4 ms·

Yes, the problem is mostly one of presentation. To most people a positive test means it is likely they have it, which is often a statistically invalid conclusi

Yes, the problem is mostly one of presentation. To most people a positive test means it is likely they have it, which is often a statistically invalid conclusion. We should instead present it as 'you currently have breast cancer with 13% probability' (population avg with no tests), a positive test means you have it with 25% probability, a negative test with 3% probability. That makes the test a lot less scary, after all you're only gaining 10% certainty either direction.

conductr 5y ago
I don't believe we should present it as a statistics. Most people would not understand or feel comforted by that explanation. 'you currently have breast cancer' is all the person will see and the numbers and implications of will be lost on them. I feel like this is where bedside manor comes into play and the human component of being a physician. Any doctor ordering a 3D mammogram, then receiving a positive result, should communicate to their patient that imaging is just a screening tool and not diagnostic. Many doctors will not even use the word "Positive" in the test result conversation. They'll use vague wording like, "we did happen to see something we'd like to investigate further to be sure, it's really hard to see exactly what's going on in your body on a camera so while I was hoping to avoid it I do believe a biopsy should be the next step". Yes, a biopsy is now warranted, but the patient should try to keep up their spirits high and not stress to much at this point. The biopsy will tell more information about what is going on inside the body and we can come up with a plan for whatever that is once we know more. It's natural/unavoidable for the patient to be worried/anxious but should not yet be scared and that is best conveyed in a human interaction with a caring physician.

4 ms·

Yes, the problem is mostly one of presentation. To most people a positive test means it is likely they have it, which is often a statistically invalid conclusi

by aeternum 5y ago

conductr 5y ago
I don't believe we should present it as a statistics. Most people would not understand or feel comforted by that explanation. 'you currently have breast cancer' is all the person will see and the numbers and implications of will be lost on them. I feel like this is where bedside manor comes into play and the human component of being a physician. Any doctor ordering a 3D mammogram, then receiving a positive result, should communicate to their patient that imaging is just a screening tool and not diagnostic. Many doctors will not even use the word "Positive" in the test result conversation. They'll use vague wording like, "we did happen to see something we'd like to investigate further to be sure, it's really hard to see exactly what's going on in your body on a camera so while I was hoping to avoid it I do believe a biopsy should be the next step". Yes, a biopsy is now warranted, but the patient should try to keep up their spirits high and not stress to much at this point. The biopsy will tell more information about what is going on inside the body and we can come up with a plan for whatever that is once we know more. It's natural/unavoidable for the patient to be worried/anxious but should not yet be scared and that is best conveyed in a human interaction with a caring physician.