Re PSA, Glaucoma, and other screenings:
I believe every American should read
"OVERDIAGNOSED: Making People Sick in the Pursuit of Health", H. Gilbert Welch and colleagues, Dartmouth Institute for Health Policy and Clinical Practice, Beacon Press, 2011
Shared Decision Making in Prostate Screening Holds Lessons for Primary Care — Physician’s First Watch
Shared Decision Making in Prostate Screening Holds Lessons for Primary Care
By Joe Elia
A trio of articles on shared decision making in prostate screening — although arguably rendered moot by the 2012 USPSTF recommendation against PSA-based screening — points to better ways of engaging patients. The articles appear in the Annals of Family Medicine.
One study, using 2010 National Health Interview Survey data, found two thirds of men between 50 and 74 had had no discussion with their physicians on the pros, cons, and uncertainties of PSA screening. Another study found that physicians who'd completed a 30-minute interactive educational program were more likely to engage their patients in screening discussions. A third study found that physicians who'd undergone the interactive training were more likely to mention no screening as an option and to encourage seeking advice from others.
Looking at these results, the journal's editorialists suggest that "rather than implementing a series of disease-specific shared decision-making interventions, it would make sense to approach shared decision making developmentally, as a learned skill."