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.

Educate yourself about stroke prevention

A few days ago, I saw a notice about a series of screenings by a commercial venture at a local church building. You've probably seen ads for this in newspaper inserts or in your mailbox. This bothers me a great deal.

Why? Because this type of screening, without advice from your doctor, is not an effective way to prevent strokes. For a total of $240, you supposedly get carotid artery screening, heart rhythm screening, abdominal aortic aneurysm screening and peripheral arterial disease screening.

Now, that sounds all well and good, except....


If you have zero stroke risk factors, you don't need these screenings. If you do have stroke risk factors, then you should have already talked to your doctor about what to do about these risk factors and what tests are needed.


If you don't trust your own doctor to provide meaningful help in that decision-making process, you need another doctor.

Follow this link to get details about stroke risk factors. For your future and the ones you love.

Those factors include cholesterol and high blood pressure - and if you don't know those numbers, that's a sign you need a visit to a doctor, not fly-by-night screeners. Circulation problems - a simple exam can give a doctor the information needed to justify additional screenings - the right ones. Another risk factor is diabetes. Again, there are specific symptoms of diabetes that should lead you to a doctor visit.

Educate yourself. Don't give in to scare tactics.

By the way, I don't blame the church allowing this company to use its building. I'm sure this was pitched very cleverly. But after you review the risks you think you need to take some steps to avoid a stroke, talk to your doctor instead.

Stroke screenings in Columbia, Mo.

Tomorrow: Stroke screenings set:

In honor of stroke awareness month, University Hospital is offering free stroke health screenings from 10 a.m. to 3 p.m. May 20 in the main lobby of the hospital.

The screening will include a blood pressure check, body mass index and screening for other risk factors.

Common sense, standards help guide health screenings

It seems like a good idea - screening for stroke risks.

However, Jeff Baillon of KMSP-TV in Minneapolis-St. Paul reports that screening isn't as simple as it seems. There are actual government guidelines for tests cited in this piece aired not long ago.

Watch and learn:

Detecting danger: Stroke survivor says free screening saved her live

A story worth reading was recently in The Daily News Tribune (Waltham, Mass) and tells the story of Massachusetts General Hospital employee and, on a whim, stopped in a corridor for a free ultrasound carotid artery screening, just happened to be offered at the hospital Feb. 13.

Turns out she had 90 percent blockage in her right carotid artery, putting her in high risk for a stroke. Doctor's at the hospital's vascular center did a procedure and cleared the blockage, drastically reducing the risk.

Now, some experts say you shouldn't just have a screening on a whim. A good article from About.com makes some good points about false readings. However, the About.com writer does suggest that some people - those with a family history or those with known vascular disease - might be good candidates.

With Stroke Awareness Month just behind us, a good suggestion: Consider your own history and act accordingly. Keep in mind that this is from a non-doctor. Why not ask your own doctor for advice?