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Sat, 5 Jan 2002 17:43:46 EST

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In a message dated 1/5/2002 5:23:11 PM Eastern Standard Time, 
bertil@biogate.com writes:

> You also wrote "It is a classic--and 
> dangerous--pitfall to ever think that these shadows can substitute for 
> actually seeing a patient, and understanding what the patient tells us.  " 
> Well I did not argue that point, BUT yes, there is a BUT, there is 
> significant information about the patients status, also volume status, that 
> should be observed.
> 

AND--I did not argue your point--read my post once again.  You seem to be 
arguing with yourself.  Nonetheless--excuse me for my skepticism, but such 
nonspecific "shadow signs" are just not clinically useful--take it for how it 
is meant from one who deals in the clinical every day.  My caution was to 
radiologists who tend to lose sight of the value of the patient and 
consequently overblow the value of their shadows, in many cases--as in the 
original example cited of the radioologist giving simply outlandish orders 
completely divorced from reality--with potential harm to the patient.  
Perspective--and a respect for the final clinical--read 
CLINICAL--judgement--of the clinician in charge, is my plea.  What brings 
about this plea is the simple fact we see so often of radiologists who lose 
sight of this.
Do NOT misconstrue the above as in any way demeaning the value of 
radiographic images in the evaluation of trauma, or of the importance of the 
radiologist as part of the team.  A warped perspective, and the misuse and 
misinterpretation--usually overinterpretation-- of x-rays, is what I caution 
against, just as much as I would the misinterpretation of the clinical 
picture by surgeons.
ERF

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<HTML><FONT FACE=arial,helvetica><FONT  COLOR="#0000ff" SIZE=2 FAMILY="SCRIPT" FACE="Comic Sans MS" LANG="0"><B>In a message dated 1/5/2002 5:23:11 PM Eastern Standard Time, bertil@biogate.com writes:<BR>
<BR>
</FONT><FONT  COLOR="#000000" style="BACKGROUND-COLOR: #ffffff" SIZE=2 FAMILY="SANSSERIF" FACE="Arial" LANG="0"></B><BR>
<BLOCKQUOTE TYPE=CITE style="BORDER-LEFT: #0000ff 2px solid; MARGIN-LEFT: 5px; MARGIN-RIGHT: 0px; PADDING-LEFT: 5px">You also wrote "It is a classic--and <BR>
dangerous--pitfall to ever think that these shadows can substitute for <BR>
actually seeing a patient, and understanding what the patient tells us.&nbsp; " <BR>
Well I did not argue that point, BUT yes, there is a BUT, there is significant information about the patients status, also volume status, that should be observed.<BR>
</BLOCKQUOTE><BR>
</FONT><FONT  COLOR="#0000ff" style="BACKGROUND-COLOR: #ffffff" SIZE=2 FAMILY="SCRIPT" FACE="Comic Sans MS" LANG="0"><B><BR>
AND--I did not argue your point--read my post once again.&nbsp; You seem to be arguing with yourself.&nbsp; Nonetheless--excuse me for my skepticism, but such nonspecific "shadow signs" are just not clinically useful--take it for how it is meant from one who deals in the clinical every day.&nbsp; My caution was to radiologists who tend to lose sight of the value of the patient and consequently overblow the value of their shadows, in many cases--as in the original example cited of the radioologist giving simply outlandish orders completely divorced from reality--with potential harm to the patient.&nbsp; Perspective--and a respect for the final clinical--read CLINICAL--judgement--of the clinician in charge, is my plea.&nbsp; What brings about this plea is the simple fact we see so often of radiologists who lose sight of this.<BR>
Do NOT misconstrue the above as in any way demeaning the value of radiographic images in the evaluation of trauma, or of the importance of the radiologist as part of the team.&nbsp; A warped perspective, and the misuse and misinterpretation--usually overinterpretation-- of x-rays, is what I caution against, just as much as I would the misinterpretation of the clinical picture by surgeons.<BR>
ERF</B></FONT></HTML>

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