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March 22, 1971

To Screen or Not to Screen?

JAMA. 1971;215(12):1978-1979. doi:10.1001/jama.1971.03180250070021

People are still screaming about screening, one way or the other.

The New England Journal of Medicine, as always scrupulously fair, and on this issue possibly neutral, recently published, back to back, two articles by authors of opposite persuasion.1,2 One, entitled "Multiphasic Screening and Medical Care as a Right" and written by Dr. Sidney R. Garfield of the Kaiser Foundation Hospitals, says what one would guess it would say, considering the source and the title.

The other, "Biochemical Screening—a Critique" by clinical pathologist Dr. Robert C. Ahlvin, disagrees. This is all right in itself, but the author, among criticisms more reasonable, advances one that many will not support. Having deplored the high cost of detecting a single unexpected abnormality among a dozen or so routine chemical determinations, he goes on to question and to doubt the frequency with which clinical importance attaches to such a finding. One study cited