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Some Cautions in Labeling Effects

Some Cautions in Labeling Effects Abstract To the Editor.— Havas et al1 recently reported a neutral labeling effect in the Massachusetts Model Systems for the blood cholesterol screening project. Their report, although provocative and timely, leaves several unresolved questions of concern.First, patient selection factors are largely undefined. The authors provide no details about how patients were recruited from the four sociodemographically diverse Massachusetts communities, nor whether those participating in the last phase (3489/ 10500 screenees, 33%; September 1988 through January 1989) differed in any measurable way from those earlier in the screening sequence (October 1987 through August 1988). Most importantly, a critical reader would need to know the proportion of self-selected vs "reluctant participants."22 The latter are reportedly more likely to display adverse labeling effects.2-4Second, the investigators' intervention may not have been very powerful, either positively or negatively. They describe spending only 5 minutes per participant and still managed to address References 1. Havas S, Reisman J, Hsu L, Koumjian L. Does cholesterol screening result in negative labeling effects? Results of the Massachusetts Model Systems for blood cholesterol screening project . Arch Intern Med. 1991;151:113-119.Crossref 2. Rudd P, Price MG, Graham LE, et al. Consequences of worksite hypertension screening: changes in absenteeism . Hypertension. 1987;10:425-436.Crossref 3. Rudd P, Price MG, Graham LE, et al. Consequences of worksite hypertension screening: differential changes in psychosocial function . Am J Med. 1986;80:853-860.Crossref 4. Rudd P, Fortmann SP. Some pitfalls in disease screening . Arch Intern Med. 1990;150:1121-1125.Crossref 5. Sackett DL. A synthesis and some recommendations for future research . Clin Invest Med. 1981;4:221-225. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Some Cautions in Labeling Effects

Some Cautions in Labeling Effects

Abstract

Abstract To the Editor.— Havas et al1 recently reported a neutral labeling effect in the Massachusetts Model Systems for the blood cholesterol screening project. Their report, although provocative and timely, leaves several unresolved questions of concern.First, patient selection factors are largely undefined. The authors provide no details about how patients were recruited from the four sociodemographically diverse Massachusetts communities, nor whether those participating in the last...
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Publisher
American Medical Association
Copyright
Copyright © 1991 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1991.00400110141028
Publisher site
See Article on Publisher Site

Abstract

Abstract To the Editor.— Havas et al1 recently reported a neutral labeling effect in the Massachusetts Model Systems for the blood cholesterol screening project. Their report, although provocative and timely, leaves several unresolved questions of concern.First, patient selection factors are largely undefined. The authors provide no details about how patients were recruited from the four sociodemographically diverse Massachusetts communities, nor whether those participating in the last phase (3489/ 10500 screenees, 33%; September 1988 through January 1989) differed in any measurable way from those earlier in the screening sequence (October 1987 through August 1988). Most importantly, a critical reader would need to know the proportion of self-selected vs "reluctant participants."22 The latter are reportedly more likely to display adverse labeling effects.2-4Second, the investigators' intervention may not have been very powerful, either positively or negatively. They describe spending only 5 minutes per participant and still managed to address References 1. Havas S, Reisman J, Hsu L, Koumjian L. Does cholesterol screening result in negative labeling effects? Results of the Massachusetts Model Systems for blood cholesterol screening project . Arch Intern Med. 1991;151:113-119.Crossref 2. Rudd P, Price MG, Graham LE, et al. Consequences of worksite hypertension screening: changes in absenteeism . Hypertension. 1987;10:425-436.Crossref 3. Rudd P, Price MG, Graham LE, et al. Consequences of worksite hypertension screening: differential changes in psychosocial function . Am J Med. 1986;80:853-860.Crossref 4. Rudd P, Fortmann SP. Some pitfalls in disease screening . Arch Intern Med. 1990;150:1121-1125.Crossref 5. Sackett DL. A synthesis and some recommendations for future research . Clin Invest Med. 1981;4:221-225.

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Nov 1, 1991

References