evidence-based medicine

November 21, 2009 at 12:31 am | | science and the public

What is the greatest medical invention of all time? Bob Park says that it was the double-blind study. That may be an exaggeration, but I think we all can agree that applying scientific, fact-based methods to healthcare sounds like a good thing.

But many people don’t like science. The GOP and others are all upset that it turns out that maybe too many tests (mammograms, prostate exams, and pap smears) actually cause harm to patients. Sorry, ’bout that. I know you look forward to having fingers shoved up your ass every year, but it might do you better to get that test every other year.

(Al Gore should make a new movie about evidence-based medicine and call it A Convenient Truth.)

Here’s a good NPR news story about it. Slate has a great analysis, encouraging journalists to actually report facts. Interesting stuff.

UPDATE: Quoting from the Slate article:

So consider the actual numbers: For the average 40-year-old woman, annual mammography for a decade increases one’s overall chance of breast cancer survival from roughly 99.7 percent to 99.8 percent. That is, it increases the final batting average by only 0.001. According to the National Cancer Institute, there’s also a downside. During this time, half of all screened women will have at least one suspicious mammogram, and one-quarter of them will end up getting a biopsy. Mammograms in women from 40 to 50 years old cause a huge number of false positives, resulting in about 100 biopsies for every life saved. Even more worrisome: It’s possible the radiation from those mammograms may end up causing more cancers than they prevent.


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  1. I wanted to see what the GOP’s problem was. Answer: paranoid delusion / More fear-mongering. They think this is the beginning of rationing and evil Obama comin’ to take away your medicine. They are also confused (dissembling?) about the Task Force’s information. The RNC links us to “John Goodman’s Health Policy Blog,” which points out that there’s a “15% chance” that a mammogram will save a life of a breast cancer patient, but neglects the bit that there’s only a 1.4% chance that a woman under 40 will be a breast cancer patient in the first place. [see that Slate quote above.] Look at that! A way to cut costs in medicare spending – and spare you a little time and agony with the doctor — and the GOP opposed it. Why do they have to be the other party. Can’t we have the Whigs (the real tea partiers) or even the Tories (the correctly identified predecessor of the Conservatives) back? Or, dare I dream, the Bull Moose Party?

    Comment by jordan — November 21, 2009 #

  2. also, these studies aren’t saying that we should cut mammograms or other procedures because they are too expensive, but because that tiny increased chance of surviving cancer may be outweighed by an increased chance of complications from the resulting biopsy or surgery. the recommendation to cut mammograms is to *protect the patient*, not government coffers.

    Comment by sam — November 22, 2009 #

  3. Yeah, I should’ve said. The report *completely* disregards fiscal cost and simply weighs the potential medical risks and benefits.

    Comment by jordan — November 22, 2009 #

  4. The same method-ideologue folks are also arguing that many current vaccines are worthless. This topic is not exactly GOP versus Dems—see Rush Limbaugh and Glenn Beck’s stance on the topic— and makes for unusual bedfellows.

    Comment by joel — November 24, 2009 #

  5. no i agree, joel. one study is not great scientific law. this mammography study should be repeated by others in different ways. and this is not only GOP issue, but they are the ones making the stupidest noise about it right now.

    Comment by sam — November 24, 2009 #

  6. Looks like the Senate just amended healthcare legislation to require insurers to cover mammograms. So much for evidence-based medicine. We should all have a mammogram party!


    Comment by jordan — December 3, 2009 #

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