Thinking the unthinkable…and investigating it


“The Prostate Intervention Versus Observation Trust (PIVOT), led by Timothy Wilt, began in 1993 with 731 subjects, following them over 12 years to monitor their health.  

“It compared cancer patients who had their prostate gland removed with those monitored by “watchful waiting”, to establish how their treatment affected survival rates.

“It found those who underwent the operation had less than a three per cent better chance of survival than those who had no treatment; a figure which could have arisen by chance.

“When the results of the study were reported at a meeting of 11,000 experts at the European Association of Urology in Paris, they were met with “stunned silence”, the newspaper claimed…

“…Early data from the PIVOT trial certainly suggests that surgery to remove the prostate does not provide any significant survival benefit for men with low to medium risk prostate cancer…”

What if quality accreditation is much like radical prostatectomy?

What if it carries risks with few benefits for most accreditation sufferers?

What if only really bad labs are improved by the rituals of accreditation?

What if removing the thinking from the work leads to disfunctionality in labs that were fine?

Accreditation will wipe the smiles off their faces

Professor Duffy says of cancer screening with biomarkers:

Conclusion: Although biomarkers have many attractions as screening tests, inadequate sensitivity and specificity, when combined with the low prevalence of cancer in asymptomatic subjects, limit their value for the early detection of malignancy.
Screening has been defined as the systematic application of a test to identify subjects at sufficient risk of a specific disorder to benefit from further investigation or direct preventive action, among persons who have not sought medical attention on account of symptoms of that disorder. To be of value, screening must detect disease earlier and result in an efficacious treatment and the earlier use of efficacious treatment must lead to better outcome compared to treatment available at the onset of symptoms. Screening differs from diagnosis in that the aim is to detect disease or a predisease state when subjects are asymptomatic.


“Currently, only a small number of screening tests have been shown to reduce mortality from cancer…

What if the factory and military-influenced inspectors have applied pseudo-medical quality screening in an inappropriate way?

Like calls for inappropriate screening, what if pressure to conform has blinded doctors to the link between what they would recognise as inappropriate and unethical medical practice and the philosophy underlying ISO quality inspection?

At least with medical problems somebody does the research to find an answer.

This entry was posted in Laboratory medicine, Medicine, Practical problems, Psychology, Questions and tagged , , , , , . Bookmark the permalink.

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