Comments on: When guidelines differ – prostate cancer http://www.medrants.com/archives/3547 Internal medicine, American health care, and especially medical education Sat, 11 Feb 2012 15:15:48 +0000 hourly 1 http://wordpress.org/?v=3.3.1 By: Diora http://www.medrants.com/archives/3547/comment-page-1#comment-520608 Diora Mon, 28 Apr 2008 02:56:52 +0000 http://www.medrants.com/?p=3547#comment-520608 Wouldn't it depend on a patient? I'd imagine there are some that would just want to be screened regardless as they've heard so many "just find it early" messages that they couldn't care less about evidence. There'd be some that would want to follow your opinion whatever it is. But there will probably be a small but significant minority that really wants to know; most of these people will probably be able to understand the concepts pretty quickly. BTW - most of the evidence is really math or, more precisely, statistics rather than medicine. I'd imagine among your patients there are those who'd had a whole lot more statistics than you did - all the mathematicians, engineers, scientists. Are you sure they will not be able to understand it? For really easy to read and understand explanation of the issues involved in screening in general and PSA in particular, read H. Gilbert Welch's "Should I be tested for cancer. Maybe not and here is why". It's a fairly easy-to-read book and it nicely summarizes risks and benefits of screening. Wouldn’t it depend on a patient? I’d imagine there are some that would just want to be screened regardless as they’ve heard so many “just find it early” messages that they couldn’t care less about evidence. There’d be some that would want to follow your opinion whatever it is. But there will probably be a small but significant minority that really wants to know; most of these people will probably be able to understand the concepts pretty quickly.

BTW – most of the evidence is really math or, more precisely, statistics rather than medicine. I’d imagine among your patients there are those who’d had a whole lot more statistics than you did – all the mathematicians, engineers, scientists. Are you sure they will not be able to understand it?

For really easy to read and understand explanation of the issues involved in screening in general and PSA in particular, read H. Gilbert Welch’s “Should I be tested for cancer. Maybe not and here is why”. It’s a fairly easy-to-read book and it nicely summarizes risks and benefits of screening.

]]> By: Matt S. http://www.medrants.com/archives/3547/comment-page-1#comment-520590 Matt S. Fri, 25 Apr 2008 11:32:18 +0000 http://www.medrants.com/?p=3547#comment-520590 <i>they recommended that clinicians have an annual discussion with their patients about the potential risks and benefits of prostate cancer screening and the limitations of the evidence currently available.</i><i> I've always loved that. The evidence available is so inconclusive/contradictory/complex that all the physician groups you mentioned above cannot come to a consensus. So we're supposed to explain that evidence to the patient? It would probably take a good 3 hours for a physician to get a handle on the latest evidence and the studies. How many sessions do you have on that lecture series for patients? What are the prerequisites?</i> they recommended that clinicians have an annual discussion with their patients about the potential risks and benefits of prostate cancer screening and the limitations of the evidence currently available.

I’ve always loved that. The evidence available is so inconclusive/contradictory/complex that all the physician groups you mentioned above cannot come to a consensus.

So we’re supposed to explain that evidence to the patient? It would probably take a good 3 hours for a physician to get a handle on the latest evidence and the studies. How many sessions do you have on that lecture series for patients? What are the prerequisites?

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