post by Bill Gardner
Steve Forbes claims that the USPSTF is "The Department of Health and Human Services Death Panel." In a discussion of the Task Force's recommendation about prostate cancer screening, his column makes several false statements. One could ignore it, but Forbes tells us that it has been viewed more than 65,000 times, and it repeats a false description of the Task Force by Newt Gingrich on national TV. One could laugh at it, as Andrew Gelman does, but readers unfamiliar with the evidence may not get the joke. So, here are some facts about the Task Force and its recommendation.
- The Task Force evaluates the evidence about medical interventions. It does not make recommendations about the treatment of individual patients.
- The Task Force does not make "Soviet style" decisions about what doctors and patients can do. A negative evaluation by the Task Force does not mean that you cannot get the treatment. Despite the Task Force recommendation, any man who wants to be screened for prostate cancer can be.
- The Task Force does not consider cost in making recommendations. It evaluates the evidence for whether interventions are beneficial, and the certainty of that evidence. That's it.
- The Task Force does not base its recommendations on "tortured reasoning." They are based on empirical evidence, wherever possible the results of randomized controlled trials. In the case of prostate cancer screening, experiments involving hundreds of thousands of men failed to show evidence that screening saved lives.
Of couse, the USPSTF's recommendation could be wrong. If so, that could cost lives. That is what is at stake in medicine. Therefore, public debate of USPSTF recommendations is a good thing. False and, in my opinion, malicious characterizations of the Task Force make it more difficult to base medical decisions on the evidence.