Comments on: Mammograms and cost containment

By: Ed Whitney

Ed Whitney — Thu, 19 Nov 2009 17:15:33 +0000

The Secretary of HHS has been backing away from the USPSTF as fast as she can backpedal. This is a test of the Obama administration commitment to comparative effectiveness research. The political rhetoric has heated up as the USPSTF members, who were only "idiots" two days ago, are now "murderers." The replay of the 1997 drama, with adjustments appropriate for the age of Sarah Palin, is proceeding about on schedule.

By: Michael Kirsch, M.D.

Michael Kirsch, M.D. — Wed, 18 Nov 2009 17:22:40 +0000

I share the 'ranter's' skepticism of guidelines, often conceived and promulgated by academics (sorry Rob!) in some rarefied conference room. However, the USPSTF is highly regarded for its objectivity and conservative approach to medical care. It took guts to issue their new guidelines, which contradict their own guidelines on the same subject several years ago. The value of preventive care - including my own beloved colonosopy procedure - is overrated. I am sure that most ordinary folks, and even some physicians, would be quite surprised how modest the medical benefits of mammography are. Although I support the test, they provide very limited protection for women. To those who argue that it is worth all of the money, radiation, anxiety and false postive results if it will save even a few lives, would you support lowering the speed limit on our highways to 40 mph? www.MDWhistleblower.blogspot.com

By: Ed Whitney

Ed Whitney — Wed, 18 Nov 2009 15:22:55 +0000

Anyone have a sense of deja vu with these guidelines? In 1996 and 1997, the NCI came to similar conclusions about screening mammography. An editorial (Am J Public Health 1997 87: 1103-1106) showed the political response to the NIH Consensus Development Conference. Time to replay the theme with 2009 variations (Obamacare, death panels, government control of health care, etc).

By: boblaker

boblaker — Wed, 18 Nov 2009 14:51:19 +0000

Spot on. And Jonah Lehrer over at his Frontal Cortex Blog has an excellent piece comparing screening mammogram decision making with Bill Bellichick's fourth down decision.
http://tinyurl.com/y9hwkuv