But from a socioeconomic standpoint, the cost-benefit of ultrasound screening for stroke has not been established. A person who is asymptomatic and found to have 60% carotid stenosis, for example, has a 5-year annual stroke risk of 2%. Endarterectomy reduces that risk to 1%, and the person is still at high risk for heart disease.
Screening may be “good for business, but whether it is a good thing for patients is a bit of an open question,” Dr. Derdeyn said. One concern is that the companies will screen people who are too young to seriously be considering their stroke risk, he said.
Ms. Motolik said Life Line tends to be invited to set up screenings at places where individuals are likely to be older, like senior centers. The mean age of its clients is 62 years.
Furthermore, all clients are educated about stroke risk before they pay for anything, and persons younger than 40 are specifically informed that their risk of having any of the conditions that Life Line screens for is extremely low.
Groups such as the American Stroke Association (ASA), a division of the American Heart Association, tend not to have any position on ultrasound screening or the mobile vans.
Blood pressure, pulse, and carotid bruits continue to be the standard of care for assessing stroke risk routinely, said Edgar Kenton, M.D., past chair of ASA's media advisory committee.
But he also noted that half of individuals with hypertension are not treated adequately, and many Americans have no medical insurance. Therefore, he said, he personally cannot be opposed to any activity that increases public access to health services.