Educated guesses : making policy about medical screening tests

著者

書誌事項

Educated guesses : making policy about medical screening tests

Louise B. Russell

University of California Press, c1994

  • : cloth
  • : pbk

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注記

"A copublication with the Milbank Memorial Fund."

Includes bibliographical references and index

内容説明・目次

巻冊次

: cloth ISBN 9780520083653

内容説明

Prevention is the best cure - or is it? As medical experts stress the importance of annual check-ups and routine screening, patients have assumed that such tests are essential for saving lives. But just how effective are these tests? Medical economist Louise Russell challenges the standard wisdom that more is better by examining three routinely administered tests in the USA - those designed to detect cervical cancer, prostate cancer, and high cholesterol. What she finds should sharpen today's health-care debates. Recommendations such as annual Pap smears for women and prostate tests for men are simply rules of thumb that ignore individual cases and the trade-offs between escalating costs and early detection, Russell argues. Evidence on the effectiveness of screening tests demonstrates that the actual results are far less beneficial than one might expect. It is not clear, for example, that annual Pap smears for all women over age 18 are any more effective in reducing cervical cancer deaths than testing every three years; nor is there solid evidence for the value of annual prostate cancer screening among men under 50. The case studies Russell presents raise serious questions about how tests are evaluated, recommendations formed, and medical resources allocated.
巻冊次

: pbk ISBN 9780520083660

内容説明

A copublication with the Milbank Memorial Fund Prevention is the best cure - or is it? As medical experts hammer home the importance of annual medical checkups and routine screening for everything from high blood pressure to cancer, Americans have come to believe that frequent screening tests are essential for saving lives. But just how effective are the tests that we have come to take for granted? In this provocative book, medical economist Louise Russell challenges the standard wisdom that more is necessarily better by examining three routinely administered tests - those designed to detect cervical cancer, prostate cancer, and high levels of cholesterol. Standard recommendations such as annual Pap smears for women and prostate tests for men over forty are in fact simply rules of thumb that ignore the complexities of individual cases and the tradeoffs between escalating costs and early detection, Russell argues. By looking beyond these recommendations to examine conflicting evidence about the effectiveness of screening tests, Russell demonstrates that medical experts' recommendations are often far simpler and more solid-looking than the evidence behind them. It is not at all clear, for example, that annual Pap smears are effective enough in reducing deaths from cervical cancer to justify the enormous additional costs involved in testing all women every year rather than every three years. Nor is there solid evidence for the value of prostate cancer screening, despite recommendations that all men over forty be tested annually. The three case studies presented here, each important in its own right, raise serious questions about how tests are evaluated, recommendations formed, and medical resources allocated. At a time when American health care policies and the escalating costs of health care are the object of renewed scrutiny, Russell's challenge to conventional wisdom is especially important. Based on a detailed analysis of the available medical research, yet written in a straightforward, jargon-free style, "Educated Guesses" will be required reading for all those concerned about making informed choices about health care policies and their personal health.

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