Why data driven medical decisions will fall on deaf ears

The fallout from the mammogram screening guidelines have served as a test case, of sorts, to see how the politicians and public will respond to recommendations based on evidence-based clinical practice.

And, judging from the inflammatory reaction, it’s safe to say that we’re quite a ways from medical decisions based on the best available data.

In a recent editorial, the New York Times touched upon the issue. One of the Senate’s health care bill amendments explicitly mentioned the USPSTF and “directed the government to ignore the task force’s most recent mammography recommendations.”

It overwhelmingly passed.

Health reformers are hoping that results from comparative effectiveness trials can help reduce the amount of practice variation, which is a leading driver of rising health spending.

But whenever the evidence calls for less medicine, the political and public outcry will be deafening. Today it’s mammograms. What if tomorrow an independent body calls for, say, a reduction of angioplasty or cardiac bypass surgery, which studies have suggested are being overused?

Both the politicians and the public will simply cry, “Rationing!” Thus, the myth that more care is better care will continue to be perpetuated, and the data ignored.

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