The site, known for its systematic reviews and ratings of news stories about health care, had been funded since 2005 by the Informed Medical Decisions Foundation but lost its funding July 1, 2013. Continue reading
Gary Schwitzer, AHCJ member and HealthNewsReview.org publisher, calls for more precise language when describing medical tests and to make a bit of an example of Prevention magazine on his blog. The March issue of the magazine leads with a story titled “4 Screening Tests Women Fear.” The problem? The story’s about mammograms, colonoscopies, endoscopies and MRIs. And two of those things, Schwitzer writes, are not like the others. Emphasis mine.
…Only 2 of the 4 tests discussed are screening tests.
Yes, mammograms and colonoscopies are screening tests – used in an apparently healthy population looking for signs of trouble.
Endoscopies and MRI scans — as discussed by Prevention in this case — are not screening tests but diagnostic tests used to help diagnose what is the problem in people with signs or symptoms of something wrong. Screening tests are for people believed to be healthy. Diagnostic tests are for people believed to have a problem.
Schwitzer’s not just splitting hairs here. As he explains, getting these distinctions right can have real-world health impact.
The semantics are important. Lumping diagnostic tests like endoscopy and MRI in with screening tests like mammograms and colonoscopies can give readers the impression that everyone should consider all of them. And, no, not everyone needs to be worried about when to have their next endoscopy or MRI scan…
For physicians and patients, treating lower back pain is an exercise in restraint and patience. According to federal guidelines, such pain usually resolves itself within six weeks with minimum intervention, so it’s often a matter of resisting the temptation to order a $500 MRI within that time window. And in Minnesota, a state known for its health-care-related moderation, that temptation seems to be too much.
As the Christopher Snowbeck of the St. Paul Pioneer Press reports, Minnesota doctors are worse than the national average when it comes to giving lower back pain patients MRIs without exploring cheaper alternatives. And in the land of Lake Wobegon, being below average is a big deal. The conclusions come from Hospital Compare’s newly released 2008 outcomes data. To learn more about this data, check out AHCJ’s recent conference call on the subject.
For some help reading between the lines of Snowbeck’s story (and the Hospital Compare data), see Gary Schwizter’s recent blog post on the subject; he doesn’t mince words.
The story includes other excuses from local providers along the lines of “the data are outdated…we’ve changed…we’re better now…that can’t be right…it’s not us!” When have you ever seen a story on health care data that didn’t have these predictable reactions? It reminds me of The Tobacco Institute continually rejecting any new finding that showed new harms from smoking. When you don’t like the data, damn the data. For most of the history of medicine we had no outcomes data to show patterns of practice or what happens to people over time. Now that we’re starting to collect some such data, vested interests find that information is a menacing thing.
For more about treatment of back pain, particularly how much money is spent on it, see the just-released “Back Problems: Use and Expenditures for the U.S. Adult Population, 2007” (PDF) from the Agency for Healthcare Research and Quality.
Gary Schwitzer, publisher of HealthNewsReview.org, announced that he has resigned from his position as an associate professor in the University of Minnesota’ School of Journalism and Mass Communication.
He announced the resignation on Twitter and through a video on Facebook, in which he explains that he made the move so he could devote his time to HealthNewsReview.org, his blog and “other writing and professional workshops.”