Who serves on the US Preventive Services Task Force?

Brenda_R · November 2009

Here's a list of the current task force members. I don't see a single Oncologist listed!

http://www.ahrq.gov/clinic/uspstfab.htm#Members

Brenda_R · November 2009

Here's the recommendations.

http://www.ahrq.gov/CLINIC/uspstf/uspsbrca.htm

Brenda_R · November 2009

So we have nurses, pediatricians and professors deciding what screenings we should get.

dlb823 · November 2009

Pediatricians, but no breast cancer docs??? Something's starting to smell very fishy about this whole thing!

rascal_gal · November 2009

I am going to see if I can find the emails of each one of these people and send them a nasty gram.

kittycat · November 2009

I wasn't even 40 when I was diagnosed. My sister was 44. This is really stupid!

Anonymous · November 2009

2tzus - thanks for posting that. I have sent the Chair an email - from what I can read not one oncologist, breast surgeon or cancer doctor in that whole mix. Everyone, please write/email these individuals - the Chair of this committee is easy to find on Google - most of these people are.

AnnNYC · November 2009

Here is the "Hall of Shame" -- with their specialties in bold:

Ned Calonge, MD, MPH, Chair (Colorado Department of Public Health and Environment, Denver, Colorado) - Associate Professor of Family Medicine and of Preventive Medicine and Biometrics at the University of Colorado Health Sciences Center; board certified in both Family Medicine and Preventive Medicine.

Diana B. Petitti, MD, MPH, Vice-Chair (Arizona State University, Phoenix, Arizona) - Professor, Department of Biomedical Informatics

Thomas G. DeWitt, MD (Professor of Pediatrics, Children's Hospital Medical Center, Cincinnati, Ohio);

Allen J. Dietrich, MD (Community and Family Medicine, Dartmouth Medical School, Hanover, New Hampshire);

Kimberly D. Gregory, MD, MPH (Director of Maternal-Fetal Medicine, Cedars-Sinai Medical Center, Los Angeles, California);

David Grossman, MD (Director of Preventive Care Group Health Cooperative, Seattle, Washington); Professor of Pediatrics, specializing in injury prevention in children and teens.

George Isham, MD, MS (Chief Health Officer and Plan Medical Director, HealthPartners [an HMO], Minneapolis, Minnesota); internal medicine

Michael L. LeFevre, MD, MSPH (Professor in the Department of Family and Community Medicine, University of Missouri School of Medicine, Columbia, Missouri);

Rosanne M. Leipzig, MD, PhD (Geriatric Medicine, Internal Medicine, Mount Sinai School of Medicine, New York, New York);

Lucy N. Marion, PhD, RN (Dean, School of Nursing, Medical College of Georgia, Augusta, Georgia); she has served on state and national advisory groups concerning mental health care, environmental risks to children, the genetics workforce, and the practice doctorate for nurses.

Bernadette Melnyk, PhD, RN (Dean, Arizona State University College of Nursing & Health Innovation, Phoenix, Arizona); specialty is neonatal nursing.

Virginia A. Moyer, MD, MPH (Section Head, Academic General Pediatrics, Baylor College of Medicine, Houston, Texas);

Judith K. Ockene, PhD (Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, Massachusetts);

George F. Sawaya, MD (Associate Professor of Obstetrics and Gynecology, University of California, San Francisco, San Francisco, California);

J. Sanford Schwartz, MD (Leon Hess Professor in Internal Medicine, School of Medicine; and Professor of Health Care Management in the Wharton School; University of Pennsylvania Medical School and the Wharton School, Philadelphia, Pennsylvania);

Timothy Wilt, MD, MPH (Center for Chronic Disease Outcomes Research University of Minnesota Department of Medicine and Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota) - board-certified internal medicine specialist

**********

Nope, not a single oncologist, breast surgeon, radiologist, radiotherapist, or oncology nurse...

Lindissima · November 2009

Thank you Ann, 2tzus and Brenda for this valuable information. I'll get busy emailing them right away!

Anonymous · November 2009

Ann - your list shows a different Chair person - anyone know why? Just curious!!!!!

Anonymous · November 2009

bump

Anonymous · November 2009

bump

2GIRLSII · November 2009

I wonder how this "task" force sleeps at night. And I wonder what their real "task" was.

Eldub · November 2009

I read elsewhere that 6 of the list actually work for insurance companies, including Kaiser, Group Health, etc. Anyone know if this is true? It does seem truly odd that no one on the task force has experience treating ANY cancer - not to mention breast cancer.

Disturbing.

Linda

thepinkbirdie · November 2009

Some things I've come across that puzzle me...

http://www.cnn.com/2009/HEALTH/11/18/mammogram.guidelines/index.html

"The Preventive Services Task Force reviews medical data and bases recommendations on effectiveness and risks involved. It is composed of 16 health care experts, none of whom are oncologists, though a team of cancer experts presented its findings to the group. "

Has anyone seen who the team of cancer experts were? I'm sorry if they are already posted on this site... so much to read that it's overwhelming.

a quote from here http://www.bcm.edu/news/item.cfm?newsID=1605

"The new recommendations are backed by studies from Sweden using mammograms every other year. "

Why Sweden and not the US? What if women in the US, for example, are exposed to carcinogens that women in Sweden are not exposed to? Or, what if meats and dairy in Sweden don't contain growth hormones?

Please forgive me if i'm ramgling on hear. i finished my last chemo treatment today and have been unable to sleep. so i just took an ambien. i better go before i'm found sleeping on the key board!

I would like to hear your thoughts on this, please.

Thanks!

thepinkbirdie · November 2009

I'd also like to know if there is a way to put a face to these people, both those on the panel as well as the cancer experts. I just like to see a face with the name of a person who makes these sort of recommendations.

Surely there must be a group photo like the ones taken of the Supreme Court?

Brenda_R · November 2009

Ann's list shows as "current as of 2002". I'm not sure who is responsible for the findings, the current list or the older list?

AnnNYC · November 2009

Wait, my list says "current as of 2002"? Where does it say that?

I took my list from the authors of the guidelines published this week in Annals of Internal Medicine. That was the Task Force as of 2008, the group that wrote the new guidelines (listed at the end of article in the following link):
http://www.annals.org/content/151/10/716.full

The Chairman in 2008 was Ned Calonge, and he is still Chairman, according to the 2009 membership list on the USPSTF website:
http://www.ahrq.gov/clinic/uspstfab.htm#Members

Three new members were appointed in late 2008 and took their seats in January 2009: Susan Curry, Joy Melnikow, Wanda Nicholson. The three members who departed in January 2009, but who were authors of the guidelines, are Virginia Moyer, Judith Ockene, and George Sawaya.

AnnNYC · November 2009

Oh, I think I see the source of the confusion: 2ztus linked to the 2002 recommendations, at which time Dr. Berg was Chairman (http://www.ahrq.gov/clinic/3rduspstf/breastCancer/brcanrr.htm).

AnnNYC · November 2009

Hi Marie317,
You asked who is "the team of cancer experts who presented its findings to the group."
There were two teams who each wrote a report, also published along with the "guidelines" in Annals of Internal Medicine this week:
One report was a review of other studies (probably including that Swedish one -- I haven't read the whole report yet):
http://www.annals.org/content/151/10/727.full
The authors are:
Heidi D. Nelson, MD, MPH; (an oncologic surgeon -- see http://mayoresearch.mayo.edu/mayo/research/Staff/nelson_h.cfm)

Kari Tyne, MD; (a family practitioner in Portland, OR at the time the paper was written; now a family practitioner with HealthPartners in Minnesota -- a panelist on the TaskForce, George Isham, is Chief Health Officer and Plan Medical Director for HealthPartners)

Arpana Naik, MD; (a breast surgeon at Oregon Health & Science University -
see http://www.ohsu.edu/xd/health/services/providers/naika.cfm)

Christina Bougatsos, BS; (research assistant)

Benjamin K. Chan, MS; (Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Sciences University)

Linda Humphrey, MD, MPH (a specialist in Preventive Medicine and Epidemiology, also Oregon Health & Sciences University)

so... one oncologic surgeon and one breast surgeon...

I will try to post more about the other team/other report tomorrow -- it was a report of 6 computer models that predicted the potential "benefits" and "harms" of screening and not screening women ages 39-49 (see http://www.annals.org/content/151/10/738.full) -- lots of PhDs among those authors...

otter · November 2009

Hey, Ann.... aren't you in the eastern time zone? Or have you become nocturnal, too?

otter

Brenda_R · November 2009

Lots of middle of the nighters on this forum.

otter · November 2009

I'm calling it quits. (The movie I'm watching is almost over.) I'll be back tomorrow, to continue the discussions! G'night, all.

otter

Anonymous · November 2009

There's over 57,000 members here at bco. That "panel" should conduct a comprehensive study based on our stories/histories.

AnnNYC · November 2009

Hi Otter, I'm quite nocturnal! But I did go to bed the minute I finished listing the authors of the review of studies about screening for breast cancer:

Screening for Breast Cancer: An Update for the U.S. Preventive Services Task Force. Heidi D. Nelson, Kari Tyne, Arpana Naik, Christina Bougatsos, Benjamin K. Chan, and Linda Humphrey. Ann Intern Med November 17, 2009 151:727-737.

SUMMARY: To inform the USPSTF recommendations about breast cancer screening, Nelson and coworkers reviewed evidence on the effectiveness of mammography screening in decreasing breast cancer mortality among average-risk women, the effectiveness of clinical breast examination and breast self-examination, and the harms of screening. They found that mammography screening reduced breast cancer mortality for women aged 39 to 69 years, but data for older women were insufficient. They also found that false-positive results and additional imaging tests were common, particularly among younger women. No benefit has been shown for clinical breast examination or breast self-examination.

*********

The other paper that "informed the guidelines" was a report of 6 computer models of the risks and benefits of screening mammography in different age groups.

Effects of Mammography Screening Under Different Screening Schedules: Model Estimates of Potential Benefits and Harms. Jeanne S. Mandelblatt, Kathleen A. Cronin, Stephanie Bailey, Donald A. Berry, Harry J. de Koning, Gerrit Draisma, Hui Huang, Sandra J. Lee, Mark Munsell, Sylvia K. Plevritis, Peter Ravdin, Clyde B. Schechter, Bronislava Sigal, Michael A. Stoto, Natasha K. Stout, Nicolien T. van Ravesteyn, John Venier, Marvin Zelen, Eric J. Feuer, and for the Breast Cancer Working Group of the Cancer Intervention and Surveillance Modeling Network (CISNET). Ann Intern Med November 17, 2009 151:738-747.SUMMARY: To inform the USPSTF recommendations about breast cancer screening, Mandelblatt and colleagues developed 6 models of breast cancer incidence and mortality in the United States and estimated benefits and harms across 20 mammography screening strategies. The models showed that biennial screening achieves most of the benefit of annual screening with less harm. Decisions about the best screening strategy depend on program and individual objectives and the weight placed on benefits, harms, and resource considerations. *******So... about the authors of the model report:Jeanne S. Mandelblatt, MD, MPH [Geriatrician and Behavioral/Population Scientist, Associate Director for Population Sciences at the Lombardi Comprehensive Cancer Center, Washington, DC -- see http://fishercenter.georgetown.edu/research/members/57793.html] Kathleen A. Cronin, PhD [Statistical Research and Applications Branch. Division of Cancer Control and Population Sciences, National Cancer Institute (NCI), Bethesda, MD] Stephanie Bailey, PhD [can't find much about her -- she was a fellow in the Dept of Radiology at Stanford in 2008 -- she's NOT the Stephanie B. Coursey Bailey, MD who is Chief of Public Health Practice at the CDC] Donald A. Berry, PhD [Dept of Biostatistics and Applied Mathematics, MD Anderson Cancer Center, Houston, TX]Harry J. de Koning, MD, PhD [Professor of Screening Evaluation, Dept of Public Health, Erasmus University, Rotterdam, The Netherlands] Gerrit Draisma, PhD [Dept of Public Health, Erasmus University, Rotterdam, The Netherlands] Hui Huang, MS [Dana-Farber Cancer Inst, Boston, MA]Sandra J. Lee, DSc [Senior Research Scientist, Biostatistics and Computational Biology, Dana-Farber Cancer Institute] Mark Munsell, MS [Senior Research Statistician at UT MD Anderson Cancer Center] Sylvia K. Plevritis, PhD [Associate Professor (Research) of Radiology, Stanford Medical Center, Stanford, CA -- see http://med.stanford.edu/profiles/bioengineering/faculty/sylvia_plevritis/] Peter Ravdin, MD, PhD [Clinical Professor of Medical Oncology The University of Texas Health Science Center at San Antonio] Clyde B. Schechter, MD, MA [Dept of Family & Social Medicine, Dept of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY] Bronislava Sigal, PhD [Engineering Research Associate, Dept of Radiology, Stanford Medical Center, Stanford, CA]Michael A. Stoto, PhD [Professor of Health Systems Administration and Population Health, Georgetown University, Washington, DC -- see http://explore.georgetown.edu/people/stotom/?PageTemplateID=179] Natasha K. Stout, PhD [Center for Risk Analysis, Harvard School of Public Health]Nicolien T. van Ravesteyn, MSc [Dept of Public Health, Erasmus University, Rotterdam, The Netherlands] John Venier, MS [Systems/Programmer Analyst, MD Anderson Cancer Center, Houston, TX] Marvin Zelen, PhD [Professor of Statistical Science, Harvard School of Public Health and Dana-Farber Cancer Institute, Boston, MA -- see this link] Eric J. Feuer, PhD [Statistical Research & Applications Branch, National Cancer Inst (NCI), Bethesda, MD] for the Breast Cancer Working Group of the Cancer Intervention and Surveillance Modeling Network (CISNET) -- see http://cisnet.cancer.gov/

thepinkbirdie · November 2009

Thanks Ann and everyone else for all the info provided! There is so much to read about all of this. Then I saw elsewhere that "they" (don't remember who they are) are wanting to change the guidelines too on pap smears and cervical cancer testing.

Margerie · November 2009

I The Current 2009 Members of the Task Force

Bruce Nedrow (Ned) Calonge, M.D., M.P.H. (Chair)- Associate Professor of Family Medicine and of Preventive Medicine and Biometrics at the University of Colorado Health Sciences Center

Diana B. Petitti, M.D., M.P.H. (Vice Chair)- Professor of Biomedical Informatics at the Fulton School of Engineering, at Arizona State University

Susan Curry, Ph.D- dean of the College of Public Health and distinguished professor of health management and policy at the University of Iowa

Allen J. Dietrich, M.D.- board-certified family physician, is a professor of community and family medicine at Dartmouth Medical School

Thomas G. DeWitt, M.D.- Professor of Pediatrics

Kimberly D. Gregory, M.D., M.P.H.- Director of Maternal-Fetal Medicine and Director of Women's Health Services Research at Cedars-Sinai Medical Center, Los Angeles, CA

David Grossman, M.D., M.P.H.- board-certified pediatrician

George Isham, M.D., M.S.- Medical Director and Chief Health Officer for HealthPartners, a large health care organization in Minnesota

Michael L. LeFevre, M.D., M.S.P.H.- Professor in the Department of Family and Community Medicine at the University of Missouri School of Medicine

Rosanne Leipzig, M.D., Ph.D.- board-certified internist and geriatrician

Lucy N. Marion, Ph.D., R.N.- family medicine/psychiatric nurse practioner

Joy Melnikow, M.D., M.P.H.- professor in the Department of Family and Community Medicine and associate director of the Center for Healthcare Policy and Research at the University of California Davis. She is currently a deputy editor of Medical Care, standing member of the health services organization and delivery study section at the National Institutes of Health

Bernadette Melnyk, Ph.D., R.N., C.P.N.P/N.P.P.- pediatric and psychiatric nurse practioner

Wanda Nicholson, M.D., M.P.H., M.B.A.- board-certified obstetrician-gynecologist and a perinatal epidemiologist

J. Sanford (Sandy) Schwartz, M.D.- board-certified internal medicine specialist

Timothy Wilt, M.D., M.P.H.- board-certified internal medicine specialist

For those keeping score:

family medicine- 5
biomed informatics- 1
health management and policy (PhD)- 1
pediatrics- 2
ob/gyns- 2
internal medicine- 3
nurse pracitioners (family medicine/psychiatry/peds)- 2

oncologists- 0
radiologists- 0
breast cancer surgeons/specialsists- 0

I always say if something stinks, check your shoe. What stinkbomb I found is that numerous members of this 16-member panel are currently or have been directly involved with the HMO or health care industry.

This information came directly from USPSTF

Dr. George Isham, MD is the Chief Health Officer for a major health care provider, Health Partners. "Dr. Isham is responsible for quality, utilization management, health promotion and disease management, research, and health professionals' education at HealthPartners. He is active in strategic planning and policy issues. He is an experienced primary care clinician and was chair of the Institute of Medicine committee that produced the report, Priority Areas for National Action: Transforming Health Care Quality." (quote from the Health Partners website)

J. Sanford Schwartz, MD, is the past executive director of the Leonard Davis Institute of Health Economics at the University of Pennsylvania. He's also on the Blue Cross and Blue Shield Medical Advisory Panel. He was also formerly the Editor of the American Journal of Managed Care

Diana B. Petitti, MD (the Vice Chair of this panel who said that these recommendation would have no effect on health insurance coverage) was a Senior Scientific Advisor for Health Policy and Medicine at Kaiser Permanente of Southern CA.

Joy Melnikow, M.D is a contributing member of the California Health Benefits Program Task Force for the University of California's Office of the President and associate medical director of Healthwise, Inc.

Hmmmmm... if you were to assemble a health care/action committee to review and possibly revise breast cancer screening guidelines for the good citizens of the U.S.A., would you not want SOMEONE on this panel that has treated a breast cancer patient? Would you consult any of these people if you had, or suspected you had breast cancer?? Is it not a conflict of interest, or at least VERY bad taste, to have the health care industry represented (by some means) by at least 25% of this panel and breast cancer specialists make up 0%? And we are supposed to believe there is no motivation here except to better the health of American women overall?

I think this smells like &$#@!

Who serves on the US Preventive Services Task Force?

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