There is no doubt that science will continue to do what it's supposed to do - change as it advances.
And there is also no doubt that science/medical recommendations will change as this occurs.
However, there is no doubt that only a very small number of people have the science literacy required to understand and come to a comfortably informed decision about the new mammography guidelines.
In our book, Advancing Health Literacy: A Framework for Understanding and Action ( Jossey Bass, 2006), we proposed a new ecological model of health literacy where science literacy is one of the critical 4 domains of health literacy:
- · familiarity with fundamental scientific concepts, scientific process
- · some understanding of technology & technical complexity, and
- understanding of scientific uncertainty and that rapid change in the accepted science is possible and likely.
Given that less than 20% of the adults in the US are scientifically literate (NSF, Public Understanding of Science, http://www.nsf.gov/sbe/srs/seind93/chap7/doc/7d1a93.htm), how likely is it that this new recommendation is going to be accessible and understood?
That is a very interesting report about mammogram screening. I haven't read the actual USPSTF findings yet but I am watching the fascinating range of responses on facebook within my groups of friends (all are college grads, some with science background some without). One friend is saying, "it's about time". Another friend (who is a young breast cancer survivor) is outraged and says if she didn't get her mammogram early, she wouldn't survive to see age 50. The comments on her page are about how hacks from the government and insurance companies are trying to reduce the cost of medical care at the expense of patients. And that the recommendations are BS!
ReplyDeleteIn my experience, the US Preventive Services Task Force is a very good and respected organization. In fact, these are the guys who really understand and analyze the best evidence. They also have a record of transparency and not bowing to political pressures. For example, even during the Bush years (oh, those dark, dark, times) Healthy People 2010 had strong sections on the goals of improving contraceptive use.
The situation right now is that we have is strongly conflicting recommendations from USPSTF, ACOG and the American Cancer Society, *all* which are legitimate organizations. *Very* challenging and confusing indeed. I think it will be hard for women to figure out and hard for doctors to figure out how to talk to patients about it.
I was in a meeting of pre-natal health care providers today - all educated and savvy women when it comes to health literacy. They were even taking part in a health literacy working group. Most women were shocked to hear the new recommendations. When I asked how they would tackle this new issue steps included: "talk to my doctor"; "read, read, read", "go with my instincts." That's where most of us are.
ReplyDeleteA very interesting post!
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