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As someone who has had several CT scans (and paid for CT scans), the idea that a CT scan is better than a physician feeling your abdomen is absolutely ridiculou

As someone who has had several CT scans (and paid for CT scans), the idea that a CT scan is better than a physician feeling your abdomen is absolutely ridiculous. Pumping contrast agents into everyone who has pain is a very bad idea. Moreover, enforcing decisions by algorithmic rules is problematic, especially considering who might be making those decisions.

DrJaws 8y ago
Plus radiation. Every CT scan increases your odds of cancer. Also, mammography or even colonoscopies have been proved for most of the population to do more harm than good. cochrane is full of meta-studies about it. The medical industry is very shady.
- onetimemanytime 8y ago
  >>Plus radiation. Every CT scan increases your odds of cancer. If the doctor makes money from your CT Scan you are absolutely right to question the need. Conflict of interest and all. Sure you increase the chances of cancer but that has to be weighed by what can happen if you don't do the CT Scan.
  - Thriptic 8y ago
    Very few modern insurance plans pay per procedure and that will be done away with entirely as time goes on. Typically physicians are paid a flat rate per patient or a flat rate per diagnosis with a complexity multiplier. This creates an incentive to NOT perform imaging unless it's necessary.
    - telchar 8y ago
      In what country? The US is still mostly per per procedure. There are codes for procedures and for diagnoses and they both get factored into the bill.
      - gwright 8y ago
        Take a look at DRGs. In the US they were first used for payments in the Medicare system but they have expanded outside that program over the years: https://en.wikipedia.org/wiki/Diagnosis-related_group https://en.wikipedia.org/wiki/Diagnosis-related_group
  - DanBC 8y ago
    You also need to balance what happens if you do have the scan too. Over-testing leads to over-diagnosis, and that can be harmful.
- 08-15 8y ago
  > Every CT scan increases your odds of cancer. There is no evidence for that statement. More specifically, there is no evidence that a single radiation dose below 100mSv is harmful at all, but plenty of evidence (Taiwanese radioactive apartment buildings, nuclear navy worker study) that it isn't. Muller made it up for political reasons.
  - deleted 8y ago
    [deleted]
  - ItsMe000001 8y ago
    There is evidence: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3660619/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3660619/ > Title: Cancer risk in 680 000 people exposed to computed tomography scans in childhood or adolescence: data linkage study of 11 million Australians > Conclusions: The increased incidence of cancer after CT scan exposure in this cohort was mostly due to irradiation. Because the cancer excess was still continuing at the end of follow-up, the eventual lifetime risk from CT scans cannot yet be determined. Radiation doses from contemporary CT scans are likely to be lower than those in 1985-2005, but some increase in cancer risk is still likely from current scans. Future CT scans should be limited to situations where there is a definite clinical indication, with every scan optimised to provide a diagnostic CT image at the lowest possible radiation dose. And about "a single radiation dose": As soon as you get a CT the chances that you will have only a single one in your life are greatly reduced, because you just had that one. So it still is better if the count remains at zero, or your precondition can easily be invalidated.
    - HeadsUpHigh 8y ago
      This study is solely focused on childhood and adolescence CT scans. Any radiation dosage you take during childhood has magnified effects.
      - ItsMe000001 8y ago
        Thanks for pointing that out, but, okay, children and adolescents count too? OP responded to a specific comment, I responded to OPs comment. I don't understand your point in that given context. I'd think showing one study - I didn't bother to look any further - that shows a risk was sufficient. Since even adults have plenty of still dividing cells left I see it as reasonable to assume that adults are at risk too, even if that will likely be lower. I also recommend at least the "Conclusion" section of this document, selected as an example, not as the one definite document: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3611719/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3611719/ It is a good read overall too.
bastijn 8y ago
Can't resist to at least provide some response here. 1) Having CT scans, and paying for them, does not really objectively lead to the conclusion that followed. Let's feel that tumor inside your lungs. 2) CT scans can also work without contrast agents. In addition they typically do not register everybody for a CT scan nor pump them full with contrast agents. There is a process. In US some hospitals are trigger happy as they get paid per case, blame the system not the technology. If anything an algorithm will fix that nasty human behaviour. 3) Having biased humans enforce decisions is not always a guarantee for success either. Every human sees only a fraction of the total amount of cases an algorithm processes within seconds. There are several fields where AI already outperforms elaborate test panels of MDs. Though it is hard to introduce these algorithms for the same reasons Tesla is having issues. Who is responsible when a mistake is made? 3.1) you would be amazed how often MDs do not agree when the same problem is put in front of them. 50/50 and 60/40 are very common cases. AI is typically more in the 80/20 90/10 range which is a huge improvement. Now, all of this does not mean we do not need MDs anymore. An important aspect often neglected due to time bounds is the interaction of a patient with the doctor. With algorithms saving time more could go to the patient. That's a win.

DrJaws 8y ago

Plus radiation. Every CT scan increases your odds of cancer. Also, mammography or even colonoscopies have been proved for most of the population to do more harm than good. cochrane is full of meta-studies about it. The medical industry is very shady.

onetimemanytime 8y ago
>>Plus radiation. Every CT scan increases your odds of cancer. If the doctor makes money from your CT Scan you are absolutely right to question the need. Conflict of interest and all. Sure you increase the chances of cancer but that has to be weighed by what can happen if you don't do the CT Scan.
- Thriptic 8y ago
  Very few modern insurance plans pay per procedure and that will be done away with entirely as time goes on. Typically physicians are paid a flat rate per patient or a flat rate per diagnosis with a complexity multiplier. This creates an incentive to NOT perform imaging unless it's necessary.
  - telchar 8y ago
    In what country? The US is still mostly per per procedure. There are codes for procedures and for diagnoses and they both get factored into the bill.
    - gwright 8y ago
      Take a look at DRGs. In the US they were first used for payments in the Medicare system but they have expanded outside that program over the years: https://en.wikipedia.org/wiki/Diagnosis-related_group https://en.wikipedia.org/wiki/Diagnosis-related_group
- DanBC 8y ago
  You also need to balance what happens if you do have the scan too. Over-testing leads to over-diagnosis, and that can be harmful.
08-15 8y ago
> Every CT scan increases your odds of cancer. There is no evidence for that statement. More specifically, there is no evidence that a single radiation dose below 100mSv is harmful at all, but plenty of evidence (Taiwanese radioactive apartment buildings, nuclear navy worker study) that it isn't. Muller made it up for political reasons.
- deleted 8y ago
  [deleted]
- ItsMe000001 8y ago
  There is evidence: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3660619/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3660619/ > Title: Cancer risk in 680 000 people exposed to computed tomography scans in childhood or adolescence: data linkage study of 11 million Australians > Conclusions: The increased incidence of cancer after CT scan exposure in this cohort was mostly due to irradiation. Because the cancer excess was still continuing at the end of follow-up, the eventual lifetime risk from CT scans cannot yet be determined. Radiation doses from contemporary CT scans are likely to be lower than those in 1985-2005, but some increase in cancer risk is still likely from current scans. Future CT scans should be limited to situations where there is a definite clinical indication, with every scan optimised to provide a diagnostic CT image at the lowest possible radiation dose. And about "a single radiation dose": As soon as you get a CT the chances that you will have only a single one in your life are greatly reduced, because you just had that one. So it still is better if the count remains at zero, or your precondition can easily be invalidated.
  - HeadsUpHigh 8y ago
    This study is solely focused on childhood and adolescence CT scans. Any radiation dosage you take during childhood has magnified effects.
    - ItsMe000001 8y ago
      Thanks for pointing that out, but, okay, children and adolescents count too? OP responded to a specific comment, I responded to OPs comment. I don't understand your point in that given context. I'd think showing one study - I didn't bother to look any further - that shows a risk was sufficient. Since even adults have plenty of still dividing cells left I see it as reasonable to assume that adults are at risk too, even if that will likely be lower. I also recommend at least the "Conclusion" section of this document, selected as an example, not as the one definite document: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3611719/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3611719/ It is a good read overall too.

bastijn 8y ago

Can't resist to at least provide some response here. 1) Having CT scans, and paying for them, does not really objectively lead to the conclusion that followed. Let's feel that tumor inside your lungs. 2) CT scans can also work without contrast agents. In addition they typically do not register everybody for a CT scan nor pump them full with contrast agents. There is a process. In US some hospitals are trigger happy as they get paid per case, blame the system not the technology. If anything an algorithm will fix that nasty human behaviour. 3) Having biased humans enforce decisions is not always a guarantee for success either. Every human sees only a fraction of the total amount of cases an algorithm processes within seconds. There are several fields where AI already outperforms elaborate test panels of MDs. Though it is hard to introduce these algorithms for the same reasons Tesla is having issues. Who is responsible when a mistake is made? 3.1) you would be amazed how often MDs do not agree when the same problem is put in front of them. 50/50 and 60/40 are very common cases. AI is typically more in the 80/20 90/10 range which is a huge improvement. Now, all of this does not mean we do not need MDs anymore. An important aspect often neglected due to time bounds is the interaction of a patient with the doctor. With algorithms saving time more could go to the patient. That's a win.