I first posted about Life Line screenings two years ago. I’m re-posting today as this post still gets a lot of traffic and I wanted to reopen the comments.
I just received an invitation in the mail!
Not to a party or a wedding or anything fun, but to a Life Line Screening event being held at a local church. The letter says they’re holding a spot for me on this particular date, but I must call NOW to confirm and register, because spaces are LIMITED!
“These aren’t just routine medical procedures—they can help save your life”
Oh, boy. There is so much wrong with Life Line Screenings, I don’t know where to start.
The five “life-saving” procedures they boast are relatively simple and non-invasive screenings tests for a variety of conditions:
- stroke/carotid artery ultrasound
- abdominal aortic aneurysm (AAA) ultrasound
- peripheral arterial disease
- atrial fibrillation EKG
- osteoporosis risk assessment
They especially push the carotid artery ultrasound to assess stroke risk, and the letter warns “Your risk of suffering a stroke is high—it affects 1 in 5 women, and 1 in 6 men—and takes a terrible toll on families.”
Fear is always a good marketing tool, isn’t it?
Sure these tests may be painless and relatively inexpensive, but the truth is they are either not recommended for the general population or not recommended at all.
Kenny Lin, MD, who blogs at Common Sense Family Doctor (one of my favorite go-to blogs for evidence-based health care advice), posted the following information about Life Line Screenings:
1. Stroke screening…doesn’t help because most patients with asymptomatic carotid artery blockages will not suffer strokes. Although the screening test is “non-invasive and painless,” the confirmatory test, angiography, is not (it actually causes a stroke in a small number of patients) and unnecessary carotid endarterectomy can lead to death.
2. Abdominal aortic aneurysm screening is only recommended in men ages 65 to 75 who have ever smoked, because aneurysms are much less common in younger, female, and non-smoking populations. Even in men who are eligible for the test, it’s important to weigh the potential benefits against the potential harms of corrective surgery, which has a not insignificant mortality rate itself.
3. “Hardening of the arteries in the legs,” or screening for peripheral vascular disease with an arterial-brachial index, hasn’t been proven to prevent heart attacks but will certainly lead to many false positive results.
4. I’ve never even heard of atrial fibrillation (irregular heart beat) screening, which I presume is doing a screening EKG, which is also totally unproven. Absolutely no organizations recommend this.
5. Screening for osteoporosis with bone density testing is the only test on the list that’s actually worthwhile for a large number of adults, especially women over 65. But it’s not appropriate to do this test without a prior consultation with a clinician who can discuss the risks and benefits of undergoing this type of screening. And there are still questions about whether men benefit to the same degree as women, or at all.
He includes links to evidence-based studies by the United States Preventive Services Task Force (USPSTF).
Related post: “The Treatment Trap”
My “invitation” came with some
manipulative helpful patient education materials. But it’s not educational material so much as marketing. One sheet asks the question: “What do doctors have to say about these preventive health screenings?” Well, I don’t know because that question is answered with half a dozen quotes from clients/patients rather than the doctors themselves.
What do doctors actually say? Dr. Lin concludes his post by saying:
In a nutshell, that’s why companies like Life Line have no business portraying these services as “preventive health screenings,” in my church or any other community setting. It’s one thing to draw blood for a cholesterol test and take someone’s blood pressure (which will cost a whole lot less than $149), and quite another to offer these other procedures which are, at the very least, a waste of money and quite possibly harmful.
If screening reduced morbidity and mortality, that might be a reason to get screened, but they are not claiming that. [Life Line] can’t claim it, because there is no evidence to support doing these tests in the general population.
For a screening test to be worthwhile, it has to meet several criteria. You want to know the predictive value of a positive test in the population being screened. You want to know not just whether it picks up an abnormality, but whether picking up that abnormality will allow earlier treatment that will make a difference in outcome. You want to know whether false positive tests will lead to harmful invasive procedures. Bottom line: does the test do more good than harm?
These tests are worthwhile when used by doctors to help diagnose patients with symptoms or patients at high risk, but when used to screen the general population of mostly healthy people, they are likely to be useless or even to do more harm than good.
The materials also include the badge of the Better Business Bureau, saying “Life Line Screening meets all accreditation standards in trust and integrity by the BBB and has been rated an A+.”
But meeting the business standards of the BBB has absolutely nothing to do with meeting evidence-based standards for screening exams.
Read the fine print!
Life Line’s claims remind me of the Quack Miranda Warning. That’s the universal disclaimer on supplements and herbal remedies that don’t fall under regulation by the FDA.
The disclaimer (always in fine print on the back of the box or bottle) reads:
This statement [whatever the product is claiming it does] has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.
When you read it, you are left wondering (I hope), “Well, why should I buy it then?”
Life Line’s letter includes the same type of disclaimers.
Life Line Screening does not participate in the Medicare program and the cost of our screening services is not covered or reimbursable by Medicare.
Medicare and health insurance generally do not allow for coverage of vascular screenings.
Life Line Screening does not file insurance claims nor provide referrals to any physician’s group or hospital.
We direct all participants with abnormal results to take the report to their physician.
In other words, we’ll take your money and perform a test that neither Medicare nor any other insurance will cover because it is not medically indicated or useful, and then if something’s abnormal we’ll let you and your doctor worry about it and repeat this test and perform more tests because your doctor most likely won’t trust our results, anyway.
Check out my Resources page for links to good evidence-based screening information websites.
- Talk to your primary care doctor. Know your health risks and which screening tests are right for YOU.
- Talk to your insurance company. Many evidence-based screening tests are covered free of charge.
- Save your money. If you receive Life Line Screening’s “invitation” in the mail, toss it in the garbage.
For more in depth information about the risks—financial and physical—of overscreening, check out one of these excellent books: