Is Pernicious Anemia Underdiagnosed?
Pernicious anemia among the elderly may often remain undiagnosed, according to a recent report published in Archives of Internal Medicine (1996; 156:1097-1100). Researchers tested blood levels of cobalamin and anti-intrinsic factor antibody in 729 community-dwelling people over the age of 60. For subjects showing abnormal results, follow-up assessment with the Schilling test was performed. Seventeen subjects were found to have pernicious anemia; 14 of these had not previously been diagnosed with the condition, resulting in a 1.9% prevalence of undiagnosed pernicious anemia in the survey population. If these findings are generalized to the entire elderly population in the United States, the study’s authors maintain that close to 800,000 elderly Americans may have undiagnosed pernicious anemia. Poor and Elderly Fare Worse in HMOs For the average patient, research indicates that health outcomes are the same whether treatment is provided through a health maintenance organization or a fee-f
