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Opinion EDITORIAL What Is Not to Be Done Kenneth A. Katz, MD, MSc, MSCE Primum non nocere, the old maxim meant to guide physi- for life. In a serologic study, 15.7% of persons aged 14 to 49 years cian conduct, translates as “first, do no harm.” Physicians too in the United States tested positive for HSV-2 infection during the often stop following the maxim, as translated, halfway through. 2005-2008 period. What that figure means for the actual genital Physicians are trained to act. They are taught—and, in many herpes prevalence is unclear, however. It might overestimate cases,paid—toelicithistories,conductphysicalexaminations,or- prevalence, owing to relatively low specificity of serologic tests der tests, render diagnoses, prescribe treatments, perform pro- and lack of confirmation in the study by more specific Western cedures, and screen for disease. (Screening means checking for blot testing. Or it might be an underestimate because the study the presence of a disease in a failed to account for genital HSV-1 infections. Determining HSV-1 person who has no signs or seroprevalence would not help clarify genital herpes prevalence symptoms suggestive of that becausemostHSV-1infectionsareoral,andserologictestscannot Related articles at jama.com disease; testing, by contrast, determine the anatomic site of infection. The importance of means performing
JAMA Dermatology – American Medical Association
Published: Mar 20, 2017
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