In the decade since I was first diagnosed with high cholesterol and hypertension, I have been subject to a twice-yearly ritual.
I set a morning appointment with my doctor for a blood test, then fast overnight so the test will be accurate, per my doctor’s instructions.
Now it turns out I could have had breakfast and have set the test for lunch time or the evening. Which also means my doctor can set these tests for any time of day, and do more of them.
A literature review conducted under Dr. John Danesh (part-time Baha’i philosopher) at Cambridge (right) says the fasting is unnecessary.
His team found after reviewing records on 300,000 people that the readings were just as accurate after a night’s fast as after a morning at the pancake house.
The review also looked at whether testing for apolipoproteins, which bind to fat to create lipoproteins, might be a more accurate way to test for heart risk than measuring LDL (bad) and HDL (good) cholesterol numbers.
The answer to that question was no.
This is a good example of the kind of research that is going to become common in the age of health reform. The question was whether one test might be more cost-effective than another, the answer was no, so the standard protocol in Britain, where the research was conducted, will reflect that.
That’s how comparative effectiveness works. You measure two procedures against a large number of cases and draw conclusions as to whether something that adds expense also adds value. U.S. doctors are not contractually bound to consider such research in making their decisions, but insurers will soon make them.
Heck, so far as I know my doctor may still insist I fast before my next visit. But now I’ve got ammunition to say no. And while we’re at it, I’ll say, let’s schedule it for after I finish my daily writing for Smartplanet. Thank you, Dr. Danesh!
