Tuesday, October 11, 2011

Medical statistics and decision-making

Back in April, I discussed Welch, Schwartz, and Woloshin's excellent book "Overdiagnosed: Making People Sick in the Pursuit of Health" in a post. The authors assume readers will want to focus on the numbers, and provide a clear guide to interpreting medical advice that comes your way. I was reminded of it several times in the past week. First the US Preventive Services Task Force issued a draft statement recommending against PSA screening for  asymptomatic men.

Second, the NY Times Magazine discussed PSA testing in an article on Sunday titled, "Can Cancer Ever Be Ignored?" FWIW, the article quotes Welch as saying, “The European trial says 50 men have to be treated for a cancer that was never going to bother them to reduce one death. Fifty men. That’s huge. To me, prostate screening feels like an incredibly bad deal.”

Third, last week I read Jerome Groopman and Pamela Hartzband's newest book "Your Medical Mind: How to Decide What is Right for You." That book is not a numbers book by any means, but it does provide several spectra intended to help the general public figure out how to respond when a doctor proposes tests, medication, or other procedures. Written in the clear style we have come to expect from Dr. Groopman, it is pitched at a level you can take in while distracted by the emotions and time pressures of a medical crisis.

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