7 ms·
Doctor here. You didn't have a false positive-- of course you feel better off. But, you're not physically better off because nothing came back as positive or tr
by CapriciousCptl 7y ago
Doctor here. You didn't have a false positive-- of course you feel better off. But, you're not physically better off because nothing came back as positive or treatable. Some will start in your shoes, but be unlucky and have a false positive. They would be mentally and physically worse off as potentially inconclusive tests followed by potentially unnecessary procedures resulted in, say, removing one of your kidneys. Yes, that will only happen very rarely and yes I've seen it happen.
There can be kind of a two prong "test" to determine if screening is harmful. Physically, is it a good idea? Answer is probably no. We're not in a scarcity situation really where the "prestige" demographic isn't getting recommended to get appropriate tests based on their risk factors (on the other hand, some of our poorest aren't getting them but that's not an issue solved here). The other side is mentally. Again, I'd argue that people with a clean unnecessary screening got out lucky. They'd be mentally much worse off had something come back positive.
Bizarrely, there's new data suggesting that even fixing known problems, like coronary artery blockages doesn't improve mortality in a lot of situations you'd think it would. That suggests that we're doing too much screening in that case (I mean, if the treatment is worse than the disease... why screen?), not too little. As another example there is a well-known vascular surgery group going to churches under the pretense of "screening" for leg atherosclerosis, then performing high-margin, high-turnover, and unnecessary procedures on the very high "induced" false-positives.
I also find it utterly bizarre that screening would include lung capacity testing. In an otherwise healthy adult who can say, climb a flight of stairs or something of the sort without getting shortness-of-breath, that test is completely meaningless and expensive from a "disease" perspective. On the other hand, it does give you a number to compare to your peer group, kind of like resting heart rate. On the other hand, resting heart rate is free, can be done yourself, and literally takes 15 seconds to measure.
In the end, I'm not really against having these sort of "prestige" medical services available. Particularly because more choice is generally good-- and it's your body, you should do what you want with it (within reasonable bounds). But, everyone should educate themselves because on balance, I doubt people end up up feeling or being better off considering the ones who will have false positives.
- enchiridion 7y agoThese type of arguments never sit right with me. It's my body, I'd like to know as much about it as possible. It's good to be aware of the risk, but at the end of the day it's my decision to take that risk on. One reason to screen more is that it provides incentive for better treatments. How many people would be researching new coronary artery treatments if we just started ignoring the disease?
- nitrogen 7y agoAnd for that matter how often will statistically motivated reductions in screening cause true positives to be missed?
- Aeolun 7y agoMuch too often for comfort. I’d much rather try filtering false positives myself than guessing at true positives.
- RankingMember 7y agoThe parent agrees with your first paragraph at the end of their comment. I disagree with what you seem to be asserting, which is that anyone who's not getting every atom of their body scanned is "ignoring the disease".
- bitexploder 7y agoMy parents have fallen prey to a quack like this. They think he walks in water, but he has done so many bad procedures on my family. It is sad, but it is hard to convince them how harmful many of the procedures are given that they won’t bother to change their unhealthy lifestyle.
- lultimouomo 7y ago> I also find it utterly bizarre that screening would include lung capacity testing Until I was 15 I used to play water polo at a reasonably competitive level; I had to get yearly "sport physicals" (not sure what they're called in English). I didn't always go to the same hospital and the procedure changed a bit from one place to another. One year they tested my lung capacity, and they told me that I had "the lungs of king kong" (I think I was at about 125% the average/median/expected for someone my age and size). It was the best physical ever, I still cherish that moment.