Health Life

The key to better decision-making

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As much of Europe is engulfed by a second wave of COVID-19, and track and trace struggles to meet demand, modeling support tools are being increasingly used by policymakers to make key decisions. Most notably, models have been used to predict the COVID-19 R0 rate—the average rate of secondary infections from a single infection, which has formed the basis for many lockdown decisions across the UK.

Models can represent the most effective tool for identifying interventions that can balance the risks of widespread infection and help assess socio-economic disruption until an effective treatment is established. However, not all models are equal, and differences in predictions during the COVID-19 pandemic have caused confusion and suspicion.

A recent paper “Three questions to ask before using model outputs for decision support” published in Nature Communications aims to help decision makers choose the best available model for the problem at hand. The paper proposes three screening questions that can help critically evaluate models with respect to their purpose, organization, and evidence, and enable more secure use of models for key decisions by policy makers.

One of the authors of the paper, Dr. Alice Johnston, Lecturer in Environmental Data Science at Cranfield University, said, “From COVID-19 to the , models are increasingly used by policymakers to support their decisions.

“However, different models are based on different assumptions and so can produce conflicting results, even when they represent the same system. Models used early on in the COVID-19 pandemic were a prime example of this, which led to confusion over which models to trust to support the decision-making process. This really highlights the need for clear communication of a model’s context, so that policymakers have confidence in which models to trust.

“We propose that before engaging with a model,

Health article

Older Adults Often Unnecessarily Screened for Cancer

by NCI Staff

Many older adults are undergoing unnecessary cancer screenings, a new study shows.

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Many older adults are being screened for cancer who no longer need to be, results from a new study show.

Based on a nationwide survey, the study found that at least half of older adults had received at least one unnecessary cancer screening test in the previous few years.

The United States Preventive Services Task Force (USPSTF) recommends that people at average risk of cancer get colorectal cancer screening through age 75, breast cancer screening through age 74, and cervical cancer screening through age 65. 

In general, above those ages, people have a greater likelihood of being harmed by than benefiting from these tests, explained Barry Kramer, M.D., M.P.H., of NCI’s Division of Cancer Control and Population Sciences, who was not involved in the study.

The term “overscreening” is used to describe the use of such tests past the point where they are likely to provide a net benefit.

People often aren’t aware that there are potential harms from cancer screening, explained Jennifer Moss, Ph.D., from Penn State University, who led the new study, which was funded in part by NCI and published July 27 in JAMA Network Open. These harms can include false-positive test results that lead to unnecessary follow-up procedures. 

“But what we’re particularly worried about for older adults is the harm from the test itself. All of these screening tests are medical procedures that have potential side effects,” Dr. Moss said. This risk of harm is highest for invasive tests, such as colonoscopy.

Studies have shown that the overall benefits of screening, such as detecting cancer earlier when it’s potentially easier to treat, outweigh the likelihood of harms in younger adults. However, the harms increase