Published 28 July 2009, doi:10.1136/bmj.b3041
Cite this as: BMJ 2009;339:b3041

Letters

Abdominal aortic aneurysm

Deciding on whether to screen

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

Godlee ably manages a difficult editorial balancing act by recognising that occasionally less is more.¹ Medicalisation can be bad for your health, as "screening for abdominal aortic aneurysm seems to be effective" hints. I agree with Heath’s informed decision to say no to breast screening.² Should I have screening for abdominal aortic aneurysm?

Buxton’s pertinent editorial discusses cost effective modelling.³ "A 42% relative risk reduction in mortality related to abdominal aortic aneurysm (absolute risk reduction from 0.33% to 0.19%)" sounds impressive. But how many were harmed, died, or were falsely reassured? "There may be a small increase in net deaths in the short term" is worrying.

Editors should require the statement of benefits and harms in absolute terms. Thompson and colleagues state: "We used unadjusted Cox regression to compare deaths related to abdominal aortic aneurysm (censoring other causes of death) and all cause mortality."⁴ The crucial data in table 1 . . . [Full text of this article]

¹ Surgery, Newport, Pembrokeshire SA42 0TJ

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This article has been cited by other articles:

• Thompson, S., Scott, A. (2009). Authors' reply. BMJ 339: b3043-b3043 [Full text]  

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