Medicare reimburses for cancer and other screenings as part of routine care for older adults. Of course, the goal is to catch diseases in their earliest, most treatable stages. But can preventive care become too much of a good thing?
For years, evidence has grown about wasted Medicare dollars on needless screenings. The Center for Public Integrity found that 40 percent of Medicare spending on common cancer screenings are unnecessary – costing billions of taxpayer dollars. Continue reading
If you’ve missed the bizarre Twitter debate between billionaire businessman and Dallas Mavericks owner Mark Cuban versus all the health and medical experts online who cared to engage, it’s worth catching up.
Cuban’s comments are key to understanding one of the most important paradigm shifts going on in American health care: the use of data to create evidence-based screening guidelines to reduce unnecessary, expensive and potentially harmful interventions. Writing about screenings therefore requires understanding both the benefits and the harms of screening.
Cuban tweeted Wednesday afternoon:
This wasn’t an April Fool’s joke – Cuban was seriously recommending to his 2.8 million followers that getting four blood tests a year, every year, was a smart health decision. Charles Ornstein called him out and later Storifyed the ensuing debate. Other journalists, such as Seema Yasmin, M.D., at The Dallas Morning News, also wrote about how wrong Cuban is. Continue reading
Soaring drug prices that make even copays unaffordable for many, an unchecked rise in robotic surgery, financial abuse revealed using previously secret Medicare data, and the health ramifications of the boom in hydraulic fracturing for oil were among the top winners of this year’s Award for Excellence in Health Care Journalism.
Awards also went to articles that examined the “collateral damage” of urban violence, followed a team of doctors and scientists fighting Ebola, and exposed the growing number of unregulated diagnostic tests that can lead to patient harm.
Read the full announcement and see the winning entries. Congratulations to all of the winners!
Last month, journalists from the New England Center for Investigative Reporting raised serious questions about prenatal genetic screening tests, saying physicians and patients may not fully understand the results of these tests for fetal abnormalities.
In their reporting, the journalists exposed a symptom of what may be a bigger problem: the proliferation of genetic tests without a full understanding about what such testing can and cannot do. Even health insurers have struggled to understand how to pay for new genetic tests.
The stories also pointed out that federal regulators are wrestling with how to classify genetic tests. Many of these tests fall into the category of what pathologists call lab-developed tests or LDTs. These tests are not regulated by the FDA, as the NECIR journalists reported. In October, the FDA proposed regulating these tests as medical devices and clinical laboratories are pushing back, saying such regulations could interfere with the practice of medicine.
We’ll address these issues one at time. Continue reading
Two U.S. senators have proposed a bill to support research into prostate cancer, calling for “a national strategy to combat prostate cancer.”
Senators Barbara Boxer (D-Calif.) and Jeff Sessions (R-Ala.) have introduced the National Prostate Cancer Council Act, which would establish a body made up of federal agencies, patients, and medical experts. It would coordinate prostate cancer research and services across all federal agencies.
In a press release announcing the legislation, Sessions said, “Testing and early detection are the keys to combat this disease. When identified early, the survival rate for prostate cancer is very high. We need to ensure that we have the most advanced screening tools available and this legislation is a step in the right direction.”
The National Cancer Institute estimates there will be 233,000 new cases of prostate cancer and 29,480 deaths in the U.S. this year. Continue reading
The U.S. Preventive Services Task Force issued recommendations on Tuesday on the value of routine cognitive screening for older adults, concluding “the current evidence is insufficient to assess the balance of benefits and harms of screening for cognitive impairment.”
The task force said there was inadequate direct evidence on the benefits, and that several drug therapies and non-pharmacologic interventions have a “small effect” on the short term cognitive function measures in patients with mild to moderate dementia. They said the extent of clinically relevant benefit is uncertain. This is the same conclusion reached in previous assessments of the clinical benefit of cognitive screening.
They did find evidence that interventions targeted to caregivers have a small effect on caregiver burden and depression, but the scope of clinical relevance is still uncertain. This recommendation applies to universal screening with formal screening instruments in community-dwelling adults in the general primary care population who are older than 65 and have no signs or symptoms of cognitive impairment. Early detection and diagnosis of dementia through the assessment of patient-, family-, or physician-recognized signs and symptoms, some of which may be subtle, are not considered screening and are not the focus of this recommendation. Continue reading