Screening tests a focus of this year’s Rocky Mountain Workshop on Evidence-Based Health Care

I’m off to the Rockies next week to speak at and participate in The Rocky Mountain Workshop on How to Practice Evidence-Based Health Care at the invitation of Dr. Andy Oxman of the Norwegian Knowledge Centre for the Health Services in Oslo.

This is the 14th annual workshop but this will be my first. I’ve always heard wonderful things about it from past participants - journalists, policymakers and public health professionals.

One of this year’s workshop themes will be screening tests – which any reader of this blog knows is a favorite topic of mine.

The organizers state:

The five-day workshop is an intense, hands-on learning experience that uses a small-group, problem-based approach to learning.

One of the small groups, supported by the NIH Office of Disease Prevention, will focus on using evidence to inform and improve reporting, policy decisions, public health decisions, clinical and personal decisions about screening.

Meantime, on the topic of screening, I finally read Alan Cassels’ book, “Seeking Sickness:  Medical Screening and the Misguided Hunt for Disease.“  Alan published the Canadian equivalent of our HealthNewsReview.org project – the Canadian Media Doctor site. He’s let that project gather some dust while he works on other things like this book.  I can’t quite seem to ever find time for my book idea because I’m so married to this site.  Maybe he’s wiser. It seems impossible to do both.

The book includes chapters on:

• The whole body scan
• Screening for eyeball pressure
• Cholesterol screening
• PSA testing
• Mammography screening
• Colon and cervix screening
• Mental health screening
• Self-screening for disease
• Lung screening for cancer and COPD
• Bone screening
• Gene screening

My yellow highlighter stained many a page, marking quotes such as:

• Dr. Nortin Hadler on “risk factor fetish.”
• Muir Gray and Angela Raffle on “the popularity paradox” -
• “The greater the harm through overdiagnosis and overtreatment from screening, the more people there are who believe they owe their health, or even their life, to the programme.”
• Dr. Cornelia Baines:
• “I remain convinced that the current enthusiasm for screening is based more on fear, false hope and greed than on evidence.”
• “After over 20 years of involvement in the screening controversy, I can only conclude that this is information few want to hear and many want to suppress.”
• Dr. Brian Rank describing executive physicals as “one of modern medicine’s most expensive and least proven approaches to care.”
• Dr. Barry Kramer’s Dudley Do-Right/Snidely Whiplash screening test analogy (also captured in this article from 5 years ago).

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