Dr. Gil Welch of the Dartmouth Institute for Health Policy and Clinical Practice has an opinion column in the New York Times, “Testing What We Think We Know.” Excerpts:
“The truth is that for a large part of medical practice, we don’t know what works. But we pay for it anyway. Our annual per capita health care expenditure is now over $8,000. Many countries pay half that — and enjoy similar, often better, outcomes. Isn’t it time to learn which practices, in fact, improve our health, and which ones don’t?
To find out, we need more medical research. But not just any kind of medical research. Medical research is dominated by research on the new: new tests, new treatments, new disorders and new fads. But above all, it’s about new markets.
We don’t need to find more things to spend money on; we need to figure out what’s being done now that is not working. That’s why we have to start directing more money toward evaluating standard practices — all the tests and treatments that doctors are already providing.
There are many places to start. Mammograms are increasingly finding a microscopic abnormality called D.C.I.S., or ductal carcinoma in situ. Currently we treat it as if it were invasive breast cancer, with surgery, radiation and chemotherapy. Some doctors think this is necessary, others don’t. The question is relevant to more than 60,000 women each year. Don’t you think we should know the answer?
Or how about this one: How should we screen for colon cancer? The standard approach, fecal occult blood testing, is simple and cheap. But more and more Americans are opting for colonoscopy — over four million per year in Medicare alone. It’s neither simple nor cheap. In terms of the technology and personnel involved, it’s more like going to the operating room. (I know, I’ve had one.) Which is better? We don’t know.”
I’ve written a number of posts on DCIS. Two examples:
And I’ve written about the fecal occult blood testing vs. colonoscopy issues. Two examples:
Opinions on other issues in news, journals, PR, advertising, marketing
We’ve written about the hype of liquid biopsies for years (see link in comment below). And now this…. https://www.statnews.com/2022/01/12/medicare-shouldnt-cover-liquid-biopsies-early-cancer-detection/
Case counts still matter. “(There) are stories that may not be told adequately if only hospitalizations and deaths are emphasized.” @garyschwitzer interviewed by @dbauder of @AP. https://apnews.com/article/omicron-changing-news-outlets-covid-data-da9272f7c4c8a109c3bfb56bed9e9c76
My friend Gary @garyschwitzer wrote to his city council representative in a Minnesota town about a Viva Las Vegas event scheduled for January.
The response he got seems to perfectly capture where we are now.
https://www.healthnewsreview.org/2021/12/2021-ends-with-covid-craziness-in-sports-and-politics/
Comments (4)
Please note, comments are no longer published through this website. All previously made comments are still archived and available for viewing through select posts.
Albert Maruggi
August 23, 2012 at 6:13 ami agree 100% – as I turn 54 I am amazed at how little we truly know about early detection of disease. Well either it’s not knowing or perhaps as your piece indicates not testing in the right ways. I say this because of learning of many younger people who are being detected with advanced stages of a disease, primarily cancer. I know more about the regular daily health of my car then I do myself.
Albert Maruggi
August 23, 2012 at 6:14 amsorry typo then, should be than (Mrs. Grady my elementary English teacher might be reading : )
Our Comments Policy
But before leaving a comment, please review these notes about our policy.
You are responsible for any comments you leave on this site.
This site is primarily a forum for discussion about the quality (or lack thereof) in journalism or other media messages (advertising, marketing, public relations, medical journals, etc.) It is not intended to be a forum for definitive discussions about medicine or science.
We will delete comments that include personal attacks, unfounded allegations, unverified claims, product pitches, profanity or any from anyone who does not list a full name and a functioning email address. We will also end any thread of repetitive comments. We don”t give medical advice so we won”t respond to questions asking for it.
We don”t have sufficient staffing to contact each commenter who left such a message. If you have a question about why your comment was edited or removed, you can email us at feedback@healthnewsreview.org.
There has been a recent burst of attention to troubles with many comments left on science and science news/communication websites. Read “Online science comments: trolls, trash and treasure.”
The authors of the Retraction Watch comments policy urge commenters:
We”re also concerned about anonymous comments. We ask that all commenters leave their full name and provide an actual email address in case we feel we need to contact them. We may delete any comment left by someone who does not leave their name and a legitimate email address.
And, as noted, product pitches of any sort – pushing treatments, tests, products, procedures, physicians, medical centers, books, websites – are likely to be deleted. We don”t accept advertising on this site and are not going to give it away free.
The ability to leave comments expires after a certain period of time. So you may find that you’re unable to leave a comment on an article that is more than a few months old.
You might also like