Wednesday, November 25, 2009

Follow the Money: Who's Screaming Loudest about Mammogram Guidelines?

Thanks again to Marilyn Mann's tip, I am pleased to recommend a post by our PharmedOut friends, Adriane Fugh-Berman and Alice Bell:

This well-crafted post starts out by analyzing the recent mammogram recommendations from the US Preventive Services Task Force, making a number of key points:
  • The USPSTF is a very prestigious group, working in a generally highly evidence-based manner, and squeaky-clean with regard to conflict of interest
  • The recommendation that women consider waiting till 50 to start mammograms, and have them every 2 years rather than annually, is about as noncontroversial as you can get, and matches the WHO recommendations and guidelines in European nations that have excellent breast cancer statistics
  • There was clearly no cost-cutting agenda involved in the USPSTF deliberations, and there are physical and psychological harms due to excess mammograms that are quite independent of cost
How can one then explain the strident screams of outrage that have filled the media, even going so far as to invoke the "death panels"? Fugh-Berman and Bell's answer-- follow the money. They list the various medical organizations that have put out press releases blasting the new recommendations, showing that they have two things in common. First, the language is amazingly similar, almost as if they were reading from the same script. Second, all have received generous contributions from those firms that make big bucks off mammograms.

Their final conclusion: "When critics with conflicts of interest are banned from the argument, the controversy vanishes."

1 comment:

Michael Kirsch, M.D. said...

The trashing of the USPSTF by our own government was shameful. The biggest victims was comparative effectiveness research and evidence-based medicine. Who won? Politics! See