Precision in Diagnosis: Sofia Erelund's Thesis on Sex- and Population-Adapted Reference Values in Healthcare

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Sofia Erelund, a Ph.D. student at the Department of Surgery and Perioperative Sciences, Umeå University, is set to defend her thesis which could significantly influence the accuracy of heart and lung function diagnoses in healthcare. Her research underscores the critical need for sex- and population-adapted reference values in medical diagnostics.

In her thesis titled "Heart and Lung Function in Health and Disease," Erelund delves into the disparities in heart and lung sizes between females and males, and how these differences should be more prominently reflected in diagnostic reference values. Her findings highlight discrepancies in current practices where these variances are often overlooked, potentially leading to delayed or incorrect diagnoses and treatments.

One of Erelund's key studies involves ECG examinations across a wide age range (20–90 years) in both sexes. She discovered that most parameters exhibited sex and age differences, which are currently not always considered in medical evaluations. This oversight can have serious implications, including misdiagnosis or inappropriate treatment.

Additionally, Erelund's sub-study reveals that international reference materials tend to underestimate lung function in both women and men in northern populations. By updating these values, the international model could be better tailored to specific populations, enhancing diagnostic accuracy.

Her research also explores heart rate variability, a measure of the variation in time between heartbeats, as an indicator of autonomic nervous system health. Erelund's findings suggest that heart rate variability is lower in patients with rheumatism compared to healthy individuals, indicating impaired autonomic function and a potential risk for high blood pressure.

In a surprising turn, Erelund's long-term follow-up study on females with coronary artery disease showed that those with the lowest heart rate variability did not necessarily have the highest risk of death. Instead, those who responded with higher heart rate variability to sympathetic nervous system provocation exhibited a greater risk.

Erelund's thesis not only advocates for the need to update reference materials but also emphasizes the importance of using tests that include various provocations. Such tests can reveal hidden abnormalities in heart autonomic function not visible during rest.

Concluding Insights:

Sofia Erelund's work is a testament to the evolving landscape of medical diagnostics, where individualized and population-specific reference values are crucial for accurate diagnosis and treatment. Her thesis, set for defense on December 1 at Umeå University, could pave the way for more nuanced and effective healthcare practices, particularly in diagnosing and treating heart and lung conditions.

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