Evidence based medicine and politics

I ' m not sure if you can read this -- I have a cookie that gives me access, but the URL doesn ' t include the proxy server and it appears to be accessible. Let me know. Anyway, it ' sa discussion in NEJM of the U.S. Preventive Services Task Force. The USPSTF is a panel of clinical experts convened by the Agency for Healthcare Research and Quality, AHRQ, which is usually pronounced like ark. It draws on available research to evaluate screening tests and preventive interventions. An A or B grade means they recommend it. A C grade means it might be worthwhile for some people, but you should discuss it with your doctor and make your own decision.  Under current law, anything with an A or B grade has to be covered by insurance, but a recent court decision, based on a fairly arcane technicality about the legal authority of the Task Force, has that in limbo. Basically, conservative judges don ' t like any form of regulation and they are using ridiculous constitutional theories to try to eliminate the powers of the federal government. That ' s kind of disturbing, but it ' s not what I want to focus on right now.The Task Force members are all generalist clinicians, by design. The main reason has to do with screening tests. If you ' ve been here recently you ' ve come across the Bayes theorem. Without rehashing all that the essential point is that even a very accurate screening test will produce false positives, maybe even most of the time, depending on the underlying rate i...
Source: Stayin' Alive - Category: American Health Source Type: blogs