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Know Your Chances
This book has been shown in two randomized trials to improve peoples' understanding of risk in the context of health care choices.
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Calling Bullshit Syllabus
Carl Bergstrom's and Jevin West's nice syllabus for 'Calling Bullshit'.
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Like a bridge overdiagnosis
James McCormack with another of his brilliant parodies, warning about the dangers of becoming inappropriately labelled as ill.
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Screen test
Ben Goldacre notes that even if people realize that screening programmes have downsides, people don’t regret being screened.
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Cancer Screening Debate
This blog discusses problems that can be associated with cancer screening, including over-diagnosis and thus (unnecessary) over-treatment.
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Misconceptions about screening
Screening should not be for everyone or all diseases. It should only be offered when it is likely to do good than harm.
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Screening – CASP
This module on screening has been designed to help people evaluate screening programmes.
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Making Sense of Screening
Screening tests can cause harm. This guide helps you to make sense of claims about screening for health conditions.
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Annals Graphic Medicine: How screening is portrayed in the media
A cartoon series addressing the theme "Earlier is not necessarily better".
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Right to remain anxious
Earlier testing is not always better, and can lead to overdiagnosis, overtreatment and anxiety.
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De-awareness day
Earlier testing is not always better, and can lead to overdiagnosis and overtreatment.
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Alicia
Earlier testing is not always better, and can lead to overdiagnosis and overtreatment.
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Gertrud
Exaggeration and hopes or fears can lead to unrealistic expectations about treatment effects.
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Understanding Overdiagnosis bias
Gilbert Welch’s 14-min video discussing the risks of overdiagnosis bias and screening.
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Understanding lead-time bias
Gilbert Welch’s 10-min video explaining why survival ALWAYS rises following early detection -- even if no one is helped.
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Signals of overdiagnosis
Gilbert Welch’s 8-min video showing how population screening for disease leads to overdiagnosis.
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Smart Health Choices: making sense of health advice
The Smart Health Choices e-book explains how to make informed health decisions.
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Who has diabetes?
So how do we decide who has diabetes? When I was in medical school, our numerical rule was this: if […]
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From person to patient
Screening will inevitably turn some people who test ‘positive’ into patients – a transformation not to be undertaken lightly. ‘If […]
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Genetic tests: sometimes useful, often dodgy
Not so long ago ‘genetic testing’ was more or less confined to generally rare, single-gene disorders – for example, the […]
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Lung cancer screening: early but not early enough?
Screening may detect disease earlier, but not always early enoughto make a difference (see Figure). Some cancers, for example lung […]
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Prostate cancer screening: clear harms with uncertain benefits
Prostate cancer is the second most common cancer in men worldwide,14 and broadly falls into two types. Some men have […]
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Breast cancer screening: well established but remains contentious
Since routine breast screening with mammography is well established in many countries one could well assume that mammographic screening must […]
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Abdominal aortic aneurysm screening: proceed with care
At the other end of the age spectrum, abdominal aortic aneurysm screening can also be beneficial. The aorta is the […]
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Phenylketonuria screening: clearly beneficial
Newborn babies are routinely screened for an inherited disease called phenylketonuria (PKU). Babies with PKU are unable to process phenylalanine, […]
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4 – Earlier is not necessarily better
In this Chapter: Introduction (this page) Lessons from neuroblastoma screening Weighing benefits and harms Phenylketonuria screening: clearly beneficial Abdominal aortic […]
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Generating and investigating hunches about unanticipated adverse effects of treatments
Generating hunches about unanticipated effects of treatments Unanticipated effects of treatments, whether bad or good, are often first suspected by […]
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The Screening Circus
In 2009, a recently retired professor of neurology with a long-standing interest in stroke prevention learnt that neighbours had received […]
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Don’t play poker with your genes
‘Acting on the knowledge of a single (or even a few) gene variants is similar to betting all your money […]
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Selling screening
‘Selling screening can be easy. Induce fear by exaggerating risk. Offer hope by exaggerating the benefit of screening. And don’t […]
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Discoverer of PSA speaks out
‘The test’s popularity has led to a hugely expensive public health disaster. It’s an issue I am painfully familiar with […]
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Overdiagnosing prostate cancer
Prostate cancer has been described as the par excellence example of overdiagnosis. This does not mean that there are not […]
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Don’t assume early detection is worthwhile
‘Screening for neuroblastoma illustrates how easily one can fall into the trap of assuming that because a disease can be […]
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Is anyone normal?
Whole-body CT scans Among the tests on offer at private clinics are whole-body computed tomography (CT) scans to look at […]
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What screening aims to achieve and why evidence matters
The examples we have already given show that, before rushing headlong into widespread screening, it is worth pausing a moment […]
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Lessons from neuroblastoma screening
Experience with screening for neuroblastoma – a rare cancer that mainly occurs in young children – is instructive in several […]
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