Science Policy For All

Because science policy affects everyone.

Archive for September 2012

Preventive Care: When anecdotal effectiveness fails to translate

leave a comment »

photo credit: Keenen Brown via photopin cc

By: Katherine Donigan

It’s been over forty years since President Nixon signed the National Cancer Act, effectively inaugurating the “war on cancer.”  In this time, many advancements have been made to further our understanding about the initiation and progression of many different types of cancers.  Significant progress has been made in the treatment of specific types of cancer (particularly childhood leukemias), however cancer remains a leading cause of death worldwide (i).  Our increased knowledge about the progression of cancer from primary tumor formation to advanced metastatic disease has underscored the importance of early detection through preventive screening.  Preventive screening aims to identify tumors at early stages before they have the opportunity to invade surrounding tissues and form satellite tumors (metasteses) throughout the body.  Catching cancer in these early stages is crucial, as the majority of cancer-related deaths are attributed to metastatic disease.  Therefore, it seemed logical that more screening would result in fewer deaths from cancer.

In 1984, the U.S. Preventive Services Task Force (USPSTF) was established by Congress to objectively evaluate existing scientific data regarding the effectiveness of preventive screening tests, medications and/or counseling (ii).  The USPSTF is comprised of primary care providers with expertise in evidence-based medicine and preventive care.  Recommendations provided by the USPSTF have mainly been used by physicians when determining whether to order preventive screening tests or medications. Insurance companies have been increasingly looking to the USPSTF recommendations to inform coverage decisions.  Medical societies also utilize task force findings to generate clinical guidelines for their members.  The USPSTF recommendations are therefore extremely far-reaching, as they inform both doctors who order tests/medications and insurers who pay for them.

The recently enacted Affordable Care Act (ACA) includes a preventive care provision, seeking to “help make prevention affordable and accessible by requiring health plans to cover recommended preventive services without charging a deductible, copayment or co-insurance” (iii).  The ACA defines “preventive care” with a specific list that includes services such as immunizations and screening for certain types of cancer.  The ACA requires these services to be covered at specified intervals and age thresholds based upon USPSTF recommendations (iv).

However, when these recommendations conflict with those supported by various medical societies, what metric should be used to define what is covered and what isn’t?   Read the rest of this entry »

Written by sciencepolicyforall

September 28, 2012 at 4:36 pm

Posted in Essays

Science Policy Around the Web – September 28, 2012

leave a comment »

photo credit: Sister72 via photopin cc

By: Rebecca Cerio

Our weekly linkpost, bringing you interesting and informative links on science policy issues buzzing about the internet.

Football’s Problem With Danger and Uncomfortable Questions – George F. Will and Jason Reid raise interesting issues at the intersection of culture and science in The Washington Post.  What should be done when the entertainment we want to see risks the health (and lives) of the entertainers?  These two opinion pieces discuss the ethical ramifications of the accumulating evidence that football players’ neurological health is being degraded by the violence of the game they play.

Well-funded Investigators Should Receive Extra Scrutiny – Jeremy Berg suggests in a comment in Nature that even the new NIH rules raising the bar for funding researchers already receiving >$1 million in grant money from the NIH aren’t stringent enough.  His suggestions?  Close loopholes that would allow exceptions and start the scrutiny at below $1M.  Also, “…special consideration should be given to investigators with strong proposals who have few or no other sources of funding, such as those at the beginning of their careers or established, productive investigators. Funding these applicants would probably have a bigger impact — by helping to develop a new lab or keeping an effective one functioning — rather than providing incremental support to an investigator who already has substantial other support.”  As the NIH struggles to divvy up the increasingly shrinking pie, discussions like this are becoming more common in the world of science funding.

Writing About Autism Science?  10 Things – Emily Willingham gives 10 very thoughtful suggestions for science writers discussing autism.  It’s worth a read for anyone else, though, to get an idea of how writing in the media about particular diseases affects people with those diseases.  Also, there are some great tips on what NOT to say when discussing scientific studies in the media (protip:  Correlation does not equal causation!)

Have an interesting science policy link?  Share it in the comments!

Written by sciencepolicyforall

September 28, 2012 at 4:18 pm

Science Policy Around the Web – September 19, 2012

leave a comment »

photo credit: ecstaticist via photo pin cc

By: Rebecca Cerio

Our weekly linkpost, bringing you interesting and informative links on science policy issues buzzing about the internet.

Lots of Chatter, Anger Over Stanford Organic Food Study – A recent study by Stanford researchers that showed that organically-raised foods were no healthier than conventionally-raised foods has been causing quite a stir in some circles…including a petition on Change.org for the researchers to retract their study.  Rosie Mestel breaks down some of the kerfluffle and serves up a side of reason on the LA Times website (hat-tip to the Knight Science Journalism Tracker.)

Sequestration Threatens Science – The looming threat of automatic budget cuts if the US Congress doesn’t approve a way to reduce the national deficit by $1.2 trillion by early January 2013 is starting to make scientists nervous.  Bob Grant at The Scientist reviews the numbers and suggests that the very threat of such massive cutbacks has already affected the science ecosystem.

New Report Aims to Improve the Science Behind Regulatory Decision-making – Nearly everyone agrees that experts should be consulted when science-based policy needs to be made.  But which experts are chosen and how they deliberate and render their advice has led to  controversy in some fields when experts’ conflicts of interest are brought to light  (DSM-V, anyone?)  The Research Integrity Roundtable (convened by the independent non-profit Keystone Center), has put together a report listing recommendations and protocols for regulatory decision-making that calls for greater transparency to head off such controversies and increase the scientific rigor of advisory panel decisions.

Have an interesting science policy link?  Share it in the comments!

Written by sciencepolicyforall

September 19, 2012 at 5:16 pm

Science Policy Around the Web – September 10, 2012

leave a comment »

Photo credit: clarita from morguefile.com

By: Rebecca Cerio

Our weekly linkpost, bringing you interesting and informative links on science policy issues buzzing about the internet.

Ethics of commercial screening tests – An opinion piece in the Annals of Internal Medicine raises concern about the perhaps misguided efforts of community groups to offer ultrasonography screening (for example, to measure bone density).  “When screenings are provided in a church and sponsored by a trusted medical organization, consumers may have a false sense of trust in the quality and appropriateness of services provided.  Consumers are generally unaware of the potential harms of screening…,” the authors state.  Such harms can include overdiagnosis and incurring needless and expensive medical care, as not all screening tests are effective at measuring what they say they’re measuring or useful to the public.  The authors go on to suggest that direct sale of such tests to the public is unethical, as the public is often not informed enough to give consent.  “Appropriate and truly informed consent cannot be obtained when the companies providing the test do not fully disclose the potential risks and lack of benefit before collecting payment and performing the tests.” (hat tip to Gary Schwitzer on Health News Review.org for pointing out this piece.)

Trash Can May Be Greenest Option For Unused Drugs – University of Michigan researchers have looked at the environmental consequences of three different disposal methods (flushing, throwing into the trash, and incinerating) and found that throwing unwanted prescription drugs into the standard trash stream seems to strike the best balance between keeping drugs out of the environment and requiring a lot of carbon-releasing transportation and burning.  Flushing drugs down the toilet was the worst option, causing the most environmental contamination and (surprisingly) the most greenhouse gas emissions.  (by Ted Burnham via NPR.org)

White House Announces Plans to Create a National Science, Math, Technology, and Engineering Master Teacher Corps – The plan will begin with 50 “Master Teachers” and eventually expand to 10,000 over 4 years.  These teachers will be chosen for their innovative and effective teaching methods and will make multi-year commitments to the program.  In return, they will receive recognition of their efforts, the chance to build STEM education infrastructure and policy, and $20,000 stipends in addition to their base salary.  The stipends are designed to “make their profession more competitive with alternative careers [and keep] the best teachers in the classrooms where they are needed.”  (by Aline D. McNaull on FYI: The AIP Bulletin of Science Policy News)

Have an interesting science policy link?  Share it in the comments!

Written by sciencepolicyforall

September 10, 2012 at 5:54 pm