The Importance of Diagnostics in Integrative Medicine Practice
The use of diagnostic tests is essential in Integrative Medicine clinical practice as it assists the practitioner in establishing whether a patient has a particular condition.
There are always new diagnostic tools available with the latest innovative technologies, such as the development of new biomarkers or apps. However, although these new diagnostics provide new technological data, they still do not produce improvements in health care as they are often not sensitive enough or the data provided is a confirmation of the symptoms which we have already deduced. While diagnostics are of value, they can also lead to overdiagnosis and provide ‘false negatives and false positives.’
Specificity, Sensitivity and Predictivity of Diagnostics
It is foolhardy to dismiss the value of Diagnostics; however, it is essential to consider the following before making clinical decisions when analysing the test results;
• Is the test sensitive enough to measure the disease progression? Often-times a positive result is reflective that the disease has already manifested itself in the body. This is the advantage of Traditional medicine systems such as Ayurveda which through skilled pulse diagnosis can detect the stage of disease e.g. accumulation, aggravation, dissemination, location, manifestation and disruption
• How specific is the test to the symptoms presented by the client? Can the Integrative Medicine practitioner link the specific biomarker or elevated /diminished values to the presented symptom(s)?
• How predictive is data from the Diagnostics?
Risk Management Analysis:
Good risk management analysis is required in Integrative Medicine practice. Thus, in terms of using Diagnostics, we need to consider the holistic health approach of:
a) Clinical Diagnosis (including Family History)
b) Imaging Studies and Lab tests
c) Severity, Prognosis, Stage, Complications
d) Risk classification
Clinical knowledge and skill for Practitioners of Integrative Medicine
There are essential strategies for Integrative medicine doctors and associated staff to reduce risk. This includes:
• Keeping up to date with clinical knowledge, skills, recent research studies and best practice
• Attending multidisciplinary peer meetings and discussing management of cases with other colleagues – this is where valuable information can be determined, and good treatment plans can be designed taking into account the traditional and modern allopathic medicine perspectives
• Taking a thorough history and examination when attending patients.
• Documenting all aspects of the consultation
• Clinical staff being aware of their own scope of practice
• Referring patients to other practitioners in the Integrative medicine team or outsource
• Continual review of clinical strategies