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Most of us like it when our health care decisions are simple and straightforward -- when the potential benefit of one option far outweighs the benefits and risks of the other. Should I smoke? No. Should I get a mammogram? Yes. However, advances in screening, preventive measures, diagnostic technologies and treatments have rendered our preference for the certainty of the simple choice obsolete.
K-Mart, Medtronic, and a bunch of specialty medical groups are sponsoring a campaign called "Find the AAAnswers" - the AAA standing for abdominal aortic aneurysms.
African-Americans are less likely than whites to be screened for colorectal cancer, and the disparity almost certainly contributes to higher mortality. A new review of studies identifies effective strategies for improving the situation, but suggests that work remains to be done.
Whether you're healthy or ill, there are a variety of medical tests your health care team might recommend for you.
Deborah Lewis got a shock when her pain management clinic called about a recent MRI test: They told me I needed to see an oncologist right away, that I had tumors on my spine. An oncologist did a lot of tests even though he said the MRI report didn't indicate anywhere that I had tumors or cancer. In fact, Lewis just had benign tumors common to her chronic medical condition. After a lot of wasted money, time and a whole lot of fear, we learned to question all test results,' she says.
A women goes from healthy to heart transplant patient in just a few weeks. Could this have been avoided? True positives, false positives, false negatives, true negatives'how can we understand and use our test results to make good treatment decisions?
Our latest Prepared Patient, Medical Testing: You Need Answers, offers guidance on how to talk to your doctor about medical tests and what to consider before and after the test. Here are related thoughts from other blogs-Dr. John Schumann of GlassHospital, Dr. Michael Kirsch of MD Whistleblower, and Anna Sayburn on Consumer Reports Health Blog. Recent feature articles on medical tests from The Wall Street Journal & the ACPHospitalist are also included.
Dr. H. Gilbert Welch has written a new book Over-diagnosed: Making People Sick in the Pursuit of Health, with co-authors Lisa Schwartz and Steven Woloshin. It identifies a serious problem, debunks medical misconceptions and contains words of wisdom. We are healthier, but we are increasingly being told we are sick. We are labeled with diagnoses that may not mean anything to our health. People used to go to the doctor when they were sick, and diagnoses were based on symptoms. Today diagnoses are increasingly made on the basis of detected abnormalities in people who have no symptoms and might never have developed them.
When doctors can self-refer for MRI, patients are more apt to receive scans – and even surgery – for low back pain.
For some patients, delaying treatment while regularly monitoring the progress of disease may benefit them more than a rush to pharmaceutical or surgical options.
Teens and young adults prefer rapid HIV testing that can deliver results in less than an hour, but some still worry about whether their tests will be confidential.
After seeing the NBC Nightly News last night, a physician urged me to write about what he saw: a story about a "simple blood test that could save women's lives." Readers - and maybe especially TV viewers - beware whenever you hear a story about "a simple blood test."
It is not just when we are seriously ill that numbers dominate our experience with health care. Advances in technology have made it possible to quantify and thus monitor a seemingly infinite number of physiological and psychological health-related states.
There are a few things a man should think about seriously before rolling up his sleeve for the supposedly "simple" blood test. 'But here, prostate cancer screening is hawked in the same setting as the modern-day carnies pitching their slice-'em-and-dice-'em devices and inventions you only see at the state fair - "only at this price today!"
Recent posts at Health News Review highlight how the over-simplification of medical journalism leads to misinformed, over-treated patients.
After breast cancer surgery, a follow-up regimen that includes regular mammograms offers a survival benefit over a follow-up regimen that does not include mammograms, according to a new systematic review.
Public health researchers have long attributed the disparity in colonoscopy rates between whites and minorities to a lack of health insurance or access to doctors. Now, a new study in the journal Health Services Research suggests the reasons for the differences are more complex.
Mexican women in the United States are less likely to get mammograms than white women, black women and other Latinas, according to a new study in the journal Cancer Epidemiology, Biomarkers & Prevention.
New research finds that patients may not always receive all of the screening tests and counseling services that are due during their medical checkups, according to a study in the American Journal of Preventive Medicine.
For type 2 diabetics who are not on insulin, monitoring their blood sugar does little to control blood sugar levels over time and may not be worth the effort or expense, according to a new evidence review in The Cochrane Library.
Your parents still might be willing to do your laundry, but if you’re over 18, they can’t make your medical decisions. Are you ready to navigate the adult health care system?
Will we - you and me and our parents and neighbors - be a significant force in quelling the tide of over-testing for the early detection of disease?
A new study finds U.S. physicians are performing Pap smears far more often than needed to prevent cervical cancer.
Recently the Annals of Internal Medicine
published a new report on how doctors (don't) understand cancer screening stats. This unusual paper reveals that some primary care physicians a majority of those who completed a survey don't really get the numbers on cancer incidence, 5-year survival and mortality.
New research about why people forego colorectal cancer (CRC) screening suggests that three fears play a significant role; fear of embarrassment, fear of getting AIDS and fear of pain may make some seniors skip the potentially lifesaving tests.
A few weeks ago, a letter arrived from the Life Line Screening company enticing me to come in for a 'simple, potentially lifesaving screening' to assess my risk for strokes and other vascular diseases.
Though I may want fast food health care when I'm healthy, I don't want it if I'm sick or have the potential to be sick. People want to have the opportunity for a dining-in experience, not just fast food.
We've all heard about well-baby visits, but if you're a healthy adult, you probably have no plan to see a doctor. When there's nothing to complain about, many of us go years without a comprehensive medical check-up.
People with a family history of certain diseases, including heart disease and diabetes, often underestimate their risk for developing them, even after completing a risk assessment and receiving personalized prevention messages, finds a new study in the American Journal of Preventive Medicine.
People who are given tools to help them decide whether to have a colorectal cancer screening test are more are likely to request the procedure, finds a new study in the American Journal of Preventive Medicine.
Find accurate information that helps you with choices about your health.
Checkups are good for establishing a relationship with your primary care clinician and for screening tests. Here are resources with more on what tests you might need to stay healthy.
Doctors run tests to check your health or to figure out what’s wrong. Here are some basic questions you should ask about medical tests.
You could be at risk for disease based on your age, health behaviors or family history. Here’s how to find out.
Almost half of older adults visiting a public health clinic where HIV/AIDS was prevalent were not screened for the disease in the past 12 months, finds a study in The Gerontologist.
Patients’ ability to make genuinely informed choices about undergoing disease screening increases when the risk information that they receive is related to their own personal risk, rather than average risks, according to the results of a Cochrane systematic review.
If I didn't object to receiving what I recognized as too much medical care, it should not be a surprise that, according to one study, many inappropriate tests and treatments are being provided more often, not less.
Shortly after we moved to Washington, DC, my wife and I purchased a basic home security system, the kind with a programmable keypad, multiple door alarms and a motion sensor. All things considered, it's hard to argue that the benefits of this preventive measure have outweighed its cumulative harms.
Most sexually active teens don’t get information about sexual health from their health care providers, finds a new study in the Journal of Adolescent Health
Despite government efforts to expand diagnostic criteria for pelvic inflammatory disease, ER doctors are not identifying the condition any more often in adolescent girls, finds a new study in Journal of Adolescent Health.
A survey of men age 40 to 74 found that 54 percent said that they would still opt for a popular prostate cancer screening test despite recent recommendations that the test not be performed, finds a new study in American Journal of Preventive Medicine
Fluctuations in the unemployment rate affect people’s health care choices, finds a new study in Health Services Research
A new study in the American Journal of Preventive Medicine finds that some cancer survivors do not always have the best access to primary care and that the type of health insurance they have—or don’t have—may be a factor.
Older women living in the most deprived areas of the U.S. Appalachia had higher rates of late stage breast cancer than women in more affluent areas, finds a new study in Health Services Research
"Your biopsy is positive." None of us ever forgets when we first heard some version of that phrase. I heard it five years ago today...
Lately it seems that more health care insiders are advocating for a "less is more" approach for some screening tests. Cancer, dementia and kidney disease are a few examples. But will we just say "no"?
Blacks, Hispanics and Asians are less likely than non-Hispanic Whites to visit a health care professional, even with health insurance, finds a recent study in the Journal of Health Care for the Poor and Underserved
My ultrasound came back "likely benign" with the recommendation that I follow up in six weeks to be sure. Over the next few weeks, I received one bill after another that totaled $1,000. Unable to pay, I felt abandoned by the system to which I had committed my career and did not call to schedule a second ultrasound...
It is challenging, in the years following a cancer diagnosis, to assemble health care that protects us from the lingering effects of the disease and its treatment and that alerts us to a recurrence or new cancer. I hope these reflections will help those who've been diagnosed with cancer live as long and as well as they can...
In 2008, breast cancer deaths in women under age 50 cost the economy $5.49 billion in productivity and resulted in an estimated 7.98 million years of potential life lost, finds a study in the American Journal of Preventive Medicine
Residents of Massachusetts saw small gains in health status following the enactment of a state-wide health insurance mandate in 2006, finds a new study in the Milbank Quarterly
In part one of our series, we look at the basics of picking a health insurance plan that's right for you, your family or a loved one. Our 'Be a Prepared Patient' resources can help you find the best coverage at the best price for your health needs...
In part five of our series, we look at the yearly check-up and offer resources for people who are trying to decide which preventive care services are right for them...
When we talk about a consistently clear pattern of news stories that exaggerate or emphasize benefits while minimizing or ignoring harms, we are talking about stories exactly like this one...
People who identify as homosexual have several health disparities relative to their heterosexual peers, finds a new study in the American Journal of Preventive Medicine
A new study in General Hospital Psychiatry
finds patients visiting the hospital for a variety of ailments can be easily screened for depression and anxiety as they wait for care.
At my six-month checkup yesterday all was routine, other than my blood pressure being 131 over something when it's usually in the 115 range. Ten years ago I wouldn't have shared my fears at all, but thanks to early-stage breast cancer it's hard for my mind not to immediately go to the worst-case scenario...
Most professional health care stakeholders believe that the more we patients and caregivers know about our health and diseases, the better our outcomes will be. When faced with the facts about our health risks and dangerous habits, they think we will rationally change our behaviors and correct our misunderstandings. As a patient, I want to know: At what point do I know enough to reap these hypothetical benefits?
My patient, Mary, was a 28-year-old woman who had completed chemotherapy for stage II breast cancer. After discussing surveillance, frequency of follow-up and ASCO guidelines, I recommended against further testing or imaging. Mary was well aware of the evidence, but she had different plans...
A new study in Health Services Research
reports that patients who get care at federally funded health centers have fewer office visits and hospitalizations, and receive similar or a better quality of preventive care when compared to similar patients of non-health center primary care providers.
If something is medically useless, does it still have value if it gives the patient (and perhaps the clinician as well) some peace of mind? To many patients, this is no small thing. Unfortunately, it's also often abetted by consumer marketing that plays up the peace-of-mind aspect of certain tests while remaining silent about the limited benefit, the possible risk and the clinical complexity that may be part of the larger picture...
Unfortunately, the nitty gritty of getting good care is not really newsworthy, unless we're talking about how poor it is. However, there are opportunities for journalists and writers to report "news you can use" that would be very helpful to many people, and there is a big gap in reporting on most of these necessary tasks...
I have offered before a few reasons for eligible patients to consider not getting screened for lung cancer. I concede, however, that reasonable people might conclude that the potential harms are outweighed by the benefit of reducing one's risk of dying by one-fifth. The next critical question that needs to be asked is: one-fifth of what?
Media-fueled flip-flops and research breakthroughs on lifestyle and health behaviors are wearing down my usual patience with the provisional nature of science. Even simple dietary recommendations like lower fat/salt recommendations have become complicated as old truisms are overturned by new evidence. So I'm asking: To whom should I turn for meaningful guidance about modifying my risk for illness and boosting my health?
A federal screening program markedly reduced death and illness from cervical cancer in underserved, low-income women but reached just 10 percent of the likely eligible population, finds a new study in the American Journal of Preventive Medicine
A mother takes her teenage son to an urgent care center that is part of her insurance plan's network. A clerk quickly refers him to the emergency room, across the street, which just happens to be part of the same hospital system as the urgent care center. Is this UCC sending some patients to its related hospital ER, clearly a place of high-priced care, to gin up revenue for the system's bottom line?...
Veterans who receive mental health screening during primary care visits are generally getting adequate follow-up treatment, but the process for acquiring care could be improved, finds a new study in General Hospital Psychiatry
As I sat on a New York subway one sizzler of a day, an ad for an ice cream cone grabbed my attention. After a closer read, I realized the ad was not touting ice cream but the Center for Advanced Digestive Care, a part of New York Presbyterian, one of the city's most prestigious hospitals and well known for its TV ads designed to cultivate brand recognition. The ice cream cone was an effective attention-grabber. So was the message…
A new study in the Journal of Adolescent Health finds that the sexual risk behaviors of young Hispanic people living in the U.S. vary considerably with their degree of acculturation.
The use of social networking sites like Facebook may have implications for accessing online health information, finds a new longitudinal study from the Journal of Health Communication
A new cross-sectional study in American Journal of Preventive Medicine
finds that only half of adults in the U.S. were screened for diabetes within the last three years, less than what is recommended by the American Diabetes Association (ADA).
As many as half to two-thirds of women who’ve undergone hysterectomies or are older than 65 years report receiving Pap tests for cervical cancer, despite recommendations against it, finds a new study in the American Journal of Preventive Medicine
Colorectal cancer, or CRC, is the second-leading cause of cancer deaths in the United States. State public health programs could screen nearly eight times as many individuals and prevent nearly twice as many CRC cases by using fecal immunochemical testing, or FIT, instead of colonoscopies, finds a new study in Health Services Research
As narrower insurance networks begin to limit where we can get our care and contradict the American notion of abundant choices, I thought about the Canadian health care system and rumors of its long waiting lists that grab U.S. headlines. Yet, narrow insurance networks, sky-high deductibles, co-insurance and co-pays are ways of controlling our medical expenditures. Instead of rationing with waiting lists, America rations with price...
New research in General Hospital Psychiatry
finds that homelessness, cocaine use, being on Medicare, having a personality disorder or having liver disease appears to be a predictor of frequent ED use by people with a psychiatric illness.
New research in the journal Cancer
finds that Medicaid recipients are more likely to undergo cancer screening tests when their doctors receive higher reimbursements for routine office visits rather than for the tests themselves.