UCSF researcher cautions against stroke screening for asymptomatic patients, due to potential harms.
Researcher questions effectiveness of stroke screenings
A leading cause of American deaths is strokes — around 150,000 deaths, to be exact. Data warrants a response from organizations like the Center for Disease Control (CDC), United States Preventive Services Task Force (USPSTF) and independent researchers alike. With sufficient screening, strokes are preventable, but the process is risky. Stroke screening harms outweigh the benefits, according to Rebecca Smith-Bindman M.D. — a biostatistician, epidemiologist, and professor, at the University of California at San Francisco.
“[W]hat continues to be striking is the overall absence of direct evidence that screening itself is actually beneficial,” Smith-Bindman noted, in her 2021 study. “A screening test is done on someone who’s doing just fine; whereas a diagnostics test evaluates the symptoms of a patient.”
Smith-Bindman’s study questions whether screening tests yield enough positive outcomes for those at risk for strokes. She proposed the conduction of a randomized clinical trial in which individuals who are asymptomatic or asymptomatic.
Carotid artery stenosis occurs in the carotid artery upon the narrowing of it. Individuals at risk for strokes can have their carotid screened to evaluate preventative treatment. Smith-Bindman and the USPSTF both recommend against screenings.
The suggested trial will track patients. Ten years will allow researchers enough time to determine whether screened patients’ prognoses worsened or improved. Screenings lead to interventional treatments. For example, endarterectomy and stenting treatments may leave patients with grave complications.
“Everything we do in medicine has what we call a trade off,” Smith-Bindman said. “When we’re talking about imaging, taking pictures, it’s widely believed that the picture taking can have no harms; but decisions made, based on that information, could lead to harm.”
Until a carotid ultrasound trial occurs, only symptomatic patients should be screened, to prevent unneeded medications and treatments.
Source List:
- Susanna McIntyre | 206.251.2771 | SusannaMcintyre@ucsf.edu
- Rebecca Smith-Bindman, M.D. | 415.377.7957 | RebeccaSmith-Bindman@ucsf.edu
