Great news ladies! Women under 50 not at risk anymore!

Originally Posted by TheMercenary

Further, Medicare and Medicaid will pay $15,000 for a patient of theirs to have a surgery done in a major hospital down the street but will not pay $8000 for the same procedure in a surgery center. It happens every day in the US.

http://online.wsj.com/article/SB1000...052451436.html

Apples and oranges and absolutely nothing to do with PSTF-funded independent research.

please cite any PSTF-funded research recommendations in the last 20 years that have been incorporated into policy guidelines for Medicare...or even into private insurance guidelines for treatment and/or coverage....or adopted by any medical association as a new standard protocol.

[TheMercenary]

So you can't refute the facts of the articles. No big deal, I didn't expect you to find anything to say they were inaccurate.

[Spexxvet]

Originally Posted by TheMercenary

And that is the problem with most government panels which try to recommend how the government should manage your healthcare.

How do they compare to profit-motivated insurance company panels which try to recommend how the insurance companies should manage your healthcare.

[TheMercenary]

Originally Posted by Spexxvet

How do they compare to profit-motivated insurance company panels which try to recommend how the insurance companies should manage your healthcare.

We aren't talking about the profit motivated insurance companies.

[Flint]

Yeah, there was only one insurance executive on this panel...

Anyway, if this is any indicator of how evidence-based medicine will be recieved as a cost-cutting measure in healthcare reform, the lesson is: people don't like having services taken away.

my opinions on this topic brought to you by: that one thing I heard on NPR the other morning

[Sundae]

I would be able to request testing from the age of 40 due to family circumstances ....... I probably won't though.

Why not?

Because the stats are against it happening.
Cousin Susan got breast cancer at 49, but Mum and Nan were in their 60s.
My GP thinks I'm having migraines because my weight means I have slightly higher than normal blood pressure. I'm more worried about that.

Also, I do check myself regularly.

If I'm going to cost the NHS money, I'd rather it was for something I was really at risk from. Sadly, of course I don't get to choose - Bucks have just cancelled funding of a counselling centre for example - nice. Right now I need that more than I need to squeeze my tit into a machine.

[SamIam]

And this just in:

WASHINGTON – The former director of the National Institutes of Health is advising women to ignore new guidelines that delay the start of routine mammogram testing for breast cancer.
Dr. Bernadine Healy says the directive would save money but not lives.

The recommendation, released last week by an independent panel, recommends that women not routinely undergo mammograms until age 50. Longtime guidelines have said women should have regular mammogram screening after age 40.
Healy says that if the new guidelines are followed, more women will die.

So now we have two completely different recommendations. I would err on the side of caution, myself.

http://news.yahoo.com/s/ap/20091122/...creening_healy

[Cicero]

I like it, "Preventative Services Task Force"........It's like the opposite game.

[monster]

Originally Posted by Sundae Girl

Because the stats are against it happening.
Cousin Susan got breast cancer at 49, but Mum and Nan were in their 60s.
My GP thinks I'm having migraines because my weight means I have slightly higher than normal blood pressure. I'm more worried about that.

Also, I do check myself regularly.

If I'm going to cost the NHS money, I'd rather it was for something I was really at risk from. Sadly, of course I don't get to choose - Bucks have just cancelled funding of a counselling centre for example - nice. Right now I need that more than I need to squeeze my tit into a machine.

Sounds like excuses to me. Get squished as soon as your eligable. If nothing else, it provides a baseline for when you do get suspicious bits that need investigating. Also, the money for the test is already spent. If you don't go, they'll just spend more money on a big campaign trying to persuade you to go

[joelnwil]

I don't know what all the fuss is about.

[Pie]

The New York Times
December 13, 2009
The Way We Live Now

Mammogram Math
By JOHN ALLEN PAULOS

In his inaugural address, Barack Obama promised to restore science to its “rightful place.” This has partly occurred, as evidenced by this month’s release of 13 new human embryonic stem-cell lines. The recent brouhaha over the guidelines put forth by the government task force on breast-cancer screening, however, illustrates how tricky it can be to deliver on this promise. One big reason is that people may not like or even understand what scientists say, especially when what they say is complex, counterintuitive or ambiguous.
As we now know, the panel of scientists advised that routine screening for asymptomatic women in their 40s was not warranted and that mammograms for women 50 or over should be given biennially rather than annually. The response was furious. Fortunately, both the panel’s concerns and the public’s reaction to its recommendations may be better understood by delving into the murky area between mathematics and psychology.
Much of our discomfort with the panel’s findings stems from a basic intuition: since earlier and more frequent screening increases the likelihood of detecting a possibly fatal cancer, it is always desirable. But is this really so? Consider the technique mathematicians call a reductio ad absurdum, taking a statement to an extreme in order to refute it. Applying it to the contention that more screening is always better leads us to note that if screening catches the breast cancers of some asymptomatic women in their 40s, then it would also catch those of some asymptomatic women in their 30s. But why stop there? Why not monthly mammograms beginning at age 15?
The answer, of course, is that they would cause more harm than good. Alas, it’s not easy to weigh the dangers of breast cancer against the cumulative effects of radiation from dozens of mammograms, the invasiveness of biopsies (some of them minor operations) and the aggressive and debilitating treatment of slow-growing tumors that would never prove fatal.
The exact weight the panel gave to these considerations is unclear, but one factor that was clearly relevant was the problem of frequent false positives when testing for a relatively rare condition. A little vignette with made-up numbers may shed some light. Assume there is a screening test for a certain cancer that is 95 percent accurate; that is, if someone has the cancer, the test will be positive 95 percent of the time. Let’s also assume that if someone doesn’t have the cancer, the test will be positive just 1 percent of the time. Assume further that 0.5 percent — one out of 200 people — actually have this type of cancer. Now imagine that you’ve taken the test and that your doctor somberly intones that you’ve tested positive. Does this mean you’re likely to have the cancer? Surprisingly, the answer is no.
To see why, let’s suppose 100,000 screenings for this cancer are conducted. Of these, how many are positive? On average, 500 of these 100,000 people (0.5 percent of 100,000) will have cancer, and so, since 95 percent of these 500 people will test positive, we will have, on average, 475 positive tests (.95 x 500). Of the 99,500 people without cancer, 1 percent will test positive for a total of 995 false-positive tests (.01 x 99,500 = 995). Thus of the total of 1,470 positive tests (995 + 475 = 1,470), most of them (995) will be false positives, and so the probability of having this cancer given that you tested positive for it is only 475/1,470, or about 32 percent! This is to be contrasted with the probability that you will test positive given that you have the cancer, which by assumption is 95 percent.
The arithmetic may be trivial, but the answer is decidedly counterintuitive and hence easy to reject or ignore. Most people don’t naturally think probabilistically, nor do they respond appropriately to very large or very small numbers. For many, the only probability values they know are “50-50” and “one in a million.” Whatever the probabilities associated with a medical test, the fact remains that there will commonly be a high percentage of false positives when screening for rare conditions. Moreover, these false positives will receive further treatments, a good percentage of which will have harmful consequences. This is especially likely with repeated testing over decades.
Another concern is measurement. Since we calculate the length of survival from the time of diagnosis, ever more sensitive screening starts the clock ticking sooner. As a result, survival times can appear to be longer even if the earlier diagnosis has no real effect on survival.
Cognitive biases also make it difficult to see the competing desiderata the panel was charged with balancing. One such bias is the availability heuristic, the tendency to estimate the frequency of a phenomenon by how easily it comes to mind. People can much more readily picture a friend dying of cancer than they can call up images of anonymous people suffering from the consequences of testing. Another bias is the anchoring effect, the tendency to be overly influenced by any initially proposed number. People quickly become anchored to such a number, whether it makes sense or not (“we use only 10 percent of our brains”), and they’re reluctant to abandon it. If accustomed to an annual mammography, they’re likely for that reason alone to resist biennial (or even semiannual) ones.
Whatever the role of these biases, the bottom line is that the new recommendations are evidence-based. This doesn’t mean other right-thinking people would necessarily come to the same judgments. To oppose the recommendations, however, requires facts and argument, not invective.

John Allen Paulos, professor of mathematics at Temple University, is the author most recently of “Irreligion.”

[Elspode]

Can I please have a copy of your "pull news articles from the future" software? Please? Pretty please?

[Pie]

It was published in the NYTimes Sunday Magazine (dated 12/13/09). The mag is traditionally released on Friday.

Here's the link: http://www.nytimes.com/2009/12/13/ma...ob-wwln-t.html

[regular.joe]

Wow, since today is the 12th of December 2009, and I am arguably "in your future" based on my position on the globe.......then Els is right...is this always published with a future date?

[monster]

It's not unusual for magazines and journals to be released before the date on their cover. They usually take a few days to reach the bulk of consumers, so they will not seem so outdated when that happens.