Margaret McCartney: A summary of four and a half years of columns in one columnBMJ 2018; 362 doi: https://doi.org/10.1136/bmj.k3745 (Published 04 September 2018) Cite this as: BMJ 2018;362:k3745
- Margaret McCartney, general practitioner
Follow Margaret on Twitter at @mgtmccartney
Screening is only for people with no symptoms. If you have symptoms it’s not screening.
Screening is often counterintuitive. False positives proportionately rise when prevalence falls.
“Case finding” is the recourse of those who do non-evidence based screening but can’t seem to admit it.
Inadequately tested tech can do as much harm as inadequately tested medicine.
The NHS is a pie. If you ask the NHS to do more without making the pie bigger, something else won’t get done.
Apparent problems are fixed more effectively when they’re first understood.
A system that uses blame to attempt improvement is likely to make good professionals miserable and leave.
Earlier isn’t necessarily better. Lead time bias and overdiagnosis create mirages and do harm.
If it’s not evidence based …