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Point and Counterpoint |

Rebuttal From Drs Courtright and ManakerRebuttal From Drs Courtright and Manaker

Katherine Courtright, MD; Scott Manaker, MD, PhD, FCCP
Author and Funding Information

From the Pulmonary, Allergy and Critical Care Division (Drs Courtright and Manaker), Hospital of the University of Pennsylvania (Drs Courtright and Manaker), and Department of Medicine (Dr Manaker), University of Pennsylvania.

CORRESPONDENCE TO: Katherine Courtright, MD, Pulmonary, Allergy and Critical Care Division, Hospital of the University of Pennsylvania, Gates Bldg, 806 W, 3400 Spruce St, Philadelphia, PA 19104; e-mail: katherine.courtright@uphs.upenn.edu


FINANCIAL/NONFINANCIAL DISCLOSURES: The authors have reported to CHEST the following conflicts of interest: Dr Manaker has received fees as a grand rounds speaker, lecturer, consultant, and expert witness on documentation, coding, billing, and reimbursement from hospitals, physicians, departments, practice groups, professional societies, insurers, and various attorneys. In March 2011, he received $5,400 from Aetna Inc for consultation on diagnosis coding. He serves on the Hospital Outpatient Panel, a federal advisory commission to the Centers for Medicare & Medicaid Services; serves on the Contractor Advisory Committee for Novitas Solutions, Inc, a Medicare contractor; and chairs the Practice Expense Subcommittee of the American Medical Association, Specialty Society Relative Value Unit Update Committee. Dr Manaker also serves on the board of directors of ACCP Enterprises, Inc, a wholly owned, for-profit subsidiary of the American College of Chest Physicians. Dr Courtright has reported that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2015;147(2):293-294. doi:10.1378/chest.14-2816
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Extract

We appreciate Dr Yankelevitz’s1 discussion favoring coverage for lung cancer screening with low-dose CT (LDCT) scanning and agree with many of his thoughtful points. The divergent viewpoints expressed in this debate stem from the philosophical question of whether the glass is half empty or half full. The former approach best aligns with the ethical principles underlying preventive medicine, specifically that all potential harms are held to the highest level of scrutiny. Thus, we are obliged to confess, not underestimate or necessarily accept, the gaps in evidence for LDCT scan screening.

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