Monday, February 7, 2011

"Preventive health screenings" that are hardly a Life Line

The following deceptive advertisement appeared in my church's bulletin yesterday: Life Line Screening, the nation's leading provider of preventive health screenings, will offer their affordable, non-invasive, painless health screenings [in the church cafeteria] on April 9th. Five screenings will be offered that scan for potential health problems related to: blocked arteries, which is a leading cause of stroke; abdominal aortic aneurysms, which can lead to a ruptured aorta; hardening of the arteries in the legs, which is a strong predictor of heart disease; atrial fibrillation or irregular heart beat, which is closely tied to stroke risk; and a bone density screening, for men and women, used to assess the risk of osteoporosis. Register for a Wellness Package with Heart Rhythm for $149. Add Disease Risk Assessment with blood testing & biometrics for $79 more.

Although all of these tests sound good, every one is either 1) scientifically unproven; 2) proven to be beneficial only in certain groups of patients (rather than all adults); or 3) likely harmful in the long run, by increasing rates of false positive tests, subsequent unnecessary diagnostic procedures, and the adverse effects of those procedures. As you know, until last November I worked for a federally-supported program that reviews the scientific evidence to support screening tests, and based on that experience, I would not offer most of these tests to my own patients, much less market them directly to a church congregation. Specifically:

1. "Blocked arteries" / stroke screening is most likely a carotid ultrasound scan, which doesn't help because most patients with asymptomatic carotid artery blockages will not suffer strokes. Although the screening test is "non-invasive and painless," the confirmatory test, angiography, is not (it actually causes a stroke in a small number of patients) and unnecessary carotid endarterectomy can lead to death.

2. Abdominal aortic aneurysm screening is only recommended in men ages 65 to 75 who have ever smoked, because aneurysms are much less common in younger, female, and non-smoking populations. Even in men who are eligible for the test, it's important to weigh the potential benefits against the potential harms of corrective surgery, which has a not insignificant mortality rate itself.

3. "Hardening of the arteries in the legs," or screening for peripheral vascular disease with an arterial-brachial index, hasn't been proven to prevent heart attacks but will certainly lead to many false positive results.

4. I've never even heard of atrial fibrillation (irregular heart beat) screening, which I presume is doing a screening EKG, which is also totally unproven. Absolutely no organizations recommend this.

5. Screening for osteoporosis with bone density testing is the only test on the list that's actually worthwhile for a large number of adults, especially women over 65. But it's not appropriate to do this test without a prior consultation with a clinician who can discuss the risks and benefits of undergoing this type of screening. And there are still questions about whether men benefit to the same degree as women, or at all.

In a nutshell, that's why companies like Life Line have no business portraying these services as "preventive health screenings," in my church or any other community setting. (I've sent an e-mail to my pastor recommending that they be dis-invited for the reasons I've outlined above.) It's one thing to draw blood for a cholesterol test and take someone's blood pressure (which will cost a whole lot less than $149), and quite another to offer these other procedures which are, at the very least, a waste of money and quite possibly harmful.

32 comments:

  1. Completely agree! As I noted in my post, take the money and buy a good pair of walking shoes to improve overall health would be far more advantageous!
    http://davisliumd.blogspot.com/2010/05/life-line-screening-worth-money.html

    Keep up the good work!
    --
    Davis Liu, MD
    Author of Stay Healthy, Live Longer, Spend Wisely: Making Intelligent Choices in America's Healthcare System
    (available in hardcover, Kindle, and iPad / iBooks)
    Website: www.davisliumd.com
    Blog: www.davisliumd.blogspot.com
    Twitter: davisliumd

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  2. Very important post. Three or four times per year my patients bring in the brochure for this "screening". I discuss your main points with them and see what happens- usually they cancel or don't sign up. Thanks for adding even more power to the argument.

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  3. I absolutely agree with the above comments (although, for obvious reasons of what has become popular culture, will not say "ditto!").
    I am going to recommend it to my blog readers.

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  4. Stroke is the 4th leading cause of death in the United States. It affects some 800,000 people a year, and the risk doubles every decade after age 55. Yet, 80% of strokes are preventable.

    I have been a vascular and cardiothoracic surgeon for more than 30 years and also serve as the Chief Medical Officer of Life Line Screening. I became interested in the work that LLS does because I found it sad and tragic to be called to the ER to see a patient dying from a ruptured abdominal aortic aneurysm which, had it been discovered even a day earlier, could have been repaired. I found it similarly sad to be called to see patients who suffered completed embolic strokes and for whom nothing could be offered except the often vain hope of months or years of rehabilitation.

    There are three known causes of greater than 99% of all strokes: carotid artery disease, atrial fibrillation, and hypertension. At LLSA, we screen for all three. Isn’t it better to know before the catastrophic stroke occurs, when medical therapy or a simple lifestyle change could reduce the likelihood of such a calamity?

    New carotid artery guidelines by the American College of Cardiology and the American Heart Association/American Stroke Association recommend screening for people with two or more risk factors. These include age, family history, smoking, high cholesterol, high blood pressure, lack of exercise and being overweight. Life Line Screening is completely in accord with these guidelines. .

    If screening for the three major causes of stroke (carotid stenosis, atrial fibrillation, hypertension) is unnecessary and not worth the cost, why then are there more than 600,000 first-ever strokes and more than 185,000 recurrent strokes in the US alone?

    Many groups, such as the Society for Vascular Surgery and the American Diabetes Association, recommend Peripheral Arterial Disease screening for every diabetic age 50 and over. PAD screening is also recommended for better cardiovascular risk prediction, as documented in a paper published in the Journal of the American Medical Association (JAMA) by Jaff and colleagues from the University of Massachusetts as well as by Consumer Reports.

    AAA screening is already recommended for male smokers. Now, newer research reveals that women are at higher risk than previously thought and that 50% of these women are ineligible for screening under current federal guidelines. This new AAA research was conducted by independent researchers using data from Life Line Screening.

    Vascular surgeons, Drs. Kent and Zwolak, highlight the importance of vascular screening and the necessity to do more of it, when they cited Life Line Screening as an example of a successful company in the field of AAA and vascular screening in a paper in Endovascular Today, writing “The most successful of these organizations is Life Line Screening, which has screened more than 6 million individuals for vascular disease since 1993. Despite the progress made by Life Line and other companies, this is still only a fraction of the individuals at risk.”

    Community-based screenings are an innovative approach that is appreciated by hospitals and doctors, who often send their patients to us. In addition, we hear regularly from people who feel the screenings save lives. We encourage everyone to talk to their doctors, visit our website, and consult their family and friends and decide for themselves whether the benefits of preventive screenings are right for them.

    While smoking cessation, weight control and other modalities are very useful for the prevention of stroke and other atherosclerotic illnesses, I have found that confronting an obese, smoking patient with the hard data of significant plaque in their carotid arteries, aorta or peripheral arteries is a far more powerful motivator for behavioral change than simple physician advice.


    Andrew Manganaro, MD, FACC, FACS
    Chief Medical Officer
    Life Line Screening

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  5. Dr. Manganaro- shame on you for exploiting fear for profit. Your arguments are unconvincing and as a practicing FP I commonly see very anxious patients with incidental findings that now need further expensive and often potentially risky further evaluation. I believe one's support of this screening is directly proportional to the profits one reaps from the procedure.

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  6. Incidentally, I don't mean to single out Life Life Screening - there are many other companies out there doing the same thing and hawking unproven screening tests to uninformed patients. (They just happened to be the one that wants to come to my church!) But let me respond to a couple of Dr. Manganaro's arguments.

    Isn't it better to know if you're at elevated risk for a stroke before it occurs? Of course, IF SUCH KNOWLEDGE IS PROVEN TO LEAD TO BETTER HEALTH OUTCOMES. That's the key ingredient missing here - there is no proof except anecdotes (patients who believe that their lives were "saved" by screening) that performing a carotid endarterectomy or putting in a stent in someone with an asymptomatic, non-critical carotid stenosis detected via a community screening will do them more good than harm. Not everyone at risk will suffer the bad outcome. And even those who will won't necessarily have that bad outcome prevented through earlier intervention. And even those who do benefit may not outweigh the far greater number who suffer inconvenience and adverse effects.

    The evidence that presenting patients with scan results (rather than risk calculations based on clinical factors) will motivate them more to adopt healthy lifestyle habits is also unproven. Changing behaviors is a complex and poorly understood science. On the other hand, in physicians with the technical capability to perform an intervention, a stenosis on ultrasound or CT scan will trigger the "oculostenotic reflex" - that is, if you can see a lesion, put a stent in it, even if medical management is just as good.

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  7. This lifeline screening is a complete waste of time. They are just using the church as a means to promote their ineffective method of preventive health screening. It would be better to consult with a licensed medical practitioner instead.

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  8. I thank the doctors for their candor!! My husband and I were scheduled through our local hospital for this screening but I am canceling. We are non smokers age 57 and 59. My husband had a scare he thought was his heart and it was negative with the EKG and blood test, he ended up having walking pneumonia. We don't have insurance and own our own business so we thought this would help for the future. We are starting an exercise program and we are very careful with our diets. Gloria glo_heart@yahoo.com

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  9. I agree with Dr. Lin's advice. The USPSTF is very clear with their methodologies and their reasoning for making recommendations in asymptomatic adults. It would be preferable to do a full risk assessment of patients rather than screening to provide patients with an idea of their chances of developing the disease in question (ie why not use the Framingham risk assessment tools) and then engage them in shared-decision-making, as I comment on my blog: http://clinicalpreventivemedicine.blogspot.com
    In addition, although screening may yield positive results, fear alone has been shown not to be effective in motivating people to change behavior and sustain that behavior change. Physician advice, if given in the appropriate context, such as through motivational interviewing and considering the patient's environment (moving beyond the health belief model into the social cognitive model for instance) is more effective in achieving sustainable behavior change.

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  10. Thank you for your valuable post.

    We have decided to share it with our global physician audience at PhysicianNexus.com: http://physiciannexus.com/forum/topics/preventive-health-screenings


    Ruby
    Team Member
    www.PhysicianNexus.com
    Physicians connecting worldwide

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  11. I worked for lifeline screening, until recently, I told them where to shove that job. Its definately a complete ripoff company. I was told not to spend much time talking to participants and we were to rush them in and out. Not a good practice so I quit

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  12. Not only are they a complete waste of time and a rip off they do not yield accurate results. This company makes money by preying on the elderly and un(medically)educated. They gave my mom some bogus print out explaining that she had CKD3 and for a normal person to have gotten these results it might have gone unnoticed, but because I worked in Nephrology for almost 3 years I caught it! My mother's creatnine and GFR at the lifeline screening basically would have doubled from her last CMP drawn by her physician 6 days prior meaning she lost 50% kidney function in 6 days really?! When I questioned how they did these scientific tests her response was "well it was kind of like those mobile blood banks and they pricked my finger and the lady came back with this paper" Yeah pretty sure this is VERY unorthodox, unethical and maybe even illegal.

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  13. Quote: "I've never even heard of atrial fibrillation (irregular heart beat) screening, which I presume is doing a screening EKG, which is also totally unproven. Absolutely no organizations recommend this."


    I'm not sure why the author believes a screening EKG is an "unproven method" of detecting afib. I was diagnosed with afib four years ago - which was quite unexpected since I was 50 at the time and in excellent health. I have always been very sensitive to my heart rhythm so I knew immediately something abnormal was occurring and went to the ER. (I was also very symptomatic at the time - dizziness, etc.)

    Since my original diagnosis I have joined an online support group for people with afib and frequently visit sites such as stopafib.org. I was surprised to learn how many people were totally unaware they were in sustained afib until it was discovered during a routine EKG. This happens much more frequently than the author seems to believe. Undetected afib can result in catastrophic stroke so it seems hard to argue against a simple and non-evasive EKG which may detect it. BTW - many of the people who were unaware of their sustained afib were like me - under 65 and otherwise in good health with no other cardiac abnormalities (aka "lone afibbers").

    This study looks at screening versus routine practice in detection of atrial fibrillation in patients aged 65 or over: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1952508/

    Also: http://www.preventaf-strokecrisis.org/report/call-to-action

    It's definitely not true that no organizations recommend routine screening for afib.

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  14. Perhaps there is an organization that recommends routine screening for atrial fibrillation, but I'm hard pressed to name one, and certainly no major cardiology or primary care group does. The study Afibber cited actually found that the most effective "screening" strategy was taking the patient's pulse and doing EKGs on the abnormals, rather than just doing EKGs on everyone. I would argue that the former isn't screening at all, but part of standard vital signs. You don't need an EKG to suspect rapid A-fib, just a few seconds of attentive pulse taking by the doctor, nurse, or medical assistant. Screening EKGs have been promoted for other reasons, such as screening for asymptomatic left ventricular hypertrophy (a risk factor for sudden cardiac death), but a recent systematic review found no evidence this works in practice: http://www.uspreventiveservicestaskforce.org/uspstf11/coronarydis/chdupd.htm

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  15. Thank you for this post and all the comments. This is what I needed to decide whether to get my mom to take these tests! And for a company to take advantage of elderly population in churches....that's simply unscrupulous and unethical!

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  16. Dear all, hi my name is Luis Lee, MD, currently a PGY-4 in surgery; PGY-1/2 were clinical and PGY-3/4 in research in trauma surgery. There are a few points I'd like to make here in response to your posts:
    -"unnecessary carotid endarterectomy can lead to death". The ACAS and NASCET trials have given us very clear guidelines when to perform these surgeries, hence there's no such thing as "unnecessary" CEA. ie: medical management vs CEA depending on the degree of blockage.
    -"oculostenotic reflex"- that doesn't exist with carotid atherosclerosis. Depending on your degree of blockage, you are either on medical management or you get a CEA. Stent options are for those with too many risk factors to undergo surgery.
    -While the USPSTF is "is very clear with their methodologies and their reasoning for making recommendations" - really? I'm sure OB/GYNs and Breast surgeons would argue against you when you (FPs who strictly follow USPSTF) do screening mammography starting at the age of 50. While it's a respected task force, it's not the only one that provides guidelines. Hence, Dr. Manganaro's paragraph: "New carotid artery guidelines by the American College of Cardiology and the American Heart Association/American Stroke Association recommend screening for people with two or more risk factors. These include age, family history, smoking, high cholesterol, high blood pressure, lack of exercise and being overweight." (I am not affiliated in any way to LLC). Whether you agree with Dr. Manganaro or not, he does make a compelling case to support his business...which leads me to my next point...
    -One thing I've learned about medicine is that - aside from its altruistic intentions - it IS a BUSINESS. "exploiting fear for profit..." Whether there's fear or not, exploitation or not, there WILL be profit, guaranteed. This is a capitalistic society. Perhaps you'd prefer socialized medicine. Occupy Doctor's Office? I hope not...i got too much loans to pay off...
    -I think the truth is somewhere in between. I'm sure you FPs get swamped with patients telling you "doc, I saw this screening program..." "doc, I saw this ad on TV about..." that usually does nothing but to increase the patient's anxiety, and then it becomes your job to debunk their myths/beliefs. On the other hand, I don't think it's wrong to do these "screenings", as the USPSTF puts it, every screening should be individualized. Whether patients get enticed by the advertisements...that's a different story.
    -"draw blood for a cholesterol test and take someone's blood pressure (which will cost a whole lot less than $149)...a waste of money and quite possibly harmful. ". False statement. The copay can vary, but what the insurance company pays the physician/practice is more than $149 - again, medicine is a business. Waste of money? probably. But at least it won't come out of the health insurance, which would keep everyone else's premiums low. "possibly harmful" - relative risk of this screening doesn't seem to be significantly different than someone getting hit by a car.
    -Again, in CEA there is NO such thing as "unnecessary".
    -Thank you all for reading this. I look forward to finishing my surgery residency and work with other MDs of any specialty. And if FPs think that we do "unnecessary surgeries", I hope I will change your mind about that. I love to operate, but I'd prefer Not to operate if I don't have to..

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  17. "In CEA there is no such thing as 'unnecessary'" - the medical literature says otherwise. A systematic review of the overuse of health care services in the U.S. recently published in the Archives of Internal Medicine (http://archinte.ama-assn.org/cgi/content/short/172/2/171) found 13 studies from 1996-2008 demonstrating that carotid endarterectomy was performed up to 33 percent more often than indications from the ACC/AHA guidelines recommend. (If you don't have a subscription to this journal, this Medscape article has a good summary: http://www.medscape.com/viewarticle/757527)

    Now, is this overuse all driven by unscrupulous surgeons only interested in increasing their incomes? Of course not. The vast majority of surgeons, I'm sure, have only their patients' best interests in mind when they consent patients for surgery. But whether it's due to lack of awareness of current literature/guidelines, "soft" indications, or pressure from patients who are scared to death by their Life Line screenings, it's a fact that too many patients in the U.S. are undergoing CEA who are unlikely to benefit from it.

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  18. One more thing. Dr. Manganaro writes: "While smoking cessation, weight control and other modalities are very useful for the prevention of stroke and other atherosclerotic illnesses, I have found that confronting an obese, smoking patient with the hard data of significant plaque in their carotid arteries, aorta or peripheral arteries is a far more powerful motivator for behavioral change than simple physician advice."

    If it were actually true that showing someone an image of their carotid stenosis would motivate them to make lifestyle changes such as quitting smoking, I would agree that perhaps there would be a good reason to do more imaging. Unfortunately, this hypothesis was recently tested in a randomized controlled trial, and even though 58 percent of smokers in the intervention group were found to have carotid plaques, there was no statistical difference in cessation rates between the groups after one year, and patients with plaques were not more likely to quit smoking than those with normal ultrasound results: http://archinte.ama-assn.org/cgi/content/short/172/4/344

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  19. I believe kennylin might be taking his opinion a little too far. My first thought is: according to Doc, no organization recommends these screenings. Well, do you really want to live your life according to what some govt group/agency reccommends? The FDA? What a joke. I'd rather be proactive and spend the $150 to see if I am risk for a aneurysm etc that groups like lifeline does. Also, if they are of no value; why do hospitals offer these screenings? Whey do they partner up with groups like lifeline? Because its all about the money; not helping people. So shame on you doctors out there bashing screenings when the hospital that pays your salary probably has their hands in the "screening cookie jar" anyways.

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  20. Thank you all for your informed opinions about the value of these screening tests. I am a naturally born skeptic and my 58 years of existence has taught me that more lies have been told in the pursuit of making money than possibly any other endeavor on the planet. The internet has provided a wonderful tool for us all to become totally confused about the truth of any subject you can imagine. I was going to schedule an appointment for these tests, but I have considered the advice given here and I think I will decline. So to those of you who say that is a mistake I can only reply that you might be right. I guess time will tell because there seems to be dissention among the jurors on this subject. jms317@gmail.com

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  21. So, we should not have at least a Plac test done somewhere? Is just knowing I'm living and breathing today just as yesterday going to suffice?

    Instead of bashing Life Line which I was considering, how about you make affordable alternative recommendation(s) for those of us that do have deceased siblings, and parents due to heart disease. Besides the 3 X weekly exercise, low fat and Blood Pressure monitoring I already do.

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  22. I am a guy from the uk aged 75...pretty fit apart from hereditary heart conditions...with a NHS not remotely interested in my welfare owing to uk govt ageist policies...despite me having paid into the system since the age of 18. I almost have to beg for simple what should be routine check ups considering my lt atrial enlargement, severe angina, rt bundle branch block...and having had severe elevated BP for years...such is the lack of concern shown...I now self medicate with NEBIVOLOL-ENTERIC COATED ASPIRIN-L-ARGININE and GOAT WEED-which has p5 factor thus enhancing Nitric oxide. I researched all myself owing to ageist attitude shown by NHS. My BP has changed from regular 169 over 90'ish..with 89 pulse to 129 over 74 with 55 pulse. I had a screening with LLS 2 years ago...yes we were given the tests on time...with efficiency and respect...so much better than last GP appt...40 minutes late...with not even my pulse taken. I am returning to LLS on 6th June jusu to see all is still ok...and answering one point in your posts ECG is certainly of value...one showed 3 undetected MRIs! My specialist diagnosed AF 6 years ago...with recommended annual checkup which my GP-earning 149,000 pounds a year took no note of...so THANK GOD for LLS-who for a meagre 139 pounds give me peace of mind! Iain Hines...UK

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  23. Dear all,

    Thank you all for your vocal, evidence-based argument against this so-called "life-screening" b/s of a procedure. Being an allied health professional (physio) I'm always preaching my clients to adopt a proactive approach to managing their health and life in general. However, I believe this so called preventative "life-screening" blagueur has taken one step too far in interpreting the meaning of the word "proactive", with their non-approved, non-evidence based, money-gouging tests. Btw, if it's really useful, it should be approved by the national health agencies right? Anyway, I'd appreciate greatly if someone could make this blog site more accessible in Google as when I typed the words "Screen for life review" (it's called Screen for life here in Australia), I had to goto page 3 to access the blog and even then the title of the blog site wasn't all that clear in indicating that it was about the review of Screen for Life. I'd hate to think of all those vulnerable people (the elderly and their well-intentioned relatives/children)out there missing out on this very informative and valuable blog page after they've stumbled across the "Screen for life" advertisement somewhere. To be honest I was initially quite tuned to the company's professional looking brochure. Fortunately, it was only because of my EBP/google review look-up habit that made me stumble across this website. Thank you all.

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  24. Iain and others, if you're not happy with your GP/family doc, go find another one, instead of trying out your luck with these money-gougin, evidence-less so called "preventative" screening companies. So what if you get a positive test from these quacks? What are you going to do next? Arrange your own operation? You'll still need to go through specific, time consuming diagnostic tests anyway at a proper hospital as the intelligent, non-biased, non-money hungry docs there wouldn't give a hoot about the results obtained by these quacks. Do the screening test only if you have money to burn!

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  25. My husband and I both had these screenings preformed. They found a massive block in his aorta. He had to have surgery preformed to remove it, the doctors said if it had not been for Lifeline screening, my husband may have died. So please explain to me how it is a waste of money. I will gladly pay 150 dollars every year, I think that is worth my husbands life! Dont you? (by the way... you should have seen the price I would of paid had I gone to the hospital to have the ultrasound preformed! wow! Now that is money hungry!)

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  26. If it looks too good to be true and prays on vulnerability, ignorance and fear then it probably is a rip off. My crap detector was set off as soon as I saw the "places are limited and save $10 by booking now". Plus no Medicare rebate! Go see your GP and save yourself some money.

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  27. I am thankful I found this site and read all points of view from top to bottom. Kudos, Dr. Lin, for providing such an enlightening forum.

    Some observations:

    Some of the best and scariest arguments against these screenings (that I have seen on this page and others like it that I googled) come from some of the present or former screening "specialists" themselves. Some defend them and some expose them. But the inability of many of them to write at the high school graduate level leaves me wanting to ask these screening companies how they screen their technicians, honestly.

    That being said, I appreciate Dr. Lee's position that the truth is probably somewhere in between Dr. Manganaro's and Dr. Lin's polarized stances. Obviously none of us expect the CMO of Life Line to argue other than emphatically for his company's business ethics. On the other hand, while I found the discussion on this site much more informed and helpful than at other sites, I feel neither this nor those others adequately address or rebut all of the given arguments in favor of certain individuals getting the screening.

    For instance, the "go find another" GP (in response to Iain's post) did not rebut his several good points nor take into account his main complaint: that the UK's NHS (for "Nazi Healthbare Socialism" ?) has degraded into such a deplorable state that he has to do work-arounds such as self-medicating and using mobile screening services. And while the U.S. system is not at that state (yet), his and Dr. Lee's point went unanswered: the $149 is less than it would cost (co-pay + insurance costs) for a similar procedure done at a hospital, for instance.

    Also, the most compelling argument given by Dr. Manganaro (and one not well-answered) is the one for motivation. There is something to a picture worth a thousand words, whether it be an autopsy of a blackened lung, a SPECT brain scan of a drug addict, or an ultrasound image of arteries 50% or more mucked up with visible sludge, that can give many a lifestyle-change procrastinator that needed "wake up call" to get going, join a gym, etc. in time to make a difference. That many nicotine addicts will not take this to heart (no surprise there) does not nullify the reasoning that "motivatible" patients, who do get startled at unexpectedly alarming results, may well be armed with the knowledge and motivation needed to fight this ubiquitous inertia.

    As for me, I have been seriously considering getting a Life Scan myself at my church next weekend for this latter reason indeed. I have heard that men my age often have 40-50% blockage; but it has been hard to believe that "it can happen to me"--despite 3 different doctors telling me to lose weight--without something more visible than scoldings. (One ordered an organ ultrasound but I never got to see the images.) So I was hoping to get a clear picture of the state of my arteries to give me that push to lay on the laps and lay off the Lays©. Unfortunately, as I have now discovered, Life Scan will not even let me see the images taken unless, in the opinion of some Life Scan doctor (?) (whom I will never meet), there are abnormalities. I don't want to pay Life Scan extra cash (that I badly need for new walking shoes!) for all five tests if I only need one or two of them, and if they will only give a quick slipshod screen without sharing the motivational photos.

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  28. Just a Thank you, Dr. Lin for your blog on the 'screening tests'. It allayed my neighbor's anxiety and saved my doctor's time from answering the questions prompted by letter.

    Amazing how often 'fear' is used for profit and how well it always seems to work.

    Thank you, again.

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  29. I sure wish that I had googled this BEFORE I had the tests done (earlier today). I was taken in by their reference to aortic aneurism testing. My father had one and had surgery for it (unfortunately, due to complications from the surgery, he never came out of the hospital). With that in my family history, I felt that it would be good to have a look and see if they saw any evidence of one. I won't have results for a few weeks. The other scammy aspect of the service was that when I arrived they told me about another test that they recommended, for C Reactive Protein. Given the additional family history of heart disease, I added the test. This added $49 on top of the $159 for the package of 5 other tests. On top of that, when they did the bone density test, they were unable to get a reading from the machine. So they told me to go to the front desk to get a refund for that test, which was a measly $10 refund. The combination of the "added test" and the "lame refund" further confirms to me that this is a profit-machine far more than a life screen. I will certainly look at the results with some skepticism and only discuss them with my doctor if something looks very odd. Thanks for your post Dr. Lin and for all of the other comments. You'd think that as a skeptical 57 year-old, I would have smelled this. But again, given the mention of the test for the aortic aneurism, emotion got the better of me.

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  30. Thank you so much for writing about this -- I was able to convince my mother that the "screening" would be a waste of her extremely limited funds by reading parts of the post to her along with your credentials. She saw the flyers at a couple of hospitals that are acting as hosts, and trusted that they wouldn't participate unless there were real health benefits -- it's a sickening abuse of trust on their part if you ask me, especially if (as I suspect) they're getting kickbacks.

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  31. Thank you very much for sharing your knowledge on these screenings. I really do not have the extra money for the test

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  32. I was considering this testing because I have no idea of my family history (being adopted) but have watched my adopted family die one after another of heart attacks at young ages. I have heard of many women suffering heart attacks and dying without even experiencing symptoms. Once in awhile I get slight discomfort in my chest (left-side) and sometimes it goes into my arm. I don't want to be paranoid but I also want to be around for many years to raise my young boys. I am almost 46 years old. I get regular check-ups, but nothing to screen for heart disease. My last cholesterol check was a couple of years ago a and it was high. My doctor only said to monitor my diet and exercise more. But recently I have gained weight and haven't been able to exercise during this cold winter. I am wondering if this kind of testing will (at least) serve to relieve my anxiety about my health (especially as related to possible blockages in my arteries/heart). Do they even test for that? Is the ultra-sound technology good for that? I see a lot of talk here about aneurisms…but my anxiety is more about heart issues. If not Life Line screening? What can I do? I don't want to go to the ER and spend $$$$ when I have these mild symptoms that end up making me anxious in the middle of the night.

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