Just wondered, Christie, if you did a full Decision Analysis using the probabilities & values ? If not would be interesting to see how it compared to your 'intuitive' reaction given the probabilities ....
Cheers, David
On Dec 11, 2014, at 12:02 PM, write words < [log in to unmask] > wrote:
Owen,
I’m a journalist, not a physician, but I outlined the information that I believe women need to know to make an informed decision on mammography in this recent JAMA Internal Medicine essay. You can access the full text using this link .
And here’s another recent piece that touches on some of these issues, The case against early cancer detection .
Best,
Christie
Christie Aschwanden
Email: [log in to unmask]
Website: www.christieaschwanden.com
Blog: www.lastwordonnothing.com/category/christie/
Twitter: @cragcrest
On Dec 11, 2014, at 10:18 AM, OWEN DEMPSEY < [log in to unmask] > wrote:
page 21 of WHO position paper on mammography states:
"The association between mammography screening and overdiagnosis
has been demonstrated consistently across studies and is likely to be
supported by high-quality evidence. However, there is significant uncertainty
about the magnitude of overdiagnosis in the different age groups,
particularly in younger and older women. The estimates vary greatly
(from 0% to 54%) according to the method used, the source of the data and
the definition of overdiagnosis. Thus, the evidence based on the current
available data is low. Two recent reviews estimated that for every one
or two overdiagnosed cases, at least one death due to breast cancer was
avoided, a balance between benefit and harm considered to be appropriate."
This seems like an unhelpful conflation of issues. How can so much uncertainty about the rate of diagnosis tranlsate into so much certainty?
What is a womans chances of being overdiagnosed on a first screening between 40 and 49 say? And what are her chances of havng her life saved by this screening episode?
Owen
On 11 December 2014 at 08:34, Juan Gérvas < [log in to unmask] > wrote:
OMS: valoración del cribado de mamografía. No sin el consentimiento informado. Sólo con pruebas de calidad moderada.
WHO position paper on mammography screening. Not without shared decision-making. O nly with moderate quality evidence.
http://apps.who.int/iris/bitstream/10665/137339/1/9789241507936_eng.pdf?ua=1&ua=1
-un saludo
-juan gérvas
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