I was very impressed by a recent posting on The Plainview Citizen web site entitled Abnormal Liver Function Tests by Howard J. Worman, MD, New York Presbyterian Hospital, Columbia University College of Physicians and Surgeons. Here is the link to the article and below is an excerpt from it:
One of the most common ways a person finds out about a possible problem with their liver is the discovery of elevated liver function tests. Very frequently, this occurs during blood testing for life or health insurance, or when seeing a doctor for another reason....I initially told Mr. Jones the same thing I tell the first- and second-year medical students at Columbia: Liver function tests, also sometimes called liver enzymes, are not liver function tests. For reasons that are unclear, the activities of certain enzymes in the blood, usually ALT and AST, and sometimes alkaline phosphatase and GGT, are incorrectly referred to as liver function tests or LFTs. Some people even refer to them as liver count. I don’t know who coined these terms or why they caught on, but almost all doctors refer to these blood tests as liver function tests. Any or all of these blood tests can be abnormal (elevated) in someone with a perfectly functioning liver. In addition, all or most of them can be completely normal in a patient with advanced or end-stage liver disease.
There are many valuable insights into lab testing in this article -- read the whole thing. I am a pathologist and I learned a great deal from it because of the clarity of the writing and also because of the clinical perspective. But stop a minute and reflect about some of the implications of this article. Here is an academic physician explaining the subtleties of liver enzymes interpretation and the differential diagnosis of liver disease on a web version of a small-town newspaper that is now available to "the world" via the Internet.
This idea, in turn, reminded me of references on the web to citizen journalists. Here is a link to the Wikipedia article on citizen journalism.
Citizen journalism, also known as participatory journalism," is the act of citizens "playing an active role in the process of collecting, reporting, analyzing and disseminating news and information.
This highly instructive article on liver enzymes is a classic example of how the web can provide a content expert with a communication platform to share his knowledge and understanding about a medical topic with anyone who is motivated to acquire this knowledge by browsing the web. In so doing, the content expert is converted to a citizen journalist for the greater benefit of many.
This, in turn, reminded me why I so much dislike the local news and most network news shows and why I so appreciate the NewsHour with Jim Lehrer on PBS. In the former case, the job of the TV news celebrities is filter and distill information about which they have no deep understanding into news bites with most of the information wrung out of it -- it's both a form of entertainment and also a race to the bottom. In the PBS production, the moderators serve as guides and referees, asking questions and providing rules and structure to the discussion. The "news and analysis" is provided by the content experts. Balance is achieved by providing experts with varying viewpoints and biases. Content is king and the web accelerates this phenomenon.
Comments