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Screening for Abdominal Aortic Aneurysms: The U-Boat in the Belly-Reply

Robert S. Lawrence, MD
JAMA. 1987;258(13):1732. doi:10.1001/jama.1987.03400130046021.
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In Reply.—  Dr Santiago's thoughtful letter regarding abdominal aortic aneurysm (AAA) screening is an example of the response we hoped to stimulate by publishing the recommendations of the US Preventive Services Task Force. He has addressed the elements that justify the inclusion of any screening test or counseling recommendation in clinical practice: What is the burden of suffering for the individual and for society that the disease or risk factor for disease causes? What is the efficacy of the test in terms of sensitivity, specificity, and predictive value and how expensive or dangerous or painful is the test? How effective is the final intervention, whether it is a surgical procedure in the case of AAAs or a counseling intervention to stop smoking, wear seat belts, or reduce the total fat and proportion of saturated fat in the diet?Further review of the data is needed to assign quality of evidence


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