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May 14, 2008

Legislating Screening for Atherosclerosis—Reply

JAMA. 2008;299(18):2147-2148. doi:10.1001/jama.299.18.2148-a

In Reply: In response to Dr Falk and colleagues, as a nonspecialist I cannot comment on the merits of any particular screening mechanism or the coronary artery calcium score vs the Framingham Risk Score as a better predictor of coronary artery disease. However, I take issue with their statement that “the proposed Texas legislation incorporates what we consider to be the most accepted part of the SHAPE guidelines.” Accepted by whom and under what circumstances? Are they conceding that the guidelines as a whole have not been accepted as professional consensus through the peer-review process? Most importantly, should legislators determine which aspects of guidelines should be mandated and which should not?