guidelines

  1. Why you should never trust 'doctor's orders'

    Sometimes, it might seem like your doctor is relying on years of education and experience.

    Other times, you might be convinced he's making it up as he goes.

    In reality, most doctors follow the guidelines issued by the major medical associations -- and that means some of the biggest decisions he makes about you and your health are based on badly biased information.

    Treatment guidelines are routinely written by "experts" with a direct financial stake in the outcome -- and now, a new study finds a massive chain of conflicts in the guidelines written for diabetes treatments and cholesterol control.

    Since these just so happen to be two of the most medicated (not to mention over-medicated) conditions in the country, is anyone really surprised?

    There have been 288 "experts" on the 14 cholesterol and diabetes panels that have met in the United States and Canada over the past decade, and researchers say 52 percent of them had conflicts of interest such as financial ties to the drug industry.

    Even worse, they found those conflicts among 11 percent of the panelists who claimed they were free and clear.

    Whoops. Busted!

    And of course, you can't really stack a deck without putting some of your best cards on top -- so half of all chairs of the guideline-writing committees had conflicts.

    The panels were convened by organizations including private ones like the American Diabetes Association and American Heart Association as well as government groups such as the U.S. Preventive Services Task Force.

    But when you break it down, only 16 percent of the members of government-sponsored panels had conflicts, versus 69 percent of those convened by nongovernmental groups.

    What's more, five of the groups in the study didn't even require conflict disclosures -- and the U.S. Preventive Services Task Force won't reveal its own without a Freedom of Information Act request.

    That's one of those things that make it look like you're hiding something... even if you're not.

    This isn't limited to cholesterol and diabetes panels -- not by a longshot.

    Earlier this year, researchers examined 17 critical guidelines from the American Heart Association and American College of Cardiology that were issued between 2003 and 2008, and found that 56 percent of the 498 people who helped write them had conflicts of interest... including 81 percent of those who led the groups.

    Put it all together, and it's pretty clear why you can't leave your doctor's office without yet another prescription: The deck was stacked against you long before you even walked through the door.

  2. New guidelines push more mammograms

    Just when I thought we were getting somewhere with cancer screenings, yet another organization has cooked up its own set of guidelines.

    And it's a huge step backwards.

    The American College of Obstetricians and Gynecologists is protesting recent moves toward fewer and less frequent mammograms by urging women to get one every single year, starting at age 40, no matter what.

    It's a direct -- if late -- response to the guidelines issued in 2009 by the U.S. Preventive Services Task Force, which pushed back the starting age to 50 for most women and only recommended screenings every other year.

    Still too many screenings and far too often -- but as a step away from the yearly mammogram madness, it was a welcome move that would have at least put us on the right course.

    But after years of being told they need mammograms early and often, women weren't quite ready for that message. Many continued to get them, and other groups have been coming out with their own guidelines for more frequent screenings.

    ACOG must've felt the pressure to keep up: Until now, the group recommended mammograms every other year from the age of 40, and every year after 50.

    Personally, I think you have to take every recommendation like this with a huge grain of salt anyway. I mean, this is the flagship organization of obstetricians and gynecologists -- allowing them to tell you when to get a mammogram is like letting an organization that represents car dealers tell you when to buy a new car.

    Here's the reality of the situation -- the one message that's still not cutting through the noise: Despite what you've heard, mammograms are inaccurate and dangerous.

    They lead to false positives and false negatives... they're radioactive, and can actually cause the very cancers they're supposed to detect... and they're responsible for the mass overtreatment of breast cancer in the United States, with millions of women undergoing radical surgery to remove tumors that never would have hurt them.

    Younger patients face even higher risks -- especially if they're getting that extra dose of mammogram radiation every year thanks to new screening guidelines.

    Even ACOG admits that 1,900 women between the ages of 39 and 49 would need to be screened -- and exposed to all those risks -- to save a single life.

    If you're concerned about breast cancer, don't be so quick to hop aboard the mammogram bandwagon. Thermography is quickly and quietly becoming the go-to option for women who want a safer and more accurate form of cancer detection.

    Learn more about thermography -- and why some people are working overtime to make sure you never hear a peep about it -- right here.

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