Information Technology in Primary Care Screenings: Ready for Prime Time?

Bhrandon Harris; Karl Kochendorfer; Memoona Hasnain; Masahito Jimbo

doi:10.1370/afm.250198

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RE: Information Technology (IT) in Primary Care Screenings: Ready for Prime Time?
Mark H. Ebell

Published on: 30 April 2025

Published on: (30 April 2025)
Page navigation anchor for RE: Information Technology (IT) in Primary Care Screenings: Ready for Prime Time?
RE: Information Technology (IT) in Primary Care Screenings: Ready for Prime Time?
Mark H. Ebell, Family Physician, Dept of Family Medicine, Michigan State University
The four studies discussed in this article report promising applications of IT to detect hearing loss, preconception cardiomyopathy, and dementia earlier. However, after careful review of the evidence, the US Preventive Services Task Force found insufficient evidence to recommend screening for hearing loss and dementia, and has not addressed screening for preconception cardiomyopathy screening. Detecting disease earlier is only the first step in a successful screening program. Evidence is needed that early intervention improves outcomes compared to waiting for symptoms to develop, and that harms of false positives, biopsies, and other interventions do not outweigh the potential benefits. This is particularly true for early detection of dementia given the high cost, minimal benefits, and serious harms of the new class of amyloid-targetting monoclonal antibodies as described in this journal (1).

Just because we can do something does not mean we should. Family physicians already have a huge cognitive and temporal burden to manage acute conditions, chronic disease, screening, and prevention. We should be very careful that recommended screenings provide a net benefit at a reasonable cost and with minimal burden.

Sincerely,

Mark H. Ebell MD, MS
Professor of Family Medicine, Michigan State University
The author was a member of the USPSTF for 4 years from 2012 to 2015.

1. Ebell MH, Barry HC, Baduni K, Grasso G. Clinically Important Benefits...
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The four studies discussed in this article report promising applications of IT to detect hearing loss, preconception cardiomyopathy, and dementia earlier. However, after careful review of the evidence, the US Preventive Services Task Force found insufficient evidence to recommend screening for hearing loss and dementia, and has not addressed screening for preconception cardiomyopathy screening. Detecting disease earlier is only the first step in a successful screening program. Evidence is needed that early intervention improves outcomes compared to waiting for symptoms to develop, and that harms of false positives, biopsies, and other interventions do not outweigh the potential benefits. This is particularly true for early detection of dementia given the high cost, minimal benefits, and serious harms of the new class of amyloid-targetting monoclonal antibodies as described in this journal (1).

Just because we can do something does not mean we should. Family physicians already have a huge cognitive and temporal burden to manage acute conditions, chronic disease, screening, and prevention. We should be very careful that recommended screenings provide a net benefit at a reasonable cost and with minimal burden.

Sincerely,

Mark H. Ebell MD, MS
Professor of Family Medicine, Michigan State University
The author was a member of the USPSTF for 4 years from 2012 to 2015.

1. Ebell MH, Barry HC, Baduni K, Grasso G. Clinically Important Benefits and Harms of Monoclonal Antibodies Targeting Amyloid for the Treatment of Alzheimer Disease: A Systematic Review and Meta-Analysis. Ann Fam Med. 2024 Jan- Feb;22(1):50-62. doi: 10.1370/afm.3050. PMID: 38253509.
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Competing Interests: None declared.