Ethics. Research. Community.

Over-Screening, Rigid Protocols, and Changing Guidelines: A Personal Journey Through the Looking-Glass

by Craig Klugman

A new JAMAarticle reports on a US Preventive Services Task Force recommendation against routine ECG in patients without symptoms of heart disease: “For asymptomatic adults at low risk of CVD events (individuals with a 10-year CVD event risk less than 10%), it is very unlikelythat the information from resting or exercise ECG (beyond that obtained with conventional CVD risk factors) will result in a change in the patient’s risk category….”The report states that over-screening can lead to harms such as “invasive procedures, overtreatment, and labeling.”Such advice follows with recent suggestions against many preventive screenings that were de rigueur just a few years ago for prostate cancer, breast cancerand more (the one exception is a recent expansion of colon cancer screening).…

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