3 ms·

Is there a process or technology to avoid unnecessary medical treatment? The article mentions how one patient googled his condition and sought a second opinion

Is there a process or technology to avoid unnecessary medical treatment? The article mentions how one patient googled his condition and sought a second opinion. I imagine that this direction is common among patients. I am afraid that once I get old I will also be pushed to have unnecessary treatments.

maxerickson 10y ago
The ProPublica version of the article has a chart at the end showing an evaluation of the benefit vs risk of a treatment (search "A Different Way to Think About Medicine"): https://www.propublica.org/article/when-evidence-says-no-but-doctors-say-yes https://www.propublica.org/article/when-evidence-says-no-but... So one way to avoid unnecessary treatments is to seek out doctors who are willing to discuss treatments in similar terms. They may lack the information to build such a precise estimate, but they should still be willing to talk in a clear way about the risks and benefits of a given treatment.
- randcraw 10y ago
  I think you're describing "Number Needed to Treat" (NNT, or 'How many patients need to be treated with a drug or procedure for one patient to get the hoped-for benefit?'), which is described briefly just before the graphic you mention. NNT is a great idea, but not as practically useful for individuals as for policymakers, IMHO. I suspect few primary care clinicians can discuss current and precise NNT figures. More likely they will rely on standard of care advice from the AMA or their subspecialty board that itself was shaped by NNTs.
  - maxerickson 10y ago
    No, I was specifically talking about the sort of framework used in the graphic, where the outcome of a treatment may be beneficial, benign or harmful. I'll repost my second paragraph too: So one way to avoid unnecessary treatments is to seek out doctors who are willing to discuss treatments in similar terms. They may lack the information to build such a precise estimate, but they should still be willing to talk in a clear way about the risks and benefits of a given treatment. Yes, it will be difficult for providers to have detailed information. They should still be open to discussing downsides and tradeoffs. It's a red flag if they hesitate to talk in terms of tradeoffs or to take the time to discuss the expected benefits and potential downsides.
ch4s3 10y ago
Yes, there's a range of products available now to many health systems that help with this exact problem. The category is called Clinical Decision Support. A CDS program may see a prescription or lab test deemed unnecessary by medical guidelines/evidence and warn the physician. However, there's still a long ways to go in terms of UX, interoperability, adoption, etc.
rsync 10y ago
"Is there a process or technology to avoid unnecessary medical treatment?" Yes - exercise and a simple diet. Michael Pollan speaks of it in the 21st century and the greek philosophers spoke of it in the negative-fourth century. And every thoughtful person in-between. Go look - every philosopher you've ever heard of has taken some amount of time to pontificate about health and diet and has concluded the same thing.

maxerickson 10y ago

The ProPublica version of the article has a chart at the end showing an evaluation of the benefit vs risk of a treatment (search "A Different Way to Think About Medicine"): https://www.propublica.org/article/when-evidence-says-no-but-doctors-say-yes https://www.propublica.org/article/when-evidence-says-no-but... So one way to avoid unnecessary treatments is to seek out doctors who are willing to discuss treatments in similar terms. They may lack the information to build such a precise estimate, but they should still be willing to talk in a clear way about the risks and benefits of a given treatment.

randcraw 10y ago
I think you're describing "Number Needed to Treat" (NNT, or 'How many patients need to be treated with a drug or procedure for one patient to get the hoped-for benefit?'), which is described briefly just before the graphic you mention. NNT is a great idea, but not as practically useful for individuals as for policymakers, IMHO. I suspect few primary care clinicians can discuss current and precise NNT figures. More likely they will rely on standard of care advice from the AMA or their subspecialty board that itself was shaped by NNTs.
- maxerickson 10y ago
  No, I was specifically talking about the sort of framework used in the graphic, where the outcome of a treatment may be beneficial, benign or harmful. I'll repost my second paragraph too: So one way to avoid unnecessary treatments is to seek out doctors who are willing to discuss treatments in similar terms. They may lack the information to build such a precise estimate, but they should still be willing to talk in a clear way about the risks and benefits of a given treatment. Yes, it will be difficult for providers to have detailed information. They should still be open to discussing downsides and tradeoffs. It's a red flag if they hesitate to talk in terms of tradeoffs or to take the time to discuss the expected benefits and potential downsides.

ch4s3 10y ago

Yes, there's a range of products available now to many health systems that help with this exact problem. The category is called Clinical Decision Support. A CDS program may see a prescription or lab test deemed unnecessary by medical guidelines/evidence and warn the physician. However, there's still a long ways to go in terms of UX, interoperability, adoption, etc.

rsync 10y ago

"Is there a process or technology to avoid unnecessary medical treatment?" Yes - exercise and a simple diet. Michael Pollan speaks of it in the 21st century and the greek philosophers spoke of it in the negative-fourth century. And every thoughtful person in-between. Go look - every philosopher you've ever heard of has taken some amount of time to pontificate about health and diet and has concluded the same thing.