You want to know why people don't trust science? Because of things like this article on new changes in screening protocols for breast cancer and cervical cancer. The article starts out talking about how they used science-driven medicine to change these protocols. How might you ask did science come to this conclusion? It says that studies have shown the screenings only save 1 in 1,904 lives. That is a science question - what is the likelihood that you will get a certain result? It also says throughout the article there is a need to weigh the costs of doing the screening with the benefits of having the screening done. Which again is a science question - what are the costs and benefit of an action?
The problem is that science doesn't (and can't) say whether you should or should not do a screening. What it says is how likely that screening will be successful in saving a life, how much money you will spend and what your likely benefits will be. Science can't answer your ultimate question, because you aren't asking a science question. You can have decisions that consider the science, but in the end the decision is made by a person, not by science. The whole point to science is that it's supposed to be unbiased. Instead many times what we do is we add in our own bias and then we say science led us to that conclusion. And thus, we have a population that doesn't understand science, and thus doesn't trust science.
The most telling sentence of the article is how one of the researchers is described: someone "who has studied whether prevention necessarily saves money (and found it does not always do so)." The decision was made on whether the screenings save money, not on whether the screenings save lives. Whether saving money is worth saving a life is a VERY personal decision. Humans, unfortunately are very prone to making decisions based on money. Believe me, I'm in the business of getting people to consider science in their decisions. One of the things I need to continually remind myself is that the science can't tell you what to do, it can only inform what you do.
Call it like it is people. You did the research, this is what the research shows, and then, this was your decision. I'm not taking up a position as to whether the decision is correct, what I'm saying is don't pawn the implications of your decision off on science. If you mom (or sister, or wife, or daughter) is the one in 1,904 lives whose screening it would have saved, don't you think it would have been worth it? You can't say that science says you shouldn't do the screening because only 1 in 1,904 lives is saved. Science could have just as easily said you should do the screening because 1 in 1,904 lives is saved. A decision is how YOU look at the information science provided.
Other commentators have noted that the US has the lowest mortality rate in the world for breast cancer. Unlike, say, most European countries, where a national program like this renders decisions on what kinds of services are available to the sheep, I mean citizens.
ReplyDeleteOn the other hand, there has been much discussion about the cost of the screenings and the high incident of false-positives...I think I have heard that the f-p rate is about 10%.
Some have noted that the rate of false-positives is higher than detection rates in women under 40, ergo, let's save some money.
The other observation is that the panel that recommended the new policy is not a recent creation; it's been around for a long time and has issued other such recommendations that have, in fact, been implemented by federal providers and private insurers. But this decision has hit a nerve with the affected segment of our society. I wonder if men would react the same if they raised the age floor to 60 for prostate coverage....