Reviews and Notes: Educated Guesses: Making Policy about Medical Screening Tests

Educated Guesses: Making Policy about Medical Screening Tests

Louise B. Russell. 143 pages. Berkeley, California: University of California Press; 1994. $30.00.

A study of commonly used screening procedures (such as the Papanicolaou smear, the prostate-specific antigen, and cholesterol screening with attention to efficacy as well as expense. Russell convincingly suggests that many of the current policies regarding screening are not supported by sufficient knowledge. She says that the concept that screening is always worthwhile is "simple, direct, and misleading." Recent bibliographic references support her statement. Who can argue with such ideas as "Resources for medical care should be allocated so that they do as much as possible to improve the life and health of the population," and "Just as it is unethical to neglect the needs of patients, so it is unethical to squander resources and unethical to entangle patients in needless investigations and treatments"? Most physicians would profit from reading this stimulating and clearly written book.

Supported by the Milbank Memorial Fund, a private organization whose mission is "using fresh ideas and information to improve health policy, especially in the broad areas of prevention and the allocation of resources," this book is certainly worthy of the organization's funding.