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Screening Debate at NAS--TeenScreen Architect Pulls Out |
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Saturday, 25 February 2006 |
Dr. David Shaffer, the architect of TeenScreen, withdrew from the debate. It was explained to me that when he withdrew, Dr. Shaffer said the debate would not be "scientific enough."
"Screening for Mental Illness in Youth: Good Preventive Medicine?" a debate organized by the Science-Technology Policy Fellows of the National Academies of Science, was scheduled for Wednesday, Feb. 22 at 12:30. It was attended by approximately 90 people mainly from the National Academies. Members of the press, at least one practicing psychiatrist, and several laypersons also attended.
However, Columbia University's head of child psychiatry, Dr. David Shaffer, the architect of TeenScreen, withdrew from the debate.
It was explained to me that when he withdrew, Dr. Shaffer said the debate would not be "scientific enough."
A third participant, Julia Graham Lear, Ph.D., M.A. , Director, Center for Health and Health Care in Schools, George Washington University Medical Center, who had been added to the debate, did not think she could present a scientific rationale for screening--as Dr. Shaffer had been expected to present--and she also withdrew.
Although deprived of the expected debate, the audience was most attentive and cordial to the sole presentation (mine). My talk raised essential, unanswered questions, questions that should be satisfied before any mass screening is undertaken.
Noting that "screening has the potential to do more harm than good,” an article in the BMJ set forth "minimum criteria for mass screening" in medicine “that should be satisfied before any mass screening is undertaken."
* The disease should be common & serious;
* Its natural history should be understood;
* There should be a good screening test;
* Acceptable treatment should be available;
* This should favorably influence outcome;
* How many positive tests will prove…false?
* How will the quality of the test, intervention & follow-up be audited?"
See: by David Mant and Godfrey Fowler, in Mass Screening: Theory and Ethics, BMJ, 1990, 300: 916-918.
I presented the minimal assessment criteria that AHRP believes should be satisfied before any mass mental screening is undertaken:
* What is the purpose of screening?
* What evidence exists that the intervention is effective?
* What risks of harm may follow?
* How many “positive” screens proved false?
* What is the risk/ benefit of treatment compared to no treatment?
* Is there scientific evidence demonstrating that screening and drugs have “saved lives?”
The presentation also raised even more basic questions about the evidence (or more accurately, the absence of evidence) to support psychiatry's theories, diagnoses, and claims about the safety and efficacy of its prescribed treatments:
* How is mental illness defined?
* Are the diagnostic tools reliable & valid?
* What evidence supports a biological cause for depression / mental disorder?
* What evidence exists demonstrating a neurochemical basis for depression?
* What evidence supports the claims that psychotropic drugs have a favorable benefit / risk ratio?
Following the 15 minute presentation--which will be posted shortly on the AHRP website--the audience engaged in extensive question and answer for an hour.
AHRP wishes to take this opportunity to ask publicly why Dr. Shaffer, the leading researcher in the United States on screening programs for youth suicide, who has testified before legislative committees, refused the opportunity--that he had accepted--to present the scientific evidence?
Dr. Shaffer, the architect of TeenScreen, and its promoters ceaselessly claim that evidence underlies mass screening efforts. If there is evidence, why has he refused to present it?
The National Academies of Science is one of the most respected scientific forums in the world.
The topical seminars of its Policy Fellowship program have attracted a wide array of knowledgeable experts in their field.
As a recipient of several government-funded research grants paid by taxpayers, Dr. Shaffer's duties include sharing the results of his studies in scientific forums and answering questions about the validity and reliabity of his methods.
The debate was planned within the context of the first NAS Policy Fellowship seminar in 2006.
The next two seminars will address equally contentious important issues in which science and public policy intersect:
Feb. 28: A Universal DNA Database: Benefits and Risks:
A database containing DNA profiles of all U.S. citizens would be a boon to law enforcement agencies, but it would also raise serious concerns about individual privacy. At this public seminar, speakers will debate the benefits and risks of creating a national, mandatory DNA database.
Panelists
Thomas F. Callaghan, Ph.D.
Chief, Combined DNA Index System (CODIS) Unit
FBI Laboratory
James G. Hodge, Jr., J.D., LL.M.
Associate Professor, Johns Hopkins Bloomberg School of Public Health
Executive Director, Center for Law and the Public's Health
Core Faculty, Berman Bioethics Institute
Tania Simoncelli
Science & Technology Fellow
Technology and Liberty Program
American Civil Liberties Union
March 8: To Educate or Advocate: When Science Informs Policy, What is the Role of the Scientist?
To what extent should scientists participate in the public policy arena? Some argue that scientists have an obligation to speak out based on their scientific expertise, while others contend that scientists tarnish their credibility when they advocate particular policy preferences.
Panelists:
David E. Blockstein, Ph.D.
Senior Scientist
National Council for Science and the Environment
Washington, DC
Daniel Greenberg
Author of Science, Money, and Politics: Political Triumph and Ethical Erosion
It is doubtful than any of the other invited speakers to an NAS Fellowship seminar would dream of pulling out.
Contact: Vera Hassner Sharav
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