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April 8, 2021

Reducing Low-Value Care and Improving Health Care Value

Author Affiliations
  • 1Center for Health Equity Research and Promotion, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
  • 2Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
JAMA. 2021;325(17):1715-1716. doi:10.1001/jama.2021.3308
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    2 Comments for this article
    Reducing Low Value Care
    Karl Stecher, AB Harvard, MD Maryland | Neurosurgeon, retired
    Quality of care has few reliable measures. Doctors who have been victims of a medical malpractice lawsuit, with barbs such as "You could have done that test, couldn't you, doctor?" might disagree with the notion that low value tests can be eliminated.
    One Easy Fix to Reduce Negative Value Care: Update American College of Radiology Mammogram Screening Guidelines
    Florence LeCraw, M.D. | Andrew Young School of Policy Studies, GA State Univ
    Unlike the USPSTF, ACP, & ACS mammogram screening guidelines, the American College of Radiology recommends annual mammogram screening for women with no breast cancer risk factors from age 40 until death. Per studies by well respected biostatisticians, using ACR mammogram screening guidelines results in more patients hurt than helped. Unfortunately, 85% of U.S. physicians and a majority of U.S. breast cancer centers follow ACR guidelines. Many members of ACR are concerned that this practice guideline is detrimental to their patients' health and the public good due to wasteful healthcare spending. Fear of malpractice claims does not justify the negative impact of over screening recommended by the ACR. I encourage ACR leaders to reevaluate their mammogram screening guidelines using experts in the field of epidemiology, econometrics, and biostatistics.