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Educated Guesses - Making Policy about Medical Screening Tests (Paperback, New)
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Educated Guesses - Making Policy about Medical Screening Tests (Paperback, New)
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"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, andmedical 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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