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In which Anne Diamond offers medical advice by post

This week we received an interesting letter from “Life Line Screening” – a company apparently conducting health screenings in Lewisham this month. Or rather, the letter came “from broadcaster and health campaigner, Anne Diamond”, with a photo to prove it:

Life Line Screening 1

As in The Sun newspaper, the bold text spells out the key messages so you don’t even have to read the rest: prevent a stroke, no prior symptoms, can’t get tested on the NHS, 61 places available, to book call 0800 etc.

The back of the leaflet explains the various “medical tests”, all of which are wrapped in “double quotes” “like this” for “no immediately obvious reason”:

.. and again, the point’s very clear: should they take the tests, the recipient might find “fatty deposits … which can restrict or stop the flow of blood to your brain, triggering a stroke without warning”, or a condition of which they may be “completely unaware” that “can increase your risk of stroke 5 fold”, or another that “increases your risk of heart attack or stroke by 2 to 6 times”*, or even another that could cause a “life-threatening rupture”. The second leaflet even refers to “silent killers”.

Which is all quite scary. And that’s probably the point. But does anyone really need to fork out £139 for the tests? I have no idea. I’m no more a medical doctor than Anne Diamond is, so I’m probably not the best person to judge whether or not this kind of screening could be beneficial.

Dr Bob Bury, on the other hand, is a consultant radiologist. Of the same letter, sent to his son, he writes:

“There are plenty of worried well people out there who would be concerned to hear the story of Sidney Larcomb from Walsall, whose surgeon said that his narrowed carotid arteries were ‘a disaster waiting to happen’, and whose life was undoubtedly saved by responding to Karen’s timely offer of screening. Of course, for every Sidney Larcomb, there will be a hundred or more Mathew Burys, who were never at significant risk of any of these conditions in the first place. And it will be the NHS (‘your full results report will be posted to you so that you can share with your GP’) that has to pick up the fall-out from all the false positives…

Ultrasound doesn’t use ionising radiation, the equipment is relatively cheap and I assume that any Tom, Dick or Harry setting up a screening service is bound only by the regulations governing advertising and the sale of goods. Even so, I can’t help feeling that Life Line Screening are sailing pretty close to the wind if they are sending out indiscriminate mailshots of the type received by my son.”

Meanwhile, over on Science Based Medicine Harriet Hall (MD, former air force surgeon) writes:

“For a screening test to be worthwhile, it has to meet several criteria.  You want to know the predictive value of a positive test in the population being screened.  You want to know not just whether it picks up an abnormality, but whether picking up that abnormality will allow earlier treatment that will make a difference in outcome. You want to know whether false positive tests will lead to harmful invasive procedures. Bottom line: does the test do more good than harm?

These tests are worthwhile when used by doctors to help diagnose patients with symptoms or patients at high risk, but when used to screen the general population of mostly healthy people, they are likely to be useless or even to do more harm than good…

If Life Line were seriously interested in improving health rather than just making profits, they would be concentrating on screening tests of proven value like blood pressure screening, and they would be addressing the most significant modifiable risk for health: smoking.”

And so, armed with this information, we’ll be conducting our own little screening process by which any further letters from Life Line get dumped straight in the recycling. Were I, for example, my grandmother, though, I wonder if I’d be reaching for my chequebook (cheques are accepted, and the leaflet reassures: “our screenings are designed for those aged 50 and older … you don’t need to remove any clothing, other than your shoes and socks”).

And as for Anne Diamond, I await her opinions on other areas in which she has a valuable insight, such as for example reviewing Halo 3 and Resident Evil 4. No, wait. Something else. There must be something.

 

* I do have to wonder: if I had both conditions, would my risk increase by between 10 to 30 times?

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