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View Diary: Health Care Friday (140 comments)

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  •  Systemic analysis is needed (0+ / 0-)

    Many of the problems with early detection are related to over reactions to the early detections. Stopping cancer screening - e.g. mammographies may not be the best response. Instead the over reactions may need to be curbed.

    The panels need to do a better job of reviewing ways to reduce unnecessary medicalization. Ignorance (lack of screening knowledge) is not strength.

    look for my DK Greenroots diary series Wednesday evening. "It's the planet, stupid."

    by FishOutofWater on Fri Nov 20, 2009 at 07:05:20 AM PST

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    •  very true (1+ / 0-)
      Recommended by:
      dinotrac

      but look at what the panel actually said.

      The balance of benefits and potential harms, therefore, grows more favorable as women age. The precise age at which the potential benefits of mammography justify the possible harms is a subjective choice. The USPSTF did not find sufficient evidence to specify the optimal screening interval for women aged 40-49

      "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

      by Greg Dworkin on Fri Nov 20, 2009 at 07:08:54 AM PST

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      •  The study's premise is wrong; data are incomplete (0+ / 0-)

        I've read the two responses to the recommendations that you highlighted, and it's amazing how one of the most basic questions isn't even addressed:

        What is the relative risk of needing a radical mastectomy when screening is delayed in accordance with the new recommendations?

        The recommendations define benefit narrowly as lives saved.  They treat it as a binary outcome.  How can anyone issue or even have an opinion about these recommendations without knowing the relative risks for a) disfiguring unnecessary treatments from overscreening compared to b) preventable disfiguring treatments from underscreening?

        •  Here is the problem (3+ / 0-)
          Recommended by:
          DemFromCT, elfling, think blue

          The recommendations deal with mortality and general population screening:

          http://www.dailykos.com/...

          We haven't been able to even look at the questions you ask because we've been so adamant about getting everyone screened. Only now, once we admit that not everyone benefits from screening, can we look to see who benefits, and why.

          All my IP addresses have been banned from Redstate.com.

          by charliehall on Fri Nov 20, 2009 at 07:45:34 AM PST

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          •  Is this the general standard for recommendations? (0+ / 0-)

            Do recommendations regarding population screening generally use only mortality as their basis?  Do they generally disregard # of future operations, quality of life, secondary diagnoses?  These are the kinds of things that treatment studies usually look at, aren't they?

            I'd like to know, because as I'm thinking about this issue, I'm really beginning to wonder whether the difference between a lumpectomy and a radical mastectomy is salient to the researchers.

          •  Your diary presents a challenge to science (1+ / 0-)
            Recommended by:
            lp3161

            When evidence appears to defy the common sense notion that early detection saves lives, scientists need to investigate. Why?

            My best guess about one of the possible answers is that some cancers are treatable and some are not. By the time the untreatable cancers are detected, even by sensitive methods, they have already metastasized.

            Whatever the reasons, we need to study the problem to deliver more effective health care. At this point I am not convinced by anyone's conclusions. We really do need more research.

            look for my DK Greenroots diary series Wednesday evening. "It's the planet, stupid."

            by FishOutofWater on Fri Nov 20, 2009 at 09:18:49 AM PST

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    •  The analyses were systematic (3+ / 0-)
      Recommended by:
      DemFromCT, elfling, FishOutofWater

      I diaried some of the data two days ago:

      http://www.dailykos.com/...

      Mammography screening in the general population has been proven NOT to save lives.

      All my IP addresses have been banned from Redstate.com.

      by charliehall on Fri Nov 20, 2009 at 07:42:50 AM PST

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      •  thank you for that link n/t (0+ / 0-)

        "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

        by Greg Dworkin on Fri Nov 20, 2009 at 07:53:05 AM PST

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      •  Thanks, but you are wrong. (1+ / 0-)
        Recommended by:
        Paid Troll

        You should know damn well that you cannot prove a negative.

        Mammography screening in the general population has been proven NOT to save lives.

        Those particular studies found no statistical differences in overall death rates in the the groups they studied. A null finding does not prove a negative.

        Those studies did not find that mammography screening saved lives. Period.

        That's shocking enough.

        Now we need to find out why.

        look for my DK Greenroots diary series Wednesday evening. "It's the planet, stupid."

        by FishOutofWater on Fri Nov 20, 2009 at 09:27:58 AM PST

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