Thursday, July 17, 2014

Routine screening - careful decision-making

Medical screenings often seem benign things to do. But there's a line between smart preventive decisions and bad decisions.

Interesting article about how experts have rejected routine screening for narrowed neck arteries:
Image from the
National Heart, Lung and Blood Institute
"Screening for carotid artery stenosis often leads to follow-up testing and surgeries that can cause serious harms, including stroke, heart attack, or death," task force member Dr. Jessica Herzstein said in a news release from the group. She explained that this type of blocked artery "is uncommon in the general adult population, so screening everyone would lead to many false-positive results."
A false-positive result is when a test shows that a person has a condition that he or she actually does not have.
The new recommendation does not apply to adults with a history of stroke, mini-stroke, or signs and symptoms of stroke. These people should consult with their doctors about getting tested, the task force advised.
"The best way to prevent a stroke, and other cardiovascular diseases, is to focus on the things we know work," task force chair Dr. Michael LeFevre said in the news release. "This includes controlling high blood pressure and cholesterol, not smoking, being physically active, maintaining a healthy weight, and eating a healthful diet."
Note that rejecting this routine screening does NOT apply to people who have known risks.

As mentioned, there's a line - sometimes, a thin line - between screen vs. not screen. Carry pro-screen to an extreme, and we'd all have once-a-month colonoscopies. Not a pretty picture. Carry no-screen to an extreme, and we wouldn't know our own blood pressure.

You can find the details about the U.S. Preventive Services Task Force's recommendation here.

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