Howard Harrell
speaker
1,260 appearances
4 recordings
1 series
first heard May 2026
last heard 23 Jul
Howard Harrell’s voice in public audio — every appearance, attributed to the second.
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recordings per month · last 12 monthsRecordings per month over the last 12 months — 4 in all, peaking in Jul 2026 with 2.
Appearances
Health issues like diabetes.
hypertension, whatever else, then it might make a lot of sense to just standardize an A one C as part of the routine prenal lab for everyone.
And in in many ways, it's probably a lot more beneficial now to our current patient populations than testing for rubella immunity, for example.
And that's part of everyone's standard prenatal lab.
Order set.
On the other hand, the
If you see a patient population with low diabetes incidence and they are getting regular medical care, let's say they just had an annual visit last year, everything was perfect, then it's probably overkill to still be doing this universal early A1C on everyone.
So you do end up over-screening when whenever you make a test universal, but there's you can't not.
end up doing that.
But the risks of a universal test are a lot lower when it's just an A one C, just the single blood draw drawn at the same time as all of the other routine prenatal labs.
compared to if you're having them come back to do a one hour long glucose or even a fasting two hour glucose test.
Right.
So so really
The only practical thing that matters is finding the patients who benefit from intervention.
Cause otherwise what do you do with that information?
you just risk overdiagnosis and then the labeling effect that we've talked about before, where you may actually harm them.
by having overlabelled them and then acting out on that and
in obstetrics basically doing cesareans when you don't need to.
So we talked about before, one example is that people who are li the labeled diabetic during pregnancy will have higher cesarean rates w without
without a corresponding improvement in neonatal outcomes.
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