It looks like an invitation you should not refuse. Inside pharmacies, a GP will question you about your risk factors for stroke, and if they add up refer you to have an ultrasound of key arteries free of charge.
Given an Australian has a stroke every 10 minutes, the idea appears well-intentioned. An ultrasound could reveal a build-up of plaque or narrowing in the carotid artery in your neck – a sign you might be at risk of stroke and need to see a specialist.
The problem is, if you have no symptoms of carotid artery stenosis (narrowing of the artery), health authorities say this test is likely to cause you more harm than good. The ultrasound will also cost taxpayers hundreds of dollars through Medicare.
Leading vascular surgeons, the Australian Medical Association and the Stroke Foundation are all warning the public to avoid “Strokecheck”, a new charity that has partnered with Amcal pharmacies and workplaces to host GP consultations about stroke risks.
The group, which appears to be directed by people with no medical experience, is promoting its work on social media and has teamed up with a gym, university and a large company to promote its work.
An Amcal pharmacy spokesman, James Nevile, said Strokecheck was paying about 300 Amcal pharmacies a confidential “modest” fee to refer people with risk factors to them for GP consultations and for use of their facilities – a payment Strokecheck will not comment on.
But surgeons say they are seeing patients who have been terrified by the group because the ultrasounds produce many “false positive” results, meaning some people are being told they’re at risk of stroke when they’re not at significant risk.
President of the Australia and New Zealand Society of Vascular Surgeons, Dr Bernard Bourke, said he was concerned the group was disease-mongering and masquerading as a charity to make money out of Medicare.
“It’s a rip-off,” he said. “They’re putting the fear of God into people.”
He said there was no evidence that people without symptoms of stroke should be getting screened for their stroke risk and having ultrasounds, and said people should talk to their regular GPs about their health instead.
Dr Bourke said the highly regarded US Preventive Services Taskforce reviewed the use of ultrasounds to screen the general population for stroke risk in 2014 and concluded it does more harm than good.
The group’s report said approximately 0.5 per cent to 1 per cent of the population has carotid artery stenosis and that there is no validated, reliable tool to determine who is at increased risk of the condition – or at risk of a stroke when it is present.
The taskforce said it therefore puts people at risk of harm because those who get a positive result on ultrasound may choose to see a surgeon and demand surgery to remove the plaque. Depending on the experience of the surgeon, the operation – a carotid endarterectomy – is associated with an up-to-6 per cent risk of stroke or death within 30 days. It also carries a 2.2 per cent risk of heart attack within 30 days.
A second procedure is carotid stenting which has been controversial. Up to 10 per cent of patients will have a stroke following it within 30 days.
Neurologist and spokesman for the Stroke Foundation, Associate Professor Tim Kleinig???, said his group did not endorse Strokecheck or support unnecessary medical tests.
“Carotid artery screening for stroke prevention is a highly controversial area and is not endorsed by national or international guidelines,” he said.
“While Strokecheck is referring to one of our stroke statistics, this should not be seen as an endorsement of its services.”
President of the Victorian branch of the Australian Medical Association and GP, Lorraine Baker, said if people were worried about having a stroke, they should discuss it with their GP, who is likely to know their family history, previous test results and other information relevant to the discussion.
Melbourne vascular surgeon Jason Chuen said it was important not to confuse the use of ultrasound for the general population with no symptoms of carotid artery stenosis with people who have a history of stroke.
“In patients who have had a stroke or ministroke then it is critically important that they have an ultrasound and we identify carotid artery stenosis, so we don’t want to discourage those patients,” he said.
Requests to interview Strokecheck’s directors – Michael O’Connor, David Boon and Darren Tappouras – were declined, but a PR firm and lawyers answered questions on email with sometimes conflicting results.
Last week, the PR firm said the group bulk-billed Medicare for consultations and had arrangements with external providers for bulk-billed scans.
But yesterday, lawyers for the group said Strokecheck does not bill Medicare.
Despite promotional material on the internet saying Strokecheck offers testing to assess plaque and stenosis in the carotid artery, abdominal aorta and peripheral arteries next to a picture of an ultrasound, a lawyer for Strokecheck also said it does not offer an ultrasound service.
The lawyer said the group’s purpose was to “educate the Australian public and raise awareness to lower the prevalence of cardiovascular disease and stroke” and that the “awareness program saves lives and lowers the cost burden of cardiovascular disease on the Australian community”.
This story Administrator ready to work first appeared on Nanjing Night Net.