the risks of health screening

A federal advisory panel [in the USA] recently set off a controversy by recommending that most women without special risk factors delay breast cancer screening until they turn 50, not 40 — and that mammograms then take place only every other year.

These guidelines, which differ from those of some other professional or advocacy organizations, have been called a rash misjudgment and an example of ostrich-like thinking. But this criticism is unfair, both to the scientists who prepared the report and to ostriches (who don’t actually bury their heads in the sand in an attempt to hide).

Richard H. Thaler, “Economic View: Gauging the Odds (and the Costs) in Health Screening”, New York Times, 20 December 2009.

Behavioural economist Richard Thayler continues with a concise “discussion of the underlying numbers and a bit of probability theory”. He complains “anyone who even suggests that some test be done less often is accused of condoning ‘rationing’, an all-purpose slur against any change that might reduce costs”.

Thaler teaches economics in the University of Chicago Graduate School of Business. He is co-author, with legal scholar Cass Sunstein, of Nudge: Improving Decisions About Health, Wealth, and Happiness (Yale University Press, 2008; updated edition, Penguin, 2009).


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