A recent analysis by the Lown Institute, a nonprofit health care think tank, highlighted some key USPSTF figures that show the limits of mammograms in a helpful way. The analysis imagines a world without screening mammograms, in which women seek evaluation for breast cancer only when they notice a breast lump or other concerning symptoms. According to the USPSTF’s models, about 28 out of every 1,000 women in this world would die from breast cancer at some point in their lives.
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The USPSTF just lowered the recommended screening age for breast cancer from 50 to 40. What were the reasons for this change and what are the potential harms and benefits?
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A recent editorial published in JAMA Dermatology discussed the balance between prevention and overdiagnosis of skin cancer. This comes in response to the U.S. Preventive Services Task Force concluding for the fourth time in a row that visual skin cancer screening has insufficient evidence to support its population-wide benefit. How do we know when we’ve crossed from prevention to overuse, and is there anything we can do to keep the balance?
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“Polypharmacy”, as doctors call it, imposes a big drag on health. A recent study at a hospital in Liverpool found that nearly one in five hospital admissions was caused by adverse reactions to drugs. The Lown Institute, an American think-tank, reckons that, between 2020 and 2030, medication overload in America could cause more than 150,000 premature deaths and 4.5m hospital admissions.
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Two recent analyses of expensive medications indicate that many drugs are being priced above their actual clinical benefit.
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The Lown Institute, a nonpartisan think tank, argues in its 2019 report, Medication Overload: America’s Other Drug Problem, that Americans are experiencing an epidemic of medication that is particularly harmful to older adults. According to the report, more than 40% of older adults take five or more prescription medicines daily, and 20% take ten drugs or more.
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Lown Institute experts explore why routine colonoscopy is recommended in the US but not in other countries.
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The FDA just updated guidelines to require mammography facilities to notify patients about their breast density. How will this impact overdiagnosis and overtreatment?
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As a consequence, older Americans are particularly susceptible to polypharmacy. "Multiple medications can be beneficial for some patients," says Judith Garber, a senior policy analyst at the Lown Institute. Nevertheless, research shows that each additional medication raises a person's risk of suffering an adverse drug event by 7 to 10%.
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The explosive growth worries Vikas Saini, a cardiologist and president of the Lown Institute, a think tank that examines quality, cost, and equity across health care. He said doctors are prescribing proton therapy in a gray area — they think it may be better for a patient than the cheaper alternative, but there’s no hard proof.
“Everybody knows the game: You get an approval, and you go out on the market, then you expand the indications,” Saini said. “It’s called indication creep, or scope creep.”
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The Lown Institute of Needham has long argued that hospitals perform way too many procedures it has identified as being low-value, meaning they offer little to no clinical benefit to patients and, in many cases, are more likely to harm them than help them.
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What could be a fruitful conversation on racial equity is being co-opted by pharmaceutical companies to sell unproven drugs.
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From approval to withdrawal, the story of Makena shows some of the major pitfalls of the FDA's drug approval process.
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Two recent studies show the high cost patients face from unnecessary imaging and follow up events.
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In January 2020, Lown Institute released “Eliminating Medication Overload: A National Action Plan.” The National Action Plan provides recommendations for policymakers, foundations, healthcare institutions, clinicians and patients across five key categories.
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How can mortality be reduced by colonoscopies but not by a colonoscopy screening program? We break down the results from the groundbreaking NordICC trial.
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'Medication Overload: America’s Other Drug Problem', a report released in 2019 by the Lown Institute, chronicles the epidemic of polypharmacy in the United States.
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Even in 2020, when many hospitals were refusing non-urgent surgeries, more than 100,000 unnecessary, and potentially harmful procedures were performed on older patients in the USA, according to anaylsis from health think-tank the Lown Institute.
"You couldn't go into your local coffee shop, but hospitals brought people in for all kinds of unnecessary procedures," said Vikas Saini, MD, president of the Lown Institute. "The fact that a pandemic barely slowed things down shows just how deeply entrenched overuse is in American healthcare."
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Do alternative payment plans like Medicare Advantage actually lead to less low-value care? A recent study in JAMA Health Forum has some encouraging results.
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“It’s very easy for doctors and patients to go down the path of doing a medical procedure because it seems like, in theory, it would be safer and better, but that’s not always the case,” says Vikas Saini, MD, a cardiologist and president of the institute. “More medical care isn’t necessarily always better, especially for older adults.”
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