JHU's Welch and Mammography Risk Modeling

Recent  USPSTF recommendations for colon cancer screening, lung cancer screening, and mammography have made significant use of modeling, and in the last few years, all three of these recommendations have seen expanded indications.   For example, mammography is recommended now age 40-50 (but every other year) based on 2023 expected updates.

Woloshin et al, senior author Gilbert Welch at Johns Hopkins, dissent.  In NEJM they write, 

"The USPSTF’s increasing reliance on complex statistical modeling is problematic. Estimated effects can be extremely sensitive to modeling assumptions, which often reflect the conventional wisdom at the time...As others have argued, policymakers should use models only if they understand the parameters and assumptions underlying them."

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Welch made headlines a few weeks ago when JAMA Internal Medicine published a group of articles on liquid biopsy and multi cancer screenning; one of the main artices focused on overall survival. Op Ed by Welch & Dey.