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How serious are the adverse effects of screening?

How serious are the adverse effects of screening? The adverse effects of screening are not commonly studied. False-positive tests lead to discomfort, costs, and risks from additional diagnostic and therapeutic procedures. False-negative tests lead to a sense of security and delays in seeking medical help when symptoms develop. Labeling an individual with a false-positive test, or with a true-positive test for which there is no evidence that intervention makes a difference, e.g., intervention on an 80-year-old asymptomatic woman with hypercholesterolemia, can have a markedly negative impact on the quality of life. Interpreting statistical abnormalities out of clinical context, e.g., lending importance to a multiphasic blood screen showing “high” alkaline phosphatase in a teenager, leads to unnecessary costs and anxiety. The cost of screening programs that may not have been shown to do more good than harm is already having an impact on the resources available to diagnose and treatment symptomatic persons. Premature implementation of unproved screening programs will continue to decrease physician and public confidence in prevention. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of General Internal Medicine Springer Journals

How serious are the adverse effects of screening?

Feldman, William
Journal of General Internal Medicine , Volume 5 (Suppl 2) – Sep 1, 1990
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References (21)

Publisher
Springer Journals
Copyright
Copyright © the Society of General Internal Medicine 1990
ISSN
0884-8734
eISSN
1525-1497
DOI
10.1007/bf02600842
Publisher site
See Article on Publisher Site

Abstract

The adverse effects of screening are not commonly studied. False-positive tests lead to discomfort, costs, and risks from additional diagnostic and therapeutic procedures. False-negative tests lead to a sense of security and delays in seeking medical help when symptoms develop. Labeling an individual with a false-positive test, or with a true-positive test for which there is no evidence that intervention makes a difference, e.g., intervention on an 80-year-old asymptomatic woman with hypercholesterolemia, can have a markedly negative impact on the quality of life. Interpreting statistical abnormalities out of clinical context, e.g., lending importance to a multiphasic blood screen showing “high” alkaline phosphatase in a teenager, leads to unnecessary costs and anxiety. The cost of screening programs that may not have been shown to do more good than harm is already having an impact on the resources available to diagnose and treatment symptomatic persons. Premature implementation of unproved screening programs will continue to decrease physician and public confidence in prevention.

Journal

Journal of General Internal Medicine – Springer Journals

Published: Sep 1, 1990

Keywords: screening; test results; labeling; prevention; false-positive tests

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