Discussion of a paper by professor miettinen

Abstract

Professor Miettinen offers a scathing critique of the criteria used by official bodies to decide for whom and how often breast cancer screening should be offered (Miettinen, 2015). He notes that these bodies often simply synthesize the results of prior randomized clinical trials with very little attention given to the question of whether individual trials constitute an adequate data source on which to make decisions concerning screening policy. He observes that most of these randomized trials suffer from many deficiencies. These include non-compliance with the assigned protocol and cross-over, problems with the randomization itself, the outmoded technologies used in older trials, inadequate length of follow-up, and restriction, by design, to just a few episodes of screening.