I have been asked to review the screening service offered by Echelon Health, 68 Harley St, W1G 7G as a specialist interventional radiologist with past experience as a physician.
The data provided to me included an assessment of the risk of death for a full range of disease processes including infection, malignant diseases, blood and bone marrow diseases, endocrine and metabolic diseases, mental disorders, diseases of the nervous system, diseases of the cardiovascular system, diseases of the respiratory system, diseases of the digestive tract skin disease, musculoskeletal disease, genitourinary disease, pregnancy and childbirth and congenital disease.
I have also been provided with a detailed explanation of the assumptions behind the calculations of the likelihood of detecting treatable disease that might otherwise lead to premature death.
I have had the opportunity to discuss and debate the method and assumptions with the clinicians and scientists who undertook this work. My comments have been robust and have been answered in detail.
It is clear that not all disease will be detected by even the most robust and comprehensive screening process. However the data presented to me with the background hypotheses and assumptions convinced me that the screening process will detect a significant proportion of treatable and dangerous disease. I’m satisfied that the risks of radiation are considerably outweighed by the potential benefit to those in the screening programme. A recent audit of CT radiation dose at European scanning shows excellent performance with radiation exposure substantially below national reference levels.
The high level and comprehensive screening packages offered include clinical examination and laboratory tests with a range of imaging investigations and are designed to detect warning signs. It is recognised that the screening process will not make a full diagnosis in every case and that a suspicious finding may require further investigation which in turn may lead to a specific diagnosis or a negative result.
I am confident that Echelon are using state-of-the-art facilities and apparatus and a high standard of practice is offered.
Within the limitations of current knowledge and in some cases limited data from the scientific literature I find the overall logic in this project to be sound. I consider that potential clients can be reassured that Echelon are providing not only an expert high quality package but are continually questioning and refining the process. They will be influenced by results as this process develops and I believe they will adjust and modify the process dependent on results. The service they are providing a present is, in my opinion, the best that can be achieved in current practice with existing knowledge.
Dr David J Wilson