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T*R
发帖数: 36302 | 1 利益集团通过制定规则掌握话语权来赚取暴利
来美国久了，基本所有的人都会发现，这个社会讲规则，讲法制。所有事都得按规则来
。医疗利益集团当然也是如此。只有通过掌握发言权，制定符合自己利益的规则，才能
可持续的赚取最大利润。
举个例子吧：
作为和普通人关系很大疾病预防，女的MAMMOGRAM，男的PSA癌筛选是最重要的检查项目
之一。
但是你对比目前的GUIDELINE和两年前的GUIDELINE，就会发现有极其显著的区别。特别
是PSA筛选，AUA推出的最新GUIDELINE，几乎是对过去的完全否定。
那么过去的GUIDELINE，为什么能存在那么久？显然是利益集团通过掌握话语权制定的
，这样他们才能最大限度的赚钱。
现在，为什么改变了？因为大饼就那么大，按目前的经济形势，很难再做大了，如果继
续目前的规则，其他利益集团就会不满。最后，就只能通过牺牲部分的利益来解决内部
的矛盾。
下面是AUA关于PSA检查的新建议：
The AUA recommends against screening in men under age 40. Such blanket
recommendations can increase the risk of younger men being overlooked and
potentially resulting in worse disease later in life. Men under 40 need to
be educated about prostate cancer and given a clear understanding of their
individual risk factors. Obesity/excess weight, a family history of
prostate
cancer, and African American race are the driving risk factors of this
disease.
• The AUA recommends against routine screening in men of average risk
aged 40 to 54 years old. Early diagnosis and treatment are the two most
important factors to successfully eliminating prostate cancer.
• The AUA strongly recommends careful consideration of the pros and
cons of screening for men between the ages of 55 and 69. The risk of
prostate cancer increases significantly by age 65; so it’s wise for men in
this age bracket to be screened. These men have the greatest opportunity
for
early detection and treatment to eliminate their prostate cancer with
optimal quality of life.
• The AUA suggests screening for prostate cancer every two years
rather than annually. PSA is not a perfect test. Prostate cancer can be an
indolent cancer, taking many years to decades before it causes problems or
it can behave in a highly aggressive manner. PSA is not able to
differentiate these two cases. However, by tracking PSA velocity and
density
we can more accurately predict one’s risk of cancer.
• The AUA recommends against PSA screening in men over age 70 with a
life expectancy less than 10-15 years. Now that such a large percentage of
Americans live well into their 80s, prostate cancer screening should be
part
of overall wellness monitoring for these men. | c*****g
发帖数: 21627 | 2 up
【在 T*R 的大作中提到】
: 利益集团通过制定规则掌握话语权来赚取暴利
: 来美国久了，基本所有的人都会发现，这个社会讲规则，讲法制。所有事都得按规则来
: 。医疗利益集团当然也是如此。只有通过掌握发言权，制定符合自己利益的规则，才能
: 可持续的赚取最大利润。
: 举个例子吧：
: 作为和普通人关系很大疾病预防，女的MAMMOGRAM，男的PSA癌筛选是最重要的检查项目
: 之一。
: 但是你对比目前的GUIDELINE和两年前的GUIDELINE，就会发现有极其显著的区别。特别
: 是PSA筛选，AUA推出的最新GUIDELINE，几乎是对过去的完全否定。
: 那么过去的GUIDELINE，为什么能存在那么久？显然是利益集团通过掌握话语权制定的
| H*********S
发帖数: 22772 | |
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