Green. Red. Positive. Negative. The simplified health test results quickly show you what to worry and what not to at the moment, but perhaps the quick read is meant for doctors that treat hundreds of patients. Only you have your best interest at heart. Why not learn some important basics and nuances to better manage your family’s and your own health in the long run?
What do your results really mean?
As a doctor specializing in analytics and health related data, I review clinical trial, and real world data on a regular basis. As a patient, I progress to see better medical doctors. And I recognize how differently patients, doctors, researchers, pharmaceutical companies, insurance companies and regulatory agencies look at patient data.
As an individual receiving healthcare, what do your test results really mean to you?
1. What is your risk level?
On average, where are your numbers in relation to the normal reference range? If any number is out of the normal reference range, there is still a range for the abnormal values with different risk levels. Where do you land? For some diseases, the algorithm of risk is more complicated. It’s helpful to discuss with your doctor what your results mean in terms of your risk level.
2. Does the abnormal result translate to symptoms?
A lot of doctors don’t prescribe treatments solely based on abnormal lab test results. This is for the overall benefit-risk profile for the patient. Patients can be asymptomatic although the numbers are abnormal. And the reversed question is equally important — does the improved lab result translate to improved symptoms? For many diseases, Food and Drug Administration (FDA) and European Medicines Agency (EMA) do not approve products solely based on biomarker improvement. On the other hand, for some diseases, the risk of developing symptoms increases with the duration of biomarker abnormality. It’s helpful to have a discussion with your doctor about the relationship between tests, symptoms and disease states
3. Some lab tests naturally vary more than others.
Triglycerides for example, fluctuate dramatically, and fasting triglycerides still vary widely. In clinical trials, a single value is not reliable for highly variable lab tests. For those, we usually take an average or use sophisticated modeling on repeated measurements. This means, if you see a little spike or dip out of the normal range, you can ask your doctor whether it’s wise to wait and repeat tests before jumping to conclusions.
4. Do your genetic makeup, demographic characteristics, lifestyle, risk factors or conditions make you predisposed?
The norm may be different for different populations. It’s a standard practice to look at results in various subgroups. You may have seen lab normal reference range by sex and age groups. Look for your own sex and age group. On top of the given genetics and characteristics, lifestyle, risk factors, conditions and medicines can make you prone to some abnormality too. After taking all these factors into consideration, the same lab results may mean different things than not. Ask your doctor to personalize the assessment based on your characteristics or risk factors. This may likely help you better understand your health and manage your action plan.
5. How do your results change over time?
Thanks to the technology advancement, we can now view our test results over time in a graph on major lab or medical center patient portals. This also means using the same lab or medical center will help consolidate your health data. Has your result been stable? Does it fluctuate? Gradual incline or decline? A big spike or dip? Another thing to be careful is the scale. Some scales of the y-axis are not appropriate so stability seems instability and vice versa.
Most importantly, you can help inform your doctor of your change over time. Doctors see so many patients. They likely will not remember your health history or take time to look into your past results. Only you can best monitor. In clinical trials and research, it’s incredibly common to evaluate change or percent change from baseline. You can easily calculate these too.
- Change from baseline
= (post baseline - baseline) - % Change from baseline
= 100 * (post baseline - baseline) / baseline
Patients can really benefit from seeing a trajectory of your own health data. But what should be used as baseline?
Measure your baseline
1. Your initial baseline
If you are an adult years into a stressful career, it’s likely too late for the first baseline measurement when you are as healthy as you can be. A physical exam with blood work when you turn adult is ideal for your baseline data. Even better, use and keep the first three years annual physical data in your adulthood as baseline of your health. Young adults may not know to do so. Parents could help guide them. If any pediatric medical care is received, it would be great to keep data before 18 years old as well.
2. What if your baseline is abnormal?
In other words, your initial baseline when you seem healthy is outside of the normal reference range. Some people may say, that is your norm. But does this mean you don’t need to worry at all? It depends. If it’s only a little out of range and stable, the risk is likely lower. Every situation is different. Different biomarker lab for patients with different characteristics and risk factors mean different things. It’s best to discuss with a knowledge doctor and even consult for a second opinion. It wouldn’t hurt to keep an eye on these seemingly normal abnormality, or abnormal normalcy.
3. Baseline of an intervention period
If you want to see how well your lifestyle change, physical therapy, naturopathic, medical or surgical treatment works for you, you can set the measurement results prior to intervention as baseline. Then you can look at change or percent change from baseline. They would give you a more precise understanding of the intervention and make comparison of different interventions or treatments easier.
Don’t be afraid to ask your doctor a lot of questions
Meaningful questions help educate both you and your doctor. All these questions of lab test results and evaluation of change from baseline can help both you and your doctor better manage your health.
If your doctor dismisses your questions, it may be a cue to switch. Does your doctor prioritize to protect his or her ego, minimize effort spent per patient, or individualize health care for each patient? It is also possible that some doctors aren’t as knowledge or don’t care as much as you need them to be. So how do I choose as an expert in health related data? I prefer doctors and healthcare providers that are more willing to listen and personalize. For complex or little-known conditions, I go to doctors that keep up with current research, understand personalized treatment management or are also professors.
The knowledge I share with you is to empower you in your own health journey. The better questions you ask, the better answers you shall receive!
