What We Don't Know Can Hurt Our Patients: Physician Innumeracy and Overuse of Screening Tests
Authors: Virginia A. Moyer
Journal: Annals of Internal Medicine (2012)

Editorials6 March 2012What We Don't Know Can Hurt Our Patients: Physician Innumeracy and Overuse of Screening TestsVirginia A. Moyer, MD, MPHVirginia A. Moyer, MD, MPHFrom Baylor College of Medicine, Houston, TX 77030.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-156-5-201203060-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Patients, the public, and even health professionals enthusiastically support screening for disease, especially screening for cancer. Unfortunately, whether many members of these groups fully understand the benefits and risks that would allow an informed decision is not clear. This has not, however, dampened the enthusiasm for screening. A decade ago, Schwartz and colleagues (1) found that 87% of a national sample of adults believed that routine cancer screening is almost always a good idea and 74% said that early detection saves lives most or all of the time—to the point that more than one third considered an 80-year-old person who ...References1. Schwartz LM, Woloshin S, Fowler FJ, Welch HG. Enthusiasm for cancer screening in the United States. JAMA. 2004;291:71-8. [PMID: 14709578] CrossrefMedlineGoogle Scholar2. Keen JD, Keen JE. What is the point: will screening mammography save my life?. BMC Med Inform Decis Mak. 2009;9:18. [PMID: 19341448] CrossrefMedlineGoogle Scholar3. Welch HG, Frankel BA. Likelihood that a woman with screen-detected breast cancer has had her “life saved” by that screening. Arch Intern Med. 2011;171:2043-6. [PMID: 22025097] CrossrefMedlineGoogle Scholar4. Hoffman RM, Lewis CL, Pignone MP, Couper MP, Barry MJ, Elmore JG, et al. Decision-making processes for breast, colorectal, and prostate cancer screening: the DECISIONS survey. Med Decis Making. 2010;30:53S-64S. [PMID: 20881154] CrossrefMedlineGoogle Scholar5. Newman TB, Kohn MA. Evidence-Based Diagnosis. New York: Cambridge Univ Pr; 2009:116-37. Google Scholar6. Cancer.Net. Understanding statistics used to estimate risk and recommend screening. Accessed at www.cancer.net/patient/All+About+Cancer/Newly+Diagnosed/Understanding+Statistics+on+Incidence%2C+Prevalence%2C+and+Mortality on 24 January 2012. Google Scholar7. National Cancer Institute. Does screening help people live longer? Accessed at www.cancer.gov/cancertopics/pdq/screening/overview/patient/page5 on 24 January 2012. Google Scholar8. Schwartz LM, Woloshin S, Welch HG. Can patients interpret health information? An assessment of the medical data interpretation test. Med Decis Making. 2005;25:290-300. [PMID: 15951456] CrossrefMedlineGoogle Scholar9. Schwartz LM, Woloshin S, Black WC, Welch HG. The role of numeracy in understanding the benefit of screening mammography. Ann Intern Med. 1997;127:966-72. [PMID: 9412301] LinkGoogle Scholar10. Wegwarth O, Schwartz LM, Woloshin S, Gaissmaier W, Gigerenzer G. Do physicians understand cancer screening statistics? A national survey of primary care physicians in the United States. Ann Intern Med. 2012;156:340-9. LinkGoogle Scholar11. Sheridan SL, Pignone M. Numeracy and the medical student's ability to interpret data. Eff Clin Pract. 2002;5:35-40. [PMID: 11874195] MedlineGoogle Scholar12. Gigerenzer G, Edwards A. Simple tools for understanding risks: from innumeracy to insight. BMJ. 2003;327:741-4. [PMID: 14512488] CrossrefMedlineGoogle Scholar13. Woloshin S, Schwartz LM, Kramer BS. Promoting healthy skepticism in the news: helping journalists get it right [Editorial]. J Natl Cancer Inst. 2009;101:1596-9. CrossrefMedlineGoogle Scholar14. Institute of Medicine. Clinical Practice Guidelines We Can Trust. Washington, DC: National Academies Pr; 2011. Google Scholar Author, Article, and Disclosure InformationAffiliations: From Baylor College of Medicine, Houston, TX 77030.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M12-0206.Corresponding Author: Virginia A. Moyer, MD, MPH, Baylor College of Medicine, 6701 Fannin Street, Suite CCC 1540, Houston, TX 77030; e-mail, [email protected]edu. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoDo Physicians Understand Cancer Screening Statistics? A National Survey of Primary Care Physicians in the United States Odette Wegwarth , Lisa M. 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