In Reply We agree with Dr Oristaglio that people should be empowered with the freedom to choose the health care options that are best for them. We also stress our support for evidence-based screening tests that have been endorsed by well-respected, unbiased organizations such as the US Preventive Services Task Force. Unfortunately, failure of direct-to-consumer screening companies and hospital systems to inform potential consumers that some of the tests they advertise are not endorsed, at best controversial, and at worst harmful does not empower patients to make the most informed decisions regarding the purchase of screening tests.