tag:blogger.com,1999:blog-1528123283952414948.post5915706935386066662..comments2017-06-20T17:47:14.765-04:00Comments on Common Sense Family Doctor: The USPSTF takes a step backward on PSA screeningkennylinhttp://www.blogger.com/profile/00240060576692353940noreply@blogger.comBlogger3125tag:blogger.com,1999:blog-1528123283952414948.post-7626829889914938612017-04-23T00:38:41.383-04:002017-04-23T00:38:41.383-04:00"I don't agree with all of the statistics..."I don't agree with all of the statistics cited in this infographic, particularly the optimistic estimate that 1-2 men out of every 1000 "<br /><br />Indeed that 1-2 range isn't an accurate reflection from a formally defined confidence interval. The average figure is 1.25 if I recall correctly but the lower confidence interval bound is a long way below 1. If they are going to use an informal approximation it would be far more honest to say 0-2.Chris O'Neillhttp://www.blogger.com/profile/01492638261070355075noreply@blogger.comtag:blogger.com,1999:blog-1528123283952414948.post-46573431635218110002017-04-19T21:25:33.528-04:002017-04-19T21:25:33.528-04:00Your Medscape article points out that ERSPC is a c...Your Medscape article points out that ERSPC is a combination of 7 trials that various bodies, including the current USPSTF panel, claim satisfy a homogeneity test for risk ratio of prostate cancer mortality between screening and control arms across all 7 trials.<br /><br />Whatever statistical test they have used to make this claim, it is not a simple Chi-square test of homogeneity because of the heterogeneity between screening and non-screening arms. I am very dubious that they have done a good test because the Swedish risk ratio is easily inconsistent with the average risk ratio of all 7 trials.<br /><br />It is absolutely vital that homogeneity of risk ratio is established otherwise the confidence interval given for that risk ratio has no meaning and the statistical significance of a general prostate cancer mortality reduction does not exist.Chris O'Neillhttp://www.blogger.com/profile/01492638261070355075noreply@blogger.comtag:blogger.com,1999:blog-1528123283952414948.post-26729722615292515322017-04-11T16:03:36.067-04:002017-04-11T16:03:36.067-04:00I agree, Kenny. Very disappointing. Some day I'...I agree, Kenny. Very disappointing. Some day I'd like to see definitive evidence that treatment of prostate cancer makes a difference, as opposed to "if you have the bad kind, you die despite treatment, and if you have the good kind you live die from something else, treatment or not" (although of course treatment has significant morbidity).Josh Freemanhttp://www.blogger.com/profile/10248920527894775520noreply@blogger.com