There’s an article in the Guardian describing the US treatment of a woman who had DCIS diagnosed at screening, in one breast. She went on to have bilateral mastectomy, with flap reconstruction, an autologous blood transfusion, and a stay in ITU. The author writes ” It is so confusing. What was that all about? Cancer? […]
Continue Reading →Nuffield Health : adverts and evidence
This is an advert from this week’s BMJ. I am positively fuming about it. Nuffield Health are responsible for some non evidence based practices via their ‘health assessments‘. These currently consist of annual mammograms for women over 40, annual cervical smears, pelvic (ie vaginal) examination, urine analysis, ‘hydration levels’ and a chest xray ‘if […]
Continue Reading →Choices for screening and paternalism
Luisa Dillner wrote a statistically correct and informative article about breast screening in the Guardian recently; she has been replied to by Chris Askew, the chief executive of Breakthrough Breast Cancer. He makes a big mistake. In his first paragraph, he says “Breakthrough Breast Cancer hopes this will not discourage women from attending their breast-screening […]
Continue Reading →We are in serious trouble over screening
BMJ summer column, here but cut and pasted till the login works below. We are in serious trouble over screening. For all that medicine has cringed at paternalism and “doctor knows best,” has wrung its collective hands, and promised to do better, screening is still the last great preserve of unethical practice. If you are […]
Continue Reading →New law on irradiating well people: will it stop screening companies profiting?
I don’t know. I hope so. An amendment has been made to the Ionising Radiation (Medical Exposure) (Amendment) Regulations 2011. It comes into force on July 25th. It says that “At the end of regulation 3(a) (application) of the Ionising Radiation (Medical Exposure) Regulations 2000(3) after “medical diagnosis or treatment” insert “, including any exposure […]
Continue Reading →Older people and alcohol: Royal College of Psychiatrists gets screening wrong
Much ado about the RCPsych report out today on ‘Our invisible addicts’; supposedly, older people addicted to drugs or alcohol. I don’t think this is a new concern. Part of the ‘problem’ is that the care of people with addictions has slowly got better and people are living longer. Northern Doctor has written very well […]
Continue Reading →Is the US waking up to the harms of screening?
Thanks to Joe Stirt for this. This Washington Post article seems to suggest that there is at least a little bit of light emerging in the debate about breast screening. But they don’t go far enough – breast screening causes harm, tangible, real harm, to women who are diagnosed with tumours that would never have […]
Continue Reading →“Setting an example?” – BMA news article on screening misses the point.
I wish I could link to this article, which is published as a feature in BMA News, a supplement that comes with the BMJ. It’s worrying. “Professor (Erica) Frank, research chair in preventative medicine and population health at the University of British Columbia in Vancouver, Canada, has spent more than 20 years examining the relationship […]
Continue Reading →Iatrogenesis: telling patients about radiation risks
The BMJ carries a good editorial today about the risks of radiation as used in clinical practice, and suggests that we should be informing patients about the dangers as well as being careful about the use of it. But the biggest issue for me is not consent for radiation as used to investigate potentially serious […]
Continue Reading →Here’s a funny thing
I didn’t know that Karol Sikora had set up the the business of screening well people with CT, MRI et al. How interesting, considering the advice from the National Screening Portal. And how interesting, too, that they recommend as one of their ‘partners‘ ‘The Causeway Retreat’ which “offers individual and group addiction & stress therapy […]
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