CervicalCheck controversy

boombang

Johnny Dogs wrote: »

That clears that one up so.

Was there a suggestion about people being disingenuous here?

Jaysus Johnny, just because she implied it rather than spelt it out doesn't mean she wasn't being disingenuous. She knows what she was saying, I know what she was saying. In my eyes she was plainly being disingenuous with an important public health story. To do so for a political motivation is reprehensible in my view.

It's fine if you don't find her comments disingenuous.

givyjoe

Red_Wake wrote: »

No this is utterly false. The errors were only discovered when the initial smears were retested following the women in question receiving a diagnosis of cancer. By the time they were aware of the errors in the smear[the false negatives], they were already receiving treatment for cancer.

This is explained several times a page in this topic.

What's utterly false? Did you read my post? I asked a question, I didn't make a statement. . I don't have a crystal ball to magically know where the exact posts that explain this are on a thread I've just seen for the first time, nor do i have the time to read 239 + posts to find in case my question is already answered. But by all means get completely arsey about it. The first mention of this explanation (that I found, while working backwards) is 4 pages back. My incorrect views were based on how this has been presented in the media and by politicians.

If it was covered multiple times, then fair to assume to multiple people were under the same impression.

boombang

kaymin wrote: »

Regardless of the lab, non-disclosure of the fact testing gave inaccurate results meant women inappropriately relied on those results to their detriment and possibly their lives. You claim inaccurate results are within normal ranges - all the indications says otherwise - the fact they are settling multi-million lawsuits and what the QA team that resigned have to say about the matter.

Dr Gibbons didn't resign on the basis of the current operation of CervicalCheck.

I'm not claiming they operated within the normal ranges; TOB claimed this. For the meantime I'll believe him. If the evidence shows otherwise, I will change my mind.

The leaflet given to women inviting them to a smear tells them the test isn't perfect.

kaymin

boombang wrote: »

Dr Gibbons didn't resign on the basis of the current operation of CervicalCheck.

I'm not claiming they operated within the normal ranges; TOB claimed this. For the meantime I'll believe him. If the evidence shows otherwise, I will change my mind.

The leaflet given to women inviting them to a smear tells them the test isn't perfect.

You might claim the current operation of CervicalCheck addressed Dr Gibbons issues - if that was the case why would Dr Gibbons and a host of others resign? Why is the US lab settling cases? Why are Dr Gibbon's predictions from 2008 seemingly coming to pass? Suggest reading this article:

https://www.independent.ie/irish-news/health/doctor-predicted-cervical-smear-test-issues-10-years-ago-36858027.html

No-one is claiming the smear test is perfect so lets put that one to bed.

HeidiHeidi

Govt press conference on this being broadcast on RTE News Now at 3.30pm

knipex

kaymin wrote: »

That's not correct. The outsourcing screening service gave 1/3 less positive results than the non-outsourced screening service. That's the whole point - the US lab spends 5 minutes analysing each sample because the test is done every year and therefore a missed diagnosis is not as drastic. The screening service in Ireland spends far longer because it is done only every 3 years.

I have tried hard but only ever seen a single source for this with no data or references behind it.

I have seen no comparison of false positives (which are also a side effect of any screening process).

All screening processes are only reliable to a point. They are not a precision diagnostic tool and like any screening process they are designed to catch the vast vast majority of cases but not all.

James Brown

boombang wrote: »

Others in this thread have also been under that impression. Read back over some of the previous posts in reply to Matt and Mr H.

The impression I'm under is we don't know for sure when the errors for each patient were discovered. You take the company line as fact. I do not, not until we have a completed investigation.
Women have died as a result of these errors.
Then we have the reluctance to make the error findings available to either the patients or the public. We have a court case where they attempted to keep it quiet. We've correspondence sent to the HSE/health department, we're not sure who got it/who didn't/who may or may not have acted on it.

We know there were errors. We know we outsourced to the US. We know there was a conscious effort to keep the errors quiet.

boombang wrote: »

Jaysus Johnny, just because she implied it rather than spelt it out doesn't mean she wasn't being disingenuous. She knows what she was saying, I know what she was saying. In my eyes she was plainly being disingenuous with an important public health story. To do so for a political motivation is reprehensible in my view.

It's fine if you don't find her comments disingenuous.

You seem more concerned about what you think a politician was thinking when she said something else, over the non-scandal.

knipex

Edward M wrote: »

OK, I get the point, these women had their cancer diagnosed later than should have been because of the bad tests, but it was too late anyway for them anyway when the audit found the mistakes.
My bad, I was inferring that they could have been saved if the audit results had been made public earlier and I accept that is not the case.
The audit results and their cover up till now wouldn't have helped these women anyway.
This still leaves a sour taste in my mouth though, its still a cover up of incompetence and a selfish face saving exercise and its of little comfort to anybody that protection of the system above the patients involved.
https://www.irishtimes.com/news/ireland/irish-news/it-hurts-husband-of-cancer-victim-shocked-at-2016-memos-1.3491656?mode=amp

Fair play.

I don't know if there was incompetence. I actually don't think there was.

I'm not sure what happened in the lab and I have not seen any reliable source point to a systemic problem with the way the samples were tested.

However I think that the decision not to inform patients that there tests had been given the all clear incorrectly was made with the best of intentions. I dont personally think that it was the correct decision but I can understand that though process.

1. Sharing the info would have had no impact on the patients treatment or outcome.
   
2. It would have had a detrimental impact on the public opinion of the smear test program and probably reduced take up of the program thereby costing lives.
   
3. it would have been another opportunity for certain individuals in media and political circles to make a lot of noise, call for a lot of heads and confuse the situation to a degree that mad 2 (above) orders of magnitude worse.

As I said I don't agree with the decision process but I can understand how it was made.

On the lab issue and the standard of testing I will wait until after the investigation and its findings are published.

And the big outcry over outsourcing of the tests, its a huge red herring. At the time the program was launched there was no capacity in Ireland to perform the quantity of tests that were required. The scheme was piloted in the Midwest and Irish labs couldn't handle the number of samples from that. There was also no lab in Ireland certified to the recognised international standard.

To build the necessary infrastructure woudl have taken years and costs a fortune and then the issue of staffing it. The decision was made to tender the testing to certified laboratories and to just start the program.

knipex

Mr.H wrote: »

Really? Because I can tell you that yes people are dead because of this. Not just dying. Dead.

When you are diagnosed with cancer it is vital you start treatment as soon as possible. Not three or four years later.

People were misdiagnosed. The people uncharged knew about this and chose to say nothing. Instead they protected the contract they had. Because of this women who had cancer thought they where healthy until their next smear test three years later. If they were receiving treatment during those three years they would have had a better chance at beating it and surviving.

Instead people died.

Again.. You are wrong.

There is no misdiagnosis.

There was a false positive from a screening program that was only discovered following an audit that took place after the cancer diagnosis.

So go before you spread any more misinformation or throw any more insults please go back and actually check the facts.

James Brown

knipex wrote: »

Again.. You are wrong.

There is no misdiagnosis.

There was a false positive from a screening program that was only discovered following an audit that took place after the cancer diagnosis.

So go before you spread any more misinformation or throw any more insults please go back and actually check the facts.

Based on poor testing, people with cancer were told they didn't have cancer. Some died as a result. Some didn't. Some are in the process of dying.
The company tried to keep the errors quiet.
The HSE/Dept. Of Health/Harris aren't sure who knew what when.

Milkman..

Self-serving press conference as expected

Matt Cooper calling it straight

"Making sure it never happens again"

Must be using the usual scriptwriter

boombang

kaymin wrote: »

You might claim the current operation of CervicalCheck addressed Dr Gibbons issues - if that was the case why would Dr Gibbons and a host of others resign? Why is the US lab settling cases? Why are Dr Gibbon's predictions from 2008 seemingly coming to pass? Suggest reading this article:

https://www.independent.ie/irish-news/health/doctor-predicted-cervical-smear-test-issues-10-years-ago-36858027.html

No-one is claiming the smear test is perfect so lets put that one to bed.

I'm not saying that he's not genuine, but I don't think we should necessarily take it to be the truth either. The article notes that they found difference on a common population size. This implies that it's not the same sample or a random selection from the same population. If Dr Gibbons' sample was from an area of higher incidence, then he would find more disease, all else equal.

I would just like more information from other sources on Dr Gibbons' claims.

We would likely see some false negatives even if everything was done at the Coombe. The question is is there an excess in false negatives and I'm waiting to see evidence of that.

Re the leaflet: wasn't trying to treat you like an idiot; I just wanted to point out that the limitations are flagged at the point of invitation.

I honestly have an open mind about the US labs. What's not been picked up yet is that there could be a regional element of this that points to poor performance at Quest. I know the country is divided up between the labs. The two commercial labs are the biggest. Vicky Phelan, Irene Teap and Emma Mhic Mhathúna are all from the South West. Does that tell us anything? It's a sample of three. I'd like to know about the other 206.

lawred2

probably asked and answered already but does this contracted lab have other clients affected beyond the HSE?

kaymin

knipex wrote: »

Fair play.

I don't know if there was incompetence. I actually don't think there was.

I'm not sure what happened in the lab and I have not seen any reliable source point to a systemic problem with the way the samples were tested.

However I think that the decision not to inform patients that there tests had been given the all clear incorrectly was made with the best of intentions. I dont personally think that it was the correct decision but I can understand that though process.

1. Sharing the info would have had no impact on the patients treatment or outcome.
   
2. It would have had a detrimental impact on the public opinion of the smear test program and probably reduced take up of the program thereby costing lives.
   
3. it would have been another opportunity for certain individuals in media and political circles to make a lot of noise, call for a lot of heads and confuse the situation to a degree that mad 2 (above) orders of magnitude worse.

As I said I don't agree with the decision process but I can understand how it was made.

On the lab issue and the standard of testing I will wait until after the investigation and its findings are published.

And the big outcry over outsourcing of the tests, its a huge red herring. At the time the program was launched there was no capacity in Ireland to perform the quantity of tests that were required. The scheme was piloted in the Midwest and Irish labs couldn't handle the number of samples from that. There was also no lab in Ireland certified to the recognised international standard.

To build the necessary infrastructure woudl have taken years and costs a fortune and then the issue of staffing it. The decision was made to tender the testing to certified laboratories and to just start the program.

Where are you getting your information? There was screening labs in Ireland. If there is no incompetence why is the US lab settling litigation for 2.5m? Best intentions? - the only intention was to limit litigation. Again, sharing the fact that tests were unreliable (over and above normal false results) would encourage patients to seek more reliable tests elsewhere (as opposed to not getting tested at all) - non-disclosure of the extent of false results has most likely cost lives.

Is Dr Gibbons (Quality Assurance chair of the Quality Assurance committee) not a reliable source? Suggest reading this article:

https://www.independent.ie/irish-new...-36858027.html

Mr.Micro

Milkman.. wrote: »

Self-serving press conference as expected

Matt Cooper calling it straight

"Making sure it never happens again"

Must be using the usual scriptwriter

Indeed. Rinse and repeat. When and where have we heard that quotation before. It never gets tired.

boombang

lawred2 wrote: »

probably asked and answered already but does this contracted lab have other clients affected beyond the HSE?

It's a big provider in the US. I think it has been sued for false negatives by US women before. I would caveat that by saying if you are a massive provider of screens you will make mistakes within you millions of screens that you provide, so it's likely that you will be sued.

McMurphy

Milkman.. wrote: »

Self-serving press conference as expected

Matt Cooper calling it straight

"Making sure it never happens again"

Must be using the usual scriptwriter

Anything to be said for another commission?

boombang

kaymin wrote: »

non-disclosure of the extent of false results has most likely cost lives.

You certainly might be right about that, but should we not wait to see evidence of a differential in performance before we rush to judgement?

kaymin

boombang wrote: »

I'm not saying that he's not genuine, but I don't think we should necessarily take it to be the truth either. The article notes that they found difference on a common population size. This implies that it's not the same sample or a random selection from the same population. If Dr Gibbons' sample was from an area of higher incidence, then he would find more disease, all else equal.

Why are you talking about sample selections? There was no sample selections since the entire population of smear samples has been tested. The populations would have been sufficiently large that the difference in results should not have been great - a one-third difference is statistically significant by a very very large margin.

James Brown

Johnny Dogs wrote: »

Anything to be said for another commission?

Looking at the McCabe thing, I don't see any point unless we bring in a foreign team with no ties to either the company or the HSE.

It's so insulting to be given a large bill and a slew of 'recommendations' as we move on, business as usual. We need something with teeth.

iamwhoiam

So the HSE audit the results and must have noticed the higher rate of false negatives from the US lab ?
And yet they carried on using the lab and spent time instead getting legal advice incase women sued . Now that to me is gross negligence and incompetence and still Tony O Brien think HE is the one hard done by . ? What a pompous arse

kaymin

boombang wrote: »

You certainly might be right about that, but should we not wait to see evidence of a differential in performance before we rush to judgement?

The reason I made this point is that Mary Lou is most likely not far wrong if she is claiming the HSE's actions have cost lives. Personally I am happy with what Dr Gibbons has to say on the matter and don't need to await the results of a tribunal in 3 years when it's all forgotten and the HSE has reverted to form.

boombang

kaymin wrote: »

Why are you talking about sample selections? There was no sample selections since the entire population of smear samples has been tested. The populations would have been sufficiently large that the difference in results should not have been great - a one-third difference is statistically significant by a very very large margin.

But were the populations that provided the samples to Dr Gibbons and the Quest the same. Age, region, prior screen history, socio-economic status, smoking rates, all of these things will mean that the disease prevalence won't necessarily be the same in different areas.

Previous media coverage had led me to believe that Dr Gibbons and Quest were working from the same sample, but the article you linked indicates that they're different samples and I'm asking can there be differences in the populations? I think it's a fair question.

boombang

kaymin wrote: »

The reason I made this point is that Mary Lou is most likely not far wrong if she is claiming the HSE's actions have cost lives. Personally I am happy with what Dr Gibbons has to say on the matter and don't need to await the results of a tribunal in 3 years when it's all forgotten and the HSE has reverted to form.

Well, I agree that it would be a farce if we have to wait 3 years for results. Presumably we should be able to get reliable results within a matter of weeks to resolve this to our mutual satisfaction?

kaymin

boombang wrote: »

But were the populations that provided the samples to Dr Gibbons and the Quest the same. Age, region, prior screen history, socio-economic status, smoking rates, all of these things will mean that the disease prevalence won't necessarily be the same in different areas.

Previous media coverage had led me to believe that Dr Gibbons and Quest were working from the same sample, but the article you linked indicates that they're different samples and I'm asking can there be differences in the populations? I think it's a fair question.

The populations would be of sufficient size that the difference in results from both populations should not be statistically significant. A one-third difference is statistically significant by a huge margin.

Mr.H

knipex wrote:

So go before you spread any more misinformation or throw any more insults please go back and actually check the facts.

I haven't thrown insults. I have had insults thrown at me.

Misinformation?

A false positive can only be given as a result of a misdiagnoses

kaymin

boombang wrote: »

Well, I agree that it would be a farce if we have to wait 3 years for results. Presumably we should be able to get reliable results within a matter of weeks to resolve this to our mutual satisfaction?

Yes, we should but considering the HSE couldn't tell which lab did particular tests, I wouldn't hold my breath.

boombang

kaymin wrote: »

The populations would be of sufficient size that the difference in results from both populations should not be statistically significant. A one-third difference is statistically significant by a huge margin.

Can you explain where the samples were from? Genuine question.

boombang

kaymin wrote: »

Yes, we should but considering the HSE couldn't tell which lab did particular tests, I wouldn't hold my breath.

Reporting of stats so far has been very poor undeniably. I'm sure the will have records of all of this in the end (blind faith on my part, maybe).

Mr.H

OK a question for the apologists.

What would be accountability in your eyes? What is the desired outcome that will put things right?