Maggie's Farm

RE: MEAD'S MIS-ANALYSIS OF MAMMOGRAM STUDY

I expect that there will be much discussion in the press about this study which originally appeared in the British Medical Journal and was later described in the NYT which apparently is Mead's source - or perhaps he merely read the headlines.

This brings to mind the old children's game where the first kid makes up a sentence and tells it to the second kid who tells it to the third kid, etc., until some version of the original sentence is relayed to the final kid. The original version and final version are then compared. The lesson being that the message is often distorted if we don't go to the original source.

In this case, Mead makes the ASSumption that mammograms are worse than nothing at all. But that's not how the study was designed nor what the results (which may or may not agree with its authors' conclusions as authors don't always correctly analyze their own results) show. The study compared (a) a manual breast exam by a nurse practitioner, versus (b) a manual exam by a nurse practitioner plus a mammogram, and found - in the opinion of the study's authors - that mammograms did not add any benefit to the nurse practitioner's exam. The conclusion that is being headlined by Mead and the press makes it sound like mammograms are worse than no screening exam at all - and that's not the case, or at least it's not what this study found.

In the US, mammograms are for many, if not most, women, the ONLY screening exam performed and a positive mammogram leads to followup with a manual breast exam. Mead's report would have many of these women skip their only screening exams altogether - and that's not a recommendation that is supported by the BMJ study.