The new USPTF guidelines for breast cancer screening have been a super hot topic for the last week. We started out with outrage, moved to outrage at the outrage, and are finally settling into a state of reasonable interpretation. The growing consensus (that I’ve seen) is that the USPTF guidelines are not so far off, but their wording could have been much better. It is true that mammograms before the age of 50 have a low positive predictive value, and thusly a high false positive rate. It is also true, based on the USPTF data, that for every 1000 women screened annually between 40 and 50 years of age, over 50% of them will need additional imaging at one point, 20% will get a breast biopsy, and only 1-2 breast cancer deaths will be prevented. Based on this, it is clearly worth discussing whether patients 40-50 should be getting mammograms.
But the world, at first, didn’t want to discuss it. We immediately attacked the USPTF, even accusing them of somehow being in league with new health care reform policies meant to reduce costs, at the known expense of women’s lives. Even Sanjay Gupta went attack dog against one of the USPTF members live on CNN. That was the most surprising thing to me.
But now people are starting to come around, and they are coming around pretty much to where I started.
Hey everyone! I have a number of great interviews with folks in the near future and want to open up the interviews a bit. If you have any questions you would like me to ask in the upcoming interviews, post them here and I’ll definitely get them in there for you. They can be about the guests are of expertise, or about something else in general that you think they might have insight on.
Here is what is coming up –
11/27/09 – Dr Paul Ridker – Massively published cardiologist from Brigham and Women’s, lead author for the 24 country JUPITER trial, examining the effects of crp on heart disease and efficacy of statins in non-hyperlipemic but crp high patients. Will be talking about crp and heart diease in women, as well as the modern model for heart disease prevention and detection. It ain’t all about lipids anymore folks! This is just 2 days away so get me the questions quick!
TBA – Dr John Schnorr – Reproductive Endocrinologist from Southeastern Fertility – Specific topics to be finalized. Dr Schnorr pioneered cryopreservation and restoration of ovarian tissue around the time of chemotherapy.
TBA – Dr Jennifer Gunter (@drjengunter) – Generalist OB/GYN and Reproductive Infectious Disease and vulvar disease specialist, also boarded in pain management (quad boarded!) Will be talking about vulvar disease and her new book!
TBA – Dr Chukwuma Onyeije(@chukwumaonyeije) – MFM and Web 2.o afficionado in Atlanta, GA. We’re going to talk about the new USPTF mammography guidelines, and the role of traditional and web media in the publics perceptions of these issues. We’d love to have a third or fourth guest for a roundtable on this one (@drjengunter, @macobgyn, @somebodyelse?)
If you have any questions for these folks, leave them in the comments. If you have ideas for people you would like to see in a podcast, or you want to be on the podcast yourself, let me know that too! I’d love to have guests to talk about their research and work, or to just help me do one of the regular journal club review episodes!
Dr Lucas Minig and I discuss his recent paper on the evidence behind postpartum and postoperative instructions. We also talk about socialized health care in the countries where he has lived, and current reforms in the United States.
One of the viewers from Switzerland wanted to see a video of the RealHand laparoscopic instruments from Novare Surgical. Here it is!
Host Dr Nicholas Fogelson discusses articles from the October and November 2009 issues of the Grey Journal. On tap are discussions of the effects of second stage length and pushing times on outcomes, ST segment automated analysis of fetal heart rate tracings, a listener question on CA125 screening, and a few other short reviews.