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informed consent rights of children since 1982.”
Associated Press Writer
ATLANTA (AP) - Childhood vaccinations and anti-smoking
counseling for adults
are the most effective preventive medicine, says a new study
that ranks
medical services based on how many lives they save and how
much they cost.
The findings also suggest that some of the best preventive
measures - such
as colon cancer screening and warning teen-agers about
drugs - are reaching
surprisingly few Americans.
The study, released Friday, was conducted by the nonprofit
Partnership for
Prevention and sponsored by the Centers for Disease
Control and Prevention.
It appears in the July issue of the American Journal of
Preventive Medicine.
The study examined 30 examples of preventive medicine,
giving each a 1-to-5
rating in two categories - cost-effectiveness and how well
it prevents disease or injury.
Vaccinating children for diseases like polio and hepatitis
was the only
measure with a perfect 10. Anti-smoking counseling for
adults and eye exams
for the elderly were close behind, ranked extremely
effective, with combined
scores of 9 each.
The next most effective measures were getting the
anti-smoking and anti-drug
messages to youngsters. But those measures were also found
to reach less
than half of their target audience.
“These gaps in care should be closed for the benefit of
everyone,” said
Dr. Jeffrey Koplan, director of the CDC.
Ashley Coffield, an author of the study, said she hopes
the findings make
health-care providers more accountable for providing
services at the top of
the list.
Two measures were given the lowest possible scores for
both disease prevention and cost-effectiveness - rubella screening for women of
childbearing age and tetanus shots for the whole population.
Cholesterol screening, counseling on a balanced diet and
regular mammograms
for women age 50 to 69 ranked in the middle.
Medical effectiveness was measured by calculating the
deaths or injuries
that could be delayed or avoided if the preventive service
reached its entire target population.
Cost-effectiveness was measured as the cost of a
preventive service divided
by its medical effectiveness.
In a commentary published in the journal, a physician with
the Kaiser Foundation Health Plan warned that doctors make decisions based on
how specific methods help specific patients - not how they compare to other preventive
methods.
“We have a long way to go before we can establish airtight
cases for one
service over another across the spectrum of health care
interventions,” Dr.
David M. Lawrence said.
On the Net:
Study: <http://www.elsevier.com/location/ajpmonline>
CDC: <http://www.cdc.gov>
Partnership for Prevention: <http://www.prevent.org>
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