Wednesday, December 2, 2009

Patient Care: A Healthy Debate

A lot has been made of the recent U.S. Preventative Services Task Force (USPSTF) report (http://www.ahrq.gov/clinic/uspstf09/breastcancer/brcanrs.htm#needs) on the role, expectations and outcomes of mammography screening in the determination of the presence of breast cancer. Here are the actual excerpts from the report that the media reacted to:

“In 2002, USPSTF concluded that there was fair evidence that mammography screening every 12 to 33 months could significantly reduce breast cancer mortality. The evidence was strongest for women aged 50 to 69 years, with weaker evidence supporting mammography screening for women aged 40 to 49 years.”

“Current knowledge about the development of breast cancer is limited. The effectiveness of screening mammography seen in trials presumably results from the early detection of smaller, earlier-stage tumors, which are more responsive to available treatments. Although the most common breast cancer occurs in the epithelial cells that line the duct system of the gland (ductal carcinoma), the sequence of development of invasive cancer is not entirely known.”

“The USPSTF noted with moderate certainty that the net benefits of screening mammography in women aged 50 to 74 years were at least moderate, and that the greatest benefits were seen in women aged 60 to 69 years. For women aged 40 to 49 years, the USPSTF had moderate certainty that the net benefits were small. Because of the uncertainties related to harms of screening, particularly over diagnosis, and the near total lack of trial data for older women, the USPSTF had low certainty about the net benefits of screening mammography for women 75 years or older.”

Patient care should never be compromised. Given the attention that Health Care reform has generated, any news is viewed good and bad based on the reader and interpretation.

The bottom line is that advancements in technology, research and education, not specific to any issue, or disease, has allowed for greater practicality in administering invasive tests. All progress is positive and debate is healthy.

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Pam Argeris is a thought leader in the Healthcare Industry and possesses extensive, hands-on experience with CMS compliance, and multiple regulatory bodies such as NCQA, JACHO, and DOI. In her role at Merrill Corp., Pam focuses on developing solutions for compliance and quality assurance, delivered in a cost effective manner to improve beneficiary and prospect communications. You can contact Pam at Pamela.Argeris@merrillcorp.com.


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