JAMA Forum: How Useful Are Screening Tests?

Go read my latest over at the JAMA Forum. A taste:

Recently, Zeke Emanuel stirred up some controversy by suggesting in the New York Times that yearly checkups are a waste of time. As part of his argument, he cited a Cochrane Collaboration systematic review that concluded that general health checkups do not reduce mortality. Given that these visits can cost billions of dollars a year, he argued that they were an unnecessary extravagance.

Many have countered in recent weeks, though, that mortality is a poor choice for outcomes in such an evaluation. After all, many good things can come out of checkups beyond a decrease in mortality. Helping patients avoid death is not the only thing doctors try to do when they see patients.

Moreover, the way our health care system is set up, yearly exams are often where screening occurs. There are relatively few other opportunities to check healthy people for diseases or disorders that could affect them. Many of these screening opportunities are recommended by the United States Preventive Services task force.

But does screening healthy individuals do any good either? A new study by John Ioannidis and colleagues argues no.

Learn more about that study, what many think of it, and how it applies to the ACA, healthcare delivery, screening, and how we think about primary care.


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