PrivateHealthScreening: What to Think About When You’re Thinking About Screening Tests

Joelle Reizes

While we understand there will always be debates about health screenings, Life Line Screening will continue to offer high quality, convenient, affordable private screenings that individuals can voluntarily choose if they have appropriate risk factors and decide that the screenings are right for them. Recent criticism of private health screenings fails to account for the context in which screenings are taking place. Others are free to disagree, but we believe a model that promotes education and prevention can serve a vital role in the health care continuum. Please visit our blog for more facts about health screenings and to read our full response to recent critiques: http://www.lifelinescreeningblog.com/index.php/presenting-the-facts-by-addressing-margaret-mccartneys-issues-against-life-line-screening/

Joelle Reizes
Communications Director at Life Line Screening

mgt mccartney

I’ve posted this on the lifeline screening blog.

Dear Joelle

Sadly your response does not actually address the issue, which is that people have been advertised to by your company through making false promises of the benefits of your tests. Screening is usually complex and always contains a balance of pros and cons. You have not informed people about the drawbacks, uncertainties, hazards or lack of evidence for what you offer. This is the real problem and one that you haven’t addressed. Your new UK adverts are a slight improvement in that they don’t make some unproven claims as before, but still do not explain the downsides of screening.

Your comments about me then effectively suggesting that I have told people to just go on ‘waiting for symptoms’ simply doesn’t reflect the evidence or indeed what I have said. People can do many things to reduce their risk of many diseases. Most of this advice is straightforward. Eat a varied diet, don’t be over or underweight, exercise daily, don’t smoke, drink moderately, do work you enjoy, see friends and meet people. My comments do however reflect the fact that screening tests can lead to harm through unnecessary interventions. The less chance of benefit, then the greater risk of unnecessary harm.

The study you cite (4) above, was a complex long term intervention examining many types of cardiovascular risk factors, in particular BP treatment. It is not possible to attribute any potential benefit (and there may have been problems with this trial in that the effect may not have been down to the activities done because of the trial, see the discussion section) to the activities of Lifeline Screening based on this.

Next, customer testimonials do not count as evidence. We know that harmed people tend to report fewer adverse outcomes because of the ‘popularity paradox’ – people tend to feel grateful that a false positive was a false positive rather than feeling angry that they were unnecessarily tested for something that wasn’t going to harm them. Also, seriously harmed patients can’t always speak up for themselves either. Testimonials are not reliable evidence.

You also say that “No screening is without risk, and any screening has a small, but certain risk of adverse outcomes as have any medicines or surgeries. On the basis of probabilities, however, its advantages far outweigh potential risks.” That’s really pretty incredible, given the huge amount of research that has been done on screening, and the many findings of ineffective screening tests – that did too much harm to make the benefits worthwhile. And in any case, it should be up to the person to decide what level of risk is acceptable to them – not for a commercial company to make that value judgement for them.

Why don’t you read the extensive evidence about the balance of benefit and harms that we have on our website?

http://privatehealthscreen.org/evidencebank.html

There is no reason to think that knowledge and prevention of disease has to include non evidence based screening tests, and the arguments you are using are similar to those that people who promote homeopathy use.

I’d like you to consider what informed choice really means and whether or not your customers are being given fair and unbiased information before handing over their money.