Free ad reflects badly on Enterprise

Regarding the “article” on stroke and osteoporosis screening published on your “Health” page March 16, page A10: This was nothing more than a blatant advertisement for a set of “services” offered by a for-profiteer. This “article” should have been clearly labeled as an advertisement.

The value of these tests was misrepresented, and even as an advertisement it is misleading, but to be represented as a presumably fact-based article on “health” is a travesty.

I would prefer to see a much smaller or less frequent paper than to have you fill your paper with propaganda for companies that offer nothing but the opportunity to put our hard-earned money in their corporate pocket in the name of “health care.”

They claim that our population can be screened to reduce the risk of stroke or bone fracture. Sounds great, but as with many things in the media and in our society in general, including the health care community, they use a kernel of truth to misrepresent the true value of what they have to offer.

Let’s look at a couple of the tests offered and give a real assessment as to the potential benefit of these tests:

The screening for osteoporosis (weak bones) that is offered is done with a DEXA scan that measures bone density.

Here’s what Consumer Reports Health says about this test:

The test usually isn’t necessary for younger people without risk factors for weak bones.

It can pose risks.

It can be a waste of money.

When is it indicated? In general, once for women over age 65 and for some men over age 70, and for women younger than 65 and men 59-70 who have risk factors for weak bones like smoking, heavy drinking, rheumatoid arthritis, long-term use of corticosteroids, a history of fracture from minor trauma or a parent who had a hip fracture. Whether or not you need a repeat scan depends on the result of the initial scan.

While there are certainly some people who will benefit from bone density screening, the value of screening also depends on the appropriate use of the information provided by the test, SO in conjunction with osteoporosis screening, individuals require interpretation of the results as well as counseling regarding fracture prevention, including lifestyle modification, fall prevention and possibly medication.

The test offered to “prevent strokes” is a carotid artery ultrasound. While this can be a useful test when used for appropriate patients, most professional societies recommend against using it for screening, and at least one study indicated that this type of mass screening could cause more strokes that it prevents.

The United States Preventive Services Task Force recommends against screening for asymptomatic carotid artery stenosis in the general population.

The American Heart Association/American Stroke Association indicates that population screening for asymptomatic carotid artery stenosis is not recommended.

Joint guidelines from multiple U.S. societies (including the American College of Cardiology, American Heart Association, American Stroke Association, American College of Radiology and the Society for Vascular Surgery) advise that carotid duplex ultrasonography “is not recommended for routine screening of asymptomatic patients who have no clinical manifestations of or risk factors for atherosclerosis.”

Whether or not individuals in our community might benefit from any medical test is best determined in consultation with their personal health care professional, not by the guy on the street corner trying to sell them the test out of the back of his truck.

It would be nice to see the Enterprise utilize its position in our community to provide a forum for education rather than simply prostitute itself for false advertising.

Elizabeth Buck, MD, lives and practices medicine in Saranac Lake.

(Editor’s note: The article to which Dr. Buck refers, titled “Stroke and osteoporosis screenings coming to Saranac Lake,” was about the Church of St. Luke hosting Life Line Screening on March 20, for a fee which was stated in the article. We appreciate her educating us and readers further about such screenings. There’s often a gray area between an event the public might want to be aware of and a commercial service of the kind we normally require to buy advertising. If we sometimes err on the side of informing the public, we are probably the worst victim in that we lose potential ad revenue. We don’t think this 220-word news brief put people in danger, but we do believe that in general, people should educate themselves and consult with their doctors before having any medical procedure done.)