Thursday, June 29, 2006

Six "must-have" medical tests for women

I always like to criticize articles on "must-have" medical tests, since they often get it wrong. This one isn't bad. There is a mistake on the bone-density test recommendation:
All women under the age of 65 should have one, but any post-menopausal women with risk factors should have one.
It should be all women over the age of 65 should have one.


Comments:
I don't like the word "must" when it comes to screening. Why not say "recommended"? Screening is a choice it is not an obligation. It benefits very few - tremendously, it harms a few; it has no effect on the majority. It is a personal choice.

For most tests NNT is in the thousands or tens of thousands. Yes you can be that 1 in 1000 who benefits, and yes it can save your life. But there is a price to pay - false positives, biopsies, overdiagnosis and overtreatment. And yes, with some tests, the harm associated with overtreatment is small and the test can actually prevent cancer, but in some cases the harm associated with overtreatment could be life-threatening.
 
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