Safeguarding the Role of Evidence-Based Medicine
August 28, 2025
At the American College of Chest Physicians (CHEST), we believe that conscientious consideration of the current best evidence is essential to guide medical decision-making and central to improving patient outcomes. To this end, medical policy must be based on proven, effective therapies and a thorough examination of scientific evidence.
Recent federal decisions that sideline, suspend, or restructure nonpartisan expert panels charged with setting and informing health care coverage directly interfere with an informed and effective approach to health care and health equity.
Examples of federal actions impeding medical policymaking include:
- The removal of all 17 members from the US Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP): Their replacements were individuals with limited or no relevant knowledge in the field. When the CDC director approves ACIP recommendations, they become official public health guidance and must be covered by health insurance.
- The abrupt cancellation of a US Preventive Services Task Force (USPSTF) meeting without cause: The USPSTF is a nonpartisan panel of volunteer doctors and health experts tasked with reviewing the latest scientific evidence and determining which screenings, medications, and other preventive services should be fully covered by insurance.
We do not view these as isolated events. The politicization of medical policy is part of a disturbing trend—one that undermines the role of evidence in shaping care and weakens the trust that patients place in their care providers. These unjustified actions represent a growing threat to health care in the United States.
When medical recommendations are delayed or manipulated for reasons other than scientific rigor, patients suffer. When expert panels are dissolved and replaced with individuals lacking appropriate credentials or driven by ideology, credibility diminishes. And when decisions lack rationality, public trust erodes.
We urge public health leaders, peer societies, and elected officials to acknowledge the risk of remaining silent in the face of systemic erosion. We also call on our members to stand with us in defending the core values that make science trustworthy—integrity, independence, transparency, and humility.
In support of this call to action, CHEST submitted a letter to Robert F. Kennedy Jr, Secretary of the US Department of Health and Human Services, on behalf of our members, stating a strong objection to any future steps that could lead to the elimination of the USPSTF or sow doubts about the efficacy of its decisions. Slowing the progress made in improving critical access to preventive care would be detrimental to our mission’s objectives. This is especially evident in lung cancer screening—an area of vital importance—where only 18% of eligible individuals currently receive annual low-dose CT scans.1 Eliminating financial barriers is a critical step toward increasing participation in lifesaving early detection programs.
CHEST will continue to monitor developments and work with partners to ensure that clinical decision-making remains rooted in evidence and guided by the needs of patients—not personal or political ideology.
READ THE LETTER »
- Bandi P, Star J, Ashad-Bishop K, et al. Lung cancer screening in the US, 2022. JAMA Intern Med.2024;184(8):882–891. doi:10.1001/jamainternmed.2024.1655