide to Medical Tests" covers such topics as patients' rights and informed consent, and the role of screening. It also provides overviews of current diagnostic imaging techniques (such as CT scans) and laboratory tests, from finger-stick blood tests to bone marrow biopsies. The second section deals with testing as it relates to specific organs, organ systems or diseases, or to groups of people, such as children or women. Among the many topics covered are testing as it relates to the vascular, circulatory, digestive, endocrine, renal, nervous, lymphatic and immune systems; the male and female reproductive systems; pregnancy; allergies; the skin; hypertension; HIV and AIDS; infectious diseases; genetic diseases; toxicology; the monitoring of drug therapy; and testing for substance abuse.
The physician authors explain how particular body systems work, what happens when they don't work, what doctors look for, and how they go about looking. Included in the book are short case histories, descriptions of common disorders and a list of signs and symptoms that indicate problems.
Tests are presented in logical sequence, from the simplest to the most complicated, Zaret notes. Newer tests, which are often more specific or less invasive than older ones, are regularly pointed out. The book's charts supply basic information such as where a specific test is done,
how long it takes, what equipment is used, what kind of discomfort or pain may occur, the risks and complications involved, and the average cost of the test. Entries on these charts cover such points as the purpose of the test, how the test works, how the patient should prepare, step-by-step descriptions of what the procedure entails, factors that could affect test results and how the tests are interpreted.
Throughout the text are illustrations and short items titled "Patient Tips" or "Did You Know?" Illustrations in the chapter "The Heart," for example, show the heart itself, as well as depicting a person getting an electrocardiogram and two samples of electrocardiogram readings -- one normal and the other taken during a heart attack. An appendix covers home tests, such as monitors for blood sugar in diabetes patients.
"The book is very comprehensive," says Zaret, "and it's designed to be exquisitely reader-friendly."
The associate editors of "The Yale University School of Medicine Patient's Guide to Medical Tests" are Dr. Peter L. Jatlow, professor and chair of laboratory medicine, and Lee D. Katz, associate professor of radiology and director of diagnostic imaging.