As of 2009, the U.S. Preventive Services Task Force no longer recommends routine screening mammograms for women ages 40 to 49, although they said the decision should be made by the patient and her physician. The U.S. Preventive Services Task Force found that physicians would need to screen 1,000 women to save 1 woman’s life and concluded that it was not worth the risks associated with false positives (anxiety, unnecessary biopsies, overtreatment). Others, such as the American Cancer Society, disagree with the U.S. Preventive Services Task Force and conclude that the lifesaving effects of routine mammogram screening outweigh the potential harm.

The idea of comparative effectiveness research is to provide information about the value of different tools. Once that information is available, who should make the decisions about whether to provide coverage and reimbursement for a particular good or service? Can one objectively assess the risks and benefits associated with mammograms or other services or medications? Should decisions be made solely by the patient and treating provider? Does it matter if decisions affect taxpayers (for example, if a patient is covered by a government program such as Medicare or the Veterans Administration)?

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