Tag Archives: screening

Komen’s funding of research drops; writer looks at charity’s message vs. science

Amid the controversy over the Susan G. Komen for the Cure foundation’s changes in funding for Planned Parenthood, Reuters’ reporters Sharon Begley and Janet Roberts took a look at the organization’s financial statements.

Their analysis shows that the charity has “cut by nearly half the proportion of fund-raising dollars it spends on grants to scientists working to understand the causes and develop effective new treatments for the disease.”

In 2008, it spent 29 percent of its donations on research awards. In 2011, that number was down to 15 percent.

Reuters reports that, according to the 2011 financial statement, “43 percent of donations were spent on education, 18 percent on fund-raising and administration, 15 percent on research awards and grants, 12 percent on screening and 5 percent on treatment.”

Meanwhile, AHCJ member and independent journalist Christie Aschwanden writes that the real scandal lies with the organization’s “science denialism.” She says it has perpetuated the “notion that breast cancer is a uniformly progressive disease that starts small and only grows and spreads if you don’t stop it in time” – breast cancer’s false narrative.

Aschwanden points out that Komen’s insistence that women be “screened now” and that early detection saves lives, as proclaimed in its ads, “flies in the face of basic cancer biology” as well as places blame on people who have metastatic breast cancer. The piece is well worth a read, especially to find out what Komen’s own chief scientific adviser says about the organization’s message.

And, for a re-cap of the Komen saga, ProPublica has put together a handy timeline of Komen’s “Shifting Story on Planned Parenthood.”

KevinMD: Media is key to curbing MRI overuse

On the MedPage Today outlet KevinMD.com, Dr. Kevin Pho himself writes that media coverage of the overuse of certain screening procedures is “long overdue,” and praises The New York Timesrecent coverage of a study showing that in some cases MRIs can lead to more harm than good.

In the Times, reporter Gina Kolata explained, when unleashed upon the throwing shoulders of 31 healthy professional baseball pitchers, “M.R.I.’s found abnormal shoulder cartilage in 90 percent of them and abnormal rotator cuff tendons in 87 percent.” It’s a result, Kolata wrote, that shows that MRIs are “easily misinterpreted and can result in misdiagnoses leading to unnecessary or even harmful treatments.”

Back at his web portal, Pho writes that there are two steps that need to be taken to curb the overuse of the MRI. The first is cracking down on physicians who own their own MRI machines or otherwise profit from the tests, and the second is what he calls “adjusting patient expectations.” That’s where, he says, the media comes in.

there are some, but not all, patients who expect a scan and equate an MRI with “being thorough.” In fact, when orthopedic fellows cited in the Times story suggest that patients may not need a scan, patients “look at them like, ‘You don’t know what you’re doing.’”

Doctors can help educate patients away from the mythical benefits of overtesting. But the most effective teacher is the media, which wields significantly more influence. That’s why a story like this in the Times should be applauded, and promoted.

A fun aside? The study was conducted by none other than Dr. James Andrews, whose name will be familiar to anyone with even a passing familiarity with the sports pages.

ProPublica’s Allen opens window into screening business

In an investigation co-published with his old friends at the Las Vegas Sun, ProPublica’s Marshall Allen offers a revealing investigation into Heart Check America, a company whose high-pressure sales tactics and dubious quality record have earned it reams of consumer complaints and attention from state authorities.

Allen’s first-person anecdotal opener alone is enough to make the story worth reading, and the fact that he backs it up with thorough investigative work that appears to have already launched probes in two states is just the icing on the cake.

Heart Check America’s business model is eerily similar to that of the time-share industry, which is exactly where manager David Haddad earned his business stripes before being forced out by a state attorney general. Patients are lured in with the promise of free tests, then subjected to high-pressure sales tactics until they fork over thousands of dollars for long-term medical screening packages which they likely didn’t need in the first place.

It’s a classic investigation with evidence unearthed from a legion of sources; here’s just a sample of what Allen has assembled:

Colorado regulators checked Heart Check America’s Denver center. They found a litany of deficiencies, including no proof that staffers operating the scanner were qualified, no controls to ensure patients received as little radiation as possible, and that tests were being conducted without doctors’ orders.

Inspectors also found that the clinic was not supervised by a physician licensed in Colorado and that test results weren’t being read by a qualified radiologist or delivered to patients in a timely manner.

Allen’s work plays right into the debate over the efficacy of various screening procedures, especially those applied to low-risk patients, which makes one paragraph at the end of the story particularly ominous.

Haddad said he is continuing to look for opportunities in the imaging business. He has formed a new company, Cancer Check America, in Hilton Head, S.C, to focus on cancer screening.

Related

Prof: Mammogram debate is data vs. anecdotes

When it comes to the recent news that a government task force opposes routine mammograms for women under 50, the public must balance research with anecdotal evidence, according to a professor who studies how breast cancer is portrayed in the media.

Cynthia Ryan, Ph.D., an associate professor of English at the University of Alabama at Birmingham, says the media is doing a “decent” job of covering the debate between the new guidelines from the U.S. Preventive Services Task Force and individuals who are advising that women continue to start having mammograms at age 40.

The professor, who has a book coming out about “the rhetoric of breast cancer in popular women’s magazines,” explains why consumers are torn:

Ryan says that when confronted with extreme representations, there is a part of the human brain that wants to go with scientific study “because we figure it must be credible and rational,” she says. “But another part of our brain embraces anecdotal advice that links the message with a face.

Business pushes screenings despite guidelines

Jeff Baillon, a reporter for KMSP-Minneapolis/St. Paul, saw Life Line’s ubiquitous mailers (here’s the one AHCJ’s Gary Schwitzer received) in which former Olympian Peggy Fleming urges people to go in for medical screening and decided to take a closer look at the company. Ohio-based Life Line sends a van to local neighborhoods and offers a variety of tests for a few hundred dollars.

Baillon and his crew, who went undercover for the occasion, found that the Life Line scans were so quick (as short as four minutes) that they wouldn’t yield good pictures, and would be more likely to turn up false positives and miss real problems. They also covered scans, like carotid artery scans, that guidelines generally advise against, and made no mention of government guidelines when scanning patients, even when prompted. For its part, Life Line, a for-profit business which screens about a million people every year and suggests tests even for low-risk groups, says they don’t “trick” customers and, in fact, actually help save lives.

Baillon’s piece:

(Hat tip to Gary Schwitzer)