A Tale of Two Screening Mammography Trials | H. Gilbert Welch

February 13, 2015 6:40 PM

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A Tale of Two Screening Mammography Trials | H. Gilbert Welch

Ockham's razor -- namely, that all other things being equal, simpler explanations are generally better than more complex ones -- has had a longstanding role in clinical medicine. The call for diagnostic parsimony is not to be viewed as a rule, simply as a good principle to regularly follow. But Ockham's razor is equally useful in the context of interpreting clinical research -- as exemplified by an analysis of the adequacy of randomization in the two randomized trials reporting the most pessimistic and optimistic findings about screening mammography.

Although both trials were initiated over three decades ago, both published long-term follow-up data in the last few years. After 25 follow-up, the Canadian National Breast Screening Study reported that screening mammography had no effect on breast cancer mortality. After 29 of follow-up, the Swedish...

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