Comparative Effectiveness Research as Patient Education Tool

A Death Panel by any other name

The question ought to be "what problem does CER solve?" This bureaucracy does not do any research. It merely collects the research that is already out there and that is already read and studied by health-care providers. What will happen is that these folks will "publish" their "recommendations" and government agencies will be required to obey.

In the metaphorical sense, the council is a "death panel" of the sort against which Sarah Palin warns. However, this panel is even more troubling: It sits on Mt. Olympus and delivers its findings from which their is no appeal. Palin is wrong in one sense: standing before this panel is not contemplated.

Here is what one of the members, Exekiel Emmanuel, has long championed denying treatment to terminal patients - especially the elderly. To justify this discrimation agains the elderly, Dr. Emmanuel say,

"Unlike allocation by sex or race, allocation by age is not invidious discrimination; every person lives through different life stages rather than being a single age. Even if 25-year-olds receive priority over 65-year-olds, everyone who is 65 years now was previously 25 years."

Michael

http://truththenopinion.blogspot.com

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Effectiveness testing is essential

I think the 'Golden Mean' is actually learning all you can and discussing 'whether' to get your PSA tested. If it appropriate, get it tested and then decide what kind of treatment may be necessary.

The fact that there's a fierce debate is in itself important - nothing should be taken for granted. There are probably a lot of other areas that could use debate, and patients should know what they are. Effectiveness testing can show what areas need debate.

I say

the more the public knows about the comparative effectiveness of treatments on anything and everything, the better off we all shall be. Medicine need not be a snow job by over-priced doctors. ANYONE CAN MAKE AN INFORMED DECISION IF HE/SHE HAS RELEVANT FACTS ABOUT OUTCOMES THAT THOUSANDS OF OTHERS HAVE ALREADY EXPERIENCED.

PSA screening

Unfortunately the headlines will give too many men an excuse not to get their PSA taken until it is too late and cancer has spread. The data are already outdated given the new and nuanced analyses available, and the improved methods of treatment. However, jumping to treatment based just on PSA readings is just as bad. Fortunately, there is a Golden Mean. Learn all you can about prostate cancer, get a good urologist who will discuss issues with you, get your PSA tested. Go on to a biopsy if it seems appropriate. Then you can begin the decision making process if some cancer is detected. Based on PSA, extent of malignancy, agressiveness, etc. should you chose surveillance and be sure you know what you are waiting for. You will ultimately have to make a choice based on the statistics for YOUR case and circu and the most current data, not an average over folks 10 years ago with a variety of MDs etc,and one's personal values re such things as one's sex life, seeing one's grandchildren, etc.