Leisure, Lifestyle & Wellness
Searching for ‘Sickness’
Is screening a dangerous marketing trick for your health?
 
There was an interesting article, some time ago, in The Atlantic, written by Oklahoma physician John Henning Schumann, which brings up the issue of over-screening—medical tests that simply are not necessary, or worse, detrimental. “General health checks did not reduce morbidity or mortality, neither overall nor for cardiovascular or cancer causes, although the number of new diagnoses was increased. Important harmful outcomes, such as the number of follow-up diagnostic procedures or short-term psychological effects, were often not studied or reported and many trials had methodological problems. With the large number of participants and deaths included, the long follow-up periods used, and considering that cardiovascular and cancer mortality were not reduced, general health checks are unlikely to be beneficial,” says the Cochrane Library.
 
I have been condemning routine screenings, especially cancer screenings, for decades. Many routine screening-detected ‘cancers’, in fact, are only incidentalomas which, if left alone or not detected in the first place, would have outlived the person. For example, the so-called ‘ductal carcinoma in situ’ in the breast is not a cancer at all. 
 
Cancer screening is not only useless but downright dangerous. The best studies (these are studies done over 10-year durations in Canada, the US and Europe) have found that you have to screen 2,100 women every year for 11 years to prevent one death. So, to answer the question, ‘Is it lifesaving?’ Yes. One in 2,100 women would benefit from being screened over an 11-year period. 
 
But, at the same time, of those 2,100 women, about 600 to 700 will have a false-positive. They will find something unusual or something abnormal and that will require biopsies, open surgeries, mastectomies and psychological trauma wrote Alan Cassels of University of Victoria (BC) who has authored several books on screening. The best one, according to me, was: Seeking Sickness: Medical Screening and the Misguided Hunt for Diseases. This book is an encyclopaedia of the scam of screening.
 
Screening in apparently healthy people is encouraged mainly to make lots of money from post-screening activities. It is just another marketing trick and a potentially dangerous one at that.
 
One can have a cancer in his/her body and live a perfectly long and healthy life. The cancer literature in medical science which is funded by the industry is mostly wrong. John Ioannidis at Stanford found that most of those studies cannot be replicated independently. Of the hundreds of studies by John Ioannidis, most did not stand up to scrutiny. This applies especially to cancers and statin drugs for prevention.
 
I would end this by quoting Dr Andrew Oxman of the Norwegian Knowledge Centre for the Health Services in Oslo, who told Reuters: “There are lots of examples where things start to be used and have entered the market based on surrogate outcomes and then actually proved harmful.” He mentioned the heart rhythm drugs encainide and flecainide which, for many years, were given to people with acute heart attacks. But trials showed they were actually bad for these patients. 
 
“These drugs were given by well-meaning clinicians, but they actually killed more people than the Vietnam War did,” Oxman said. I still remember the days when I was senior registrar in cardiology at The Middlesex Hospital, London, where the protocol in the CCU was to give all these drugs one after another even if a couple of innocent premature beats are seen on the monitor in this order—Lignocaine, procainamide, encainide, flecainide. Most of these drugs were later shown to be killers!
 
I was once hauled up before an enquiry committee for not following the protocol in a healthy MP admitted one evening directly from the House of Commons where he felt ‘suffocated’. He was, of course, absolutely normal, as proved by later tests. He was grateful to me but I had to face a trial for dereliction of my duty in preference to my patient’s safety!
 
“When it comes to screening, a doctor who says ‘Let’s err on the side of caution,’ may actually err on the side of reckless ignorance and grave harm.” – Otis Webb Brawley
 
(Professor Dr BM Hegde, a Padma Bhushan awardee in 2010, is an MD, PhD, FRCP (London, Edinburgh, Glasgow & Dublin), FACC and FAMS.)

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COMMENTS

Sreekanth Yelicherla

2 years ago

Prof, it is high time that you should think about writing a book which creates awareness among the people. Please think about it. These online articles appear for a week or two and have limited target. But a book can be gifted to elders to read.

Joseph Korah

2 years ago

Thanks Dr. Hegde for spreading the awareness of unnecessary medical tests.

What's Behind Wen Hair Care's Anti-Shampoo Claims
A look at what the shampoo-bashing product is really selling
 
When Wen hair care says to “stop using shampoo” as it does in the above TV commercial for one of its “cleansing conditioner” starter kits, it doesn’t mean stop using all shampoos — though that’s probably the takeaway most viewers get.
 
No, Wen means stop using “shampoos containing harsh sulfates.” (There are, by the way, many sulfate-free shampoos.) A fine-print disclaimer clarifies this but it’s almost impossible to catch between the video’s quick cuts at the start of the commercial.
 
We tracked down the commercial and hit pause:
 
 
Disclaimers are by nature less conspicuous than the message advertisers want to impress on consumers. Wen’s message in this commercial is that its so-called “natural” product is better than shampoo, which the company says causes “finer, thinner [and] weaker” hair.
 
But is Wen here referring to all shampoos or just those containing sulfates? It very well may be the latter, which may explain why Wen decided to plug in that elusive disclaimer at the start of the commercial. So don’t go throwing out all your shampoo just yet.
 
And in the end, what the company is really selling is a negative-option offer that charges nearly $100 every three months for additional products unless you cancel the program.
 
For more of TINA’s coverage on hair care products, click here
 

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Unapproved, but Used in Surgery
A firm sold 18,000 knee-replacement tools before the government called a halt
 
This story was co-published with the New York Times.
 
Carla Muss-Jacobs didn't give much thought to the tools her surgeon would use to replace her knee. Like most patients, she just wanted to feel better and trusted that any devices in the operating room would be safe.
 
In her case, the surgeon sliced open her leg and positioned special cutting guides, like carpentry jigs, over her thigh and shin bones to line up his bone saw precisely. The device, called the OtisKnee, was supposed to speed the surgery and the recovery.
 
Muss-Jacobs' recovery was not speedy. In terrible pain after the operation, she eventually underwent a second knee replacement.
 
As it turned out, the OtisMed Corporation, the maker of the OtisKnee, did not seek clearance from the Food and Drug Administration for its OtisKnee guides before it started selling them. When the company did apply for FDA review, its application was rejected because, the agency said, the company failed to show that the product was safe and effective.
 
In December, OtisMed and its former chief executive pleaded guilty in Federal District Court in Newark to criminal charges of distributing adulterated medical devices. The Justice Department said the company sold and distributed 18,000 of its OtisKnee devices from 2006 to 2009 without FDA approval.
 
No one can say with certainty if the OtisKnee device caused Muss-Jacobs' problems, but in announcing an $80 million settlement of criminal and civil charges against OtisMed, United States Attorney Paul J. Fishman said patients "should be entitled to trust that the devices their doctors are using are safe, effective, tested and approved."
 
An examination of the OtisKnee case shows how easily that trust can be violated in the rapidly evolving world of medical devices, a thriving $110 billion-a-year industry. If not for a whistle-blower, the public might never have learned about the widespread use of a potentially dangerous device that sidestepped regulation.
 
About 700,000 knee replacements are performed every year, making it the most common elective surgery in the country. An aging population is increasing demand, creating opportunity for companies that make orthopedic devices and the accessories used to implant them.
 
 
Courtesy: ProPublica.org

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