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Hi Rod, this was my reply to Ben: 1): 2) and 5) (it might be that tests for single enzyme deficiency at birth, e.g. for PKU should continue, as over diagnosis and false positives, and costs minimal) 2) no Owen On Sat, Nov 3, 2018 at 9:19 PM Rod Jackson <[log in to unmask]> wrote: > Hi Ben. It would be impossible to answer your very general questions, so > perhaps some examples would help the discussion. > > I have never worked in the field of newborn screening but does anyone on > the list have concerns about screening newborn babies for PKU? > > > Cheers Rod > > > On 4/11/2018, at 7:03 AM, Djulbegovic, Benjamin <[log in to unmask]> > wrote: > > > > I have changed the subject heading to allow easier tracking of this > thread, but in light of Owen’s, Vasiliy’s, Kumara’s and other people’s > posts, I’d like to poll this group on this issue. Can you please send me > your reply to the following questions ( I will then collate the responses > and share with the group): > > > > 1) should current screening programs* be abandoned? > > > > 1) yes ( all screening tests, adult and children population) > > 2) yes ( all screening tests, adults only) > > 3) yes ( all screening tests, children only) > > 4) no ( none of the current screening tests should be abolished) > > 5) no ( some screening tests should be left in place) ( if you want, > specify which screening test you support:______________) > > > > 2) should an asymptomatic patient be offered diagnostic, screening or > risk evaluation assessment? > > 1) yes > > 2) no > > > > * I realize that the “current screening programs” vary among the > countries, so try to answer it the way you understand screening as > practiced in your country. > > > > Thanks- i hope most people on the group answer the questions and not > only vocal few ( <1% of us voice their opinion in the public forum like > this, unfortunately) > > > > Ben > > > > Sent from my iPad (please excuse typos ) > > > >> On Nov 3, 2018, at 5:34 AM, Vasiliy Vlassov <[log in to unmask]> > wrote: > >> > >> [Attention: This email came from an external source. Do not open > attachments or click on links from unknown senders or unexpected emails.] > >> > >> > >> > >> > >> > >> Dear Owen, > >> thank you for the this last comment. Just one point. By the way you say > that "... this in military interventions > >>> today, on apparent humanitarian grounds, that claim to have precision > >>> bombing technolgies that achieve effects on their intended target, but > >>> fail to value, or mention, the collateral harms: deaths of increasing > >>> numbers of civilians..." > >> It is not correct. By the best estimates we have, the civilians to > militants in human wars die as 1:1 for centuries. Claims that pricesion > weapon is not precision in sense it kills more civilians are not supported > y evidence. > >> VVV > >> > >>> On 2018-11-03 14:35, Owen Dempsey wrote: > >>> To respond to Ben's question, I have tried to be succinct. > >>> Values and beliefs that guide practice: > >>> It might not be made explicit very often but the theoretical basis for > EBM, broadly speaking, is logical empiricism (Howick, 2011), and this is > based on the assumption that the human can know the world and him or > herself through emprical observation, and therefore can be fully self aware > and therefore capable of making fully free and independent decisions. > However, by contrast, our beliefs are constructed for us, through our > ‘reason and imagination’ (Henriques, 1984) within limits set by capitalist > relations of production etc. so that we all fetishise commodities for their > apparent power to generate surplus wealth and life. This makes us all > radically uncertain of our mortality (Dempsey, 2018, ch 12). > >>> Overdiagnosis > >>> Anticipatory tests try to achieve the impossible: to specify that > point of difference between the normal and the pathological, thereby > leading to inevitable over-diagnosis. Over-diagnosis is never personally > experienced as such and so can never be adequately valued as a personally > relevant harm. So this harm can never be adequately represented to > patients as a harm to be valued as harm. This makes the marketing of such > tests anti-democratic (Dempsey, 2018, pp 29-32). > >>> Science and power > >>> Mainstream institutions exercise tremendous power through a > combination of a) pragmatist science and b) political and market > imperatives to innovate and increase production of diagnosed and therefore > treatable patients. It is pragmatist science (and not logical empiricism) > that determines the praxis of EBM. The difference being that pragmatist > science (James, 1996), a) treats elite impressions of the value of intended > effects as if they are empirical facts; and b) does not value collateral > harms as harms. > >>> (We can also, by way of analogy, see this in military interventions > today, on apparent humanitarian grounds, that claim to have precision > bombing technolgies that achieve effects on their intended target, but fail > to value, or mention, the collateral harms: deaths of increasing numbers of > civilians). > >> ... > >> > >> -- > >> \/.\/.\/. > >> > >> Vasiliy V. Vlassov, MD > >> President, Society for Evidence Based Medicine, osdm.org > >> Professor, National Research University Higher School of Economics > >> e-mail: vlassov[a t]cochrane.ru > >> Web page https://www.hse.ru/en/org/persons/14527416 > >> snail mail: P.O.Box 13 Moscow 109451 Russia > >> Phone Russia +7(965)2511021 > >> > >> ######################################################################## > >> > >> To unsubscribe from the EVIDENCE-BASED-HEALTH list, click the following > link: > >> > https://www.jiscmail.ac.uk/cgi-bin/webadmin?SUBED1=EVIDENCE-BASED-HEALTH&A=1 > > > > ------------------------------------------------------------ > > -SECURITY/CONFIDENTIALITY WARNING- > > > > This message and any attachments are intended solely for the individual > or entity to which they are addressed. This communication may contain > information that is privileged, confidential, or exempt from disclosure > under applicable law (e.g., personal health information, research data, > financial information). Because this e-mail has been sent without > encryption, individuals other than the intended recipient may be able to > view the information, forward it to others or tamper with the information > without the knowledge or consent of the sender. If you are not the intended > recipient, or the employee or person responsible for delivering the message > to the intended recipient, any dissemination, distribution or copying of > the communication is strictly prohibited. If you received the communication > in error, please notify the sender immediately by replying to this message > and deleting the message and any accompanying files from your system. If, > due to the security risks, you do not wish to receive further > communications via e-mail, please reply to this message and inform the > sender that you do not wish to receive further e-mail from the sender. > (LCP301) > > ------------------------------------------------------------ > > > > ######################################################################## > > > > To unsubscribe from the EVIDENCE-BASED-HEALTH list, click the following > link: > > > https://www.jiscmail.ac.uk/cgi-bin/webadmin?SUBED1=EVIDENCE-BASED-HEALTH&A=1 > > ######################################################################## > > To unsubscribe from the EVIDENCE-BASED-HEALTH list, click the following > link: > > https://www.jiscmail.ac.uk/cgi-bin/webadmin?SUBED1=EVIDENCE-BASED-HEALTH&A=1 > -- New Book by Owen Dempsey: Anticipation and Medicine: A Critical Analysis of the Science, Praxis and Perversion of Evidence Based Healthcare <https://www.taylorfrancis.com/books/9781351374866> Blog: https://myownprivatemedicine.com/ ######################################################################## To unsubscribe from the EVIDENCE-BASED-HEALTH list, click the following link: https://www.jiscmail.ac.uk/cgi-bin/webadmin?SUBED1=EVIDENCE-BASED-HEALTH&A=1