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Background: This is the first known investigation to identify specific patient characteristics and the relationship to their understanding of laboratory test results. The study examined patient characteristics influencing their level of understanding of laboratory test results reported to them by physicians or health care professionals. Methods: Questionnaires were distributed to 143 patients. Results: The authors’ findings suggest that patients want information on and an understanding of their laboratory results. Demographic variables and who explained the results to the patients did not significantly influence the findings. Conclusion: Patients reported that understanding the purpose of their tests and their relationships to their conditions would increase their satisfaction with the health care system.

The interpretation of results measured by quantitative ultrasound (QUS) of the heel depends on the population studied. We measured estimated bone mineral density (BMD) of the heel using the Hologic Sahara sonometer. People were studied at county fairs, health fairs, and churches. Subjects were not on treatments that would affect bone density, other than calcium supplementation. This included 823 Caucasian women, 131 African American women, and 301 Caucasian men. In contrast to women, for Caucasian men the squared term for age was not significant, and a straight line of decline was the best fit for estimated BMD. African American women had a standard deviation larger than that reported by Hologic for Caucasian women. We compared a history of self-reported fractures with a subject's estimated BMD. An estimated BMD of 0.57 gm/cm 2 included 75% of all fractures. This cutoff point was associated with increased fracture prevalence in subjects over age 50, relative risk of 1.4. This result corresponds to the Hologic data T-score of –0.2. When used as a screening tool for osteoporosis fracture risk, an estimated BMD of 0.57 gm/cm 2 seems reasonable in those subjects over age 50.

OBJECTIVES To assess characteristics of high-risk populations tested for HIV at particular testing sites. METHODS BRFSS data (N=20,633) was used to quantify rates of HIV testing and identify specific racial/ethnic testing locations. RESULTS Analysis determined associations existing among high-risk individuals based on demographics. Testing differences were identified in racial/ ethnic groups among those at high-risk in the United States. HIV testing was more likely among high-risk African Americans (OR=1.62), other races (OR=1.42), and multiracial participants (OR=1.89) than whites. CONCLUSIONS Minorities were more likely to be tested at locations such as hospitals and clinics supporting the need for alternative testing locations.

Optimal information that should be included in ultrasound (US) heel bone mineral density (BMD) reports is not known. If additional information about further evaluation of patients with low heel BMD were included in reports, would responses for treatment improve? We screened people at health fairs using the Sahara heel US machine. For those with a T-score of/= 1.0, letters were sent to their primary care physician notifying them of the result. Physicians were randomly assigned to (1) a standard letter, which recommended central bone density screening (dual X-ray absorptiometry [DXA]) and treatment if the BMD was low; or (2) an extended letter, which also outlined treatment strategies based on recommended subsequent central DXA scan results for a T-score of1.50 and also if2.00. The extended letter only increased the frequency of DXA testing from 30.1 to 37.2% (not a significant increase). Of 88 people with heel BMD/= 1.00 and not previously on any treatment, 25 of 45 (56%) were treated (calcium, estrogens, bisphosphonates, or calcitonin or a combination) after physicians received a standard letter and 30 of 43 (70%) after an extended letter (one-sided p = 0.084). Of people with T/= 1.9, and initially taking nothing more than calcium, 5 of 36 (13.9%) received additional treatment after physicians received a standard letter vs 9 of 41 (22.0%) after an extended letter (one-sided p = 0.180). For those with T/= 1.0 because of the screen 25 of 197 (12.7%) received additional treatment. One hundred forty-six of 194 (75%) individuals and received treatment with calcium or other medications, and 74 of 173 (43%) of individuals before screening and 141 of 195 (72%) after physicians received letters took calcium. Physicians regarded calcium alone as adequate treatment in many cases. There was no marked increase in treatment when additional information was provided to physicians regarding evaluation and treatment for low US heel BMD results.