Screening without evidence of efficacy: Screening uncertainties concern evidence, efficacy, decisions

doi:10.1136/bmj.328.7438.521-a

BMJ 2004;328:521 (28 February), doi:10.1136/bmj.328.7438.521-a

Letter

Screening without evidence of efficacy

Screening uncertainties concern evidence, efficacy, decisions

The first 150 words of the full text of this article appear below.

EDITOR—Law argues that encouraging people to decide forthemselves whether to attend for screening is ducking the issue.¹This is true only if a well founded public health programmefor a specific disease has not been set up. Then, setting upa programme, as Law advocates, should be based on evidence,through rigorous scientific evaluation of efficacy through systematicreview of high quality trials. Outcomes assessed should be bothmortality and all associated adverse effects that affect anindividual person's quality of life. Good quality evidence basedinformation should also be made available to suit all citizensso that they have a better chance of arriving at an informeddecision with their (equally well informed) health professional,if desired.

Provision of such evidence takes time. But the screening industryand the public are not prepared to wait: mammographic screeningfor those aged 40-50 is widely practised, yet the . . . [Full text of this article]

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Hazel Thornton, honorary visiting fellow

Department of Health Sciences, University of Leicester "Saionara," Rowhedge, Colchester CO5 7EA hazelcagct@aol.com

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