|
|||||
 |
Breast Cancer | cancer screening | Communication | Diagnosis | health care costs | Medical News | Statistics | Women's Health
False positives have hit the headlines. Check the New York Times, Wall Street Journal, CNN — they’re everywhere. Even the Ladies’ Home Journal skirts the subject. …Women are ignoring the numbers, choosing reassurance over hard facts. Some say members of the pro-mammogram camp are irrational, even addicted… See more Stats in the News! A colleague sent me an email about my math. You’re more or less right, he said, but you need to account for the false positives. I agree with him. (It’s true.) The problem is, among others, how to present those numbers in the press. Statistics don’t sell; still, an explanation is due. In my next full post I’ll consider the meaning of false positives — their significance and costs - in the cancer screening debate. Related Posts:Proposed Model for Evaluating False Positives in Screening MammographyA Bit More on False Positives, Dec 2009, Part 1On Juno and Screening Test StatsStats in the News!A JAMA Press Briefing on CER, Helicopters and Time for Questions Communication | Empowered Patient | Life as a Doctor | Life as a Patient | Medical Education | Patient-Doctor Relationship
Family gatherings centered on two things – food, and talk about medicine. We spoke of interesting cases (always nameless), challenging conditions and, even back then, the constraints of health care costs. My fiancé, now husband of over 20 years, couldn’t get over how debate over health care dominated our Rosh Hashanah and Thanksgiving feasts… …when I learned I had breast cancer, I knew exactly what to do. The decisions, though difficult, were almost straightforward, buttressed by my knowledge and familiarity with the language of medicine… See more Dinner with my Family Three key issues have escaped the headlines: 1. The expert panel carried out a careful analysis using data that are, necessarily, old; 2. The recommendations don’t apply to digital mammography; 3. Mammograms are not all the same. We need to set the bar higher for mammography… See more Another Take on Mammography Breast Cancer | cancer screening | cancer treatment | Diagnosis | health care costs | Medical Ethics | Medical News | Policy | Women's Health
But consider — if the expert panel’s numbers are off just a bit, by as little as one or two more lives saved per 1904 women screened, the insurers could make a profit! By my calculation, if one additional woman at a cost of, say, $1 million, is saved among the screening group, the provider might break even. And if three women in the group are saved by the procedure, the decision gets easier… Now, imagine the technology has advanced, ever so slightly, that another four or five women are saved among the screening lot. How could anyone, even with a profit motive, elect not to screen those 2000 women? See more Getting the Math on Mammograms Smack in the midst of October-is-breast-cancer-awareness-month, the Journal of the American Medical Association published a provocative article with a low-key title: “Rethinking Screening for Breast Cancer and Prostate Cancer.” The authors examined trends in screening, diagnosis and deaths from cancer over two decades, applied theoretical models to the data and found a seemingly disappointing result. It turns out that standard cancer screening is imperfect. The subject matters, especially to me. I’m a medical oncologist and a breast cancer survivor, spared seven years ago from a small, infiltrating ductal carcinoma by one radiologist, an expert physician who noted an abnormality on my first screening mammogram… See more To Screen is Human |
||||
|
Copyright © 2012 Medical Lessons - All Rights Reserved |
|||||