3 ms·

I get a full MRI imaging every two years so I spent a lot of time researching the ethics around it just to be prepared, and there are two things I could bring u

I get a full MRI imaging every two years so I spent a lot of time researching the ethics around it just to be prepared, and there are two things I could bring up. First, false positives. There can be things that looks like problems but aren't, or that are problems but with complicated risk profiles around their management or resolution (especially true of aneurysms). For heavily studied situations where imaging is low risk and hugely effective with low false positive risk, most countries do have screening programs, such as regular cervical smears or mammograms for women of certain ages, as well as aortic aneurysm screening for men over 65 (in the UK, at least). Second, psychology. A surprising (to me) number of people do not want to know about their medical status until a problem actually occurs. But then once they do know, many folks can be prone to undue worry or hastily made emotionally driven decisions that run contrary to data. I'm going to totally make up these figures but as a demonstration of the idea, imagine that brain aneurysm scans tend to find aneurysms of concern in 5% of people and that of these 5%, 4% are likely to die within 5-10 years due to that aneurysm. Scan the entire country and you now have millions of people potentially terrified of an aneurysm that won't kill them. If an aneurysm is found and you are offered an operation with a 5% chance of mortality, are you taking it? The research I saw when I was looking into it is that, yes, most people want to get rid of the "problem", despite a higher risk of short term mortality rather than sitting it out. This is just one of the reasons doctors grimace when people want to get such scans without cause, but there are many others beyond the scope of this reply too.

SemanticStrengh 4y ago
> Although cardiovascular disease is widely recognized as the leading cause of death, a lesser known fact is that aortic aneurysm is the 15th leading cause of death over the age of 65 years in the USA. I was not aware of this. non-surgical interventions: https://www.jstage.jst.go.jp/article/circj/advpub/0/advpub_CJ-13-1252/_article/-char/ja/ https://www.jstage.jst.go.jp/article/circj/advpub/0/advpub_C... > This is just one of the reasons doctors grimace when people want to get such scans without cause, but there are many others beyond the scope of this reply too. Great points. Is it legal for a doctor to hide informations to its patient? such as the fact he has a seemingly "minor" aneurysm ? > I get a full MRI imaging every two years You might wanna study radio-protectors such as NAC. I had read it is also a contrastive agent but it's unclear to me what it help to see and what it might inadvertently hide (if anything)
- thaeli 4y ago
  MRI isn't ionizing radiation, so much lower risk profile there. You may be thinking of CT scans?
  - SemanticStrengh 4y ago
    The idea that only ionizing radiations induce damage has to stop bruh https://pubmed.ncbi.nlm.nih.gov/35237875/ https://pubmed.ncbi.nlm.nih.gov/35237875/ I mean it's much safer but still a concern.
    - hfsh 4y ago
      That has nothing to do with NAC. NAC supposedly helps protect against possible kidney damage caused by the contrast agent, nothing to do with radiation, ionizing or otherwise. Doesn't seem to be a clear indication that it actually helps for that, but it's used for quite a lot of other things, like treating paracetamol overdose.
      - SemanticStrengh 4y ago
        > nothing to do with radiation, ionizing or otherwise. bruh radiations induce oxidative stress and free radicals which is the major cause of damage, which the antioxidant GSH (NAC) prevents/reduce
throwaway18451 4y ago
I want to get regular imaging; I've never done it. I don't even have a PCP, I've been frustrated with previous PCPs not paying attention to detail or waving my symptoms as psychosomatic. I'm not sure how to assess whether a doctor ahead of time would actually be willing to work with me rather than say things that they think make me feel better. These doctors keep running me against the 99% heuristic [https://astralcodexten.substack.com/p/heuristics-that-almost-always-work https://astralcodexten.substack.com/p/heuristics-that-almost...]. Now I have real money for the first time, I'm sure that makes access easier, but I'm not sure how to search and assess for quality medical care. It seems like search engines are not the way and it's mostly word-of-mouth. I guess I'll go around my office asking coworkers if their pcp is any good / has an opening... I just want to go into a lab where I can have the imaging / diagnostics run, no question, have the ability to look at the charts myself and send them to whatever doctor -- rather than convincing a doctor to do imaging tests in the first place. Are you in the US? How are you able to request MRI scans without an immediate cause?

SemanticStrengh 4y ago

> Although cardiovascular disease is widely recognized as the leading cause of death, a lesser known fact is that aortic aneurysm is the 15th leading cause of death over the age of 65 years in the USA. I was not aware of this. non-surgical interventions: https://www.jstage.jst.go.jp/article/circj/advpub/0/advpub_CJ-13-1252/_article/-char/ja/ https://www.jstage.jst.go.jp/article/circj/advpub/0/advpub_C... > This is just one of the reasons doctors grimace when people want to get such scans without cause, but there are many others beyond the scope of this reply too. Great points. Is it legal for a doctor to hide informations to its patient? such as the fact he has a seemingly "minor" aneurysm ? > I get a full MRI imaging every two years You might wanna study radio-protectors such as NAC. I had read it is also a contrastive agent but it's unclear to me what it help to see and what it might inadvertently hide (if anything)

thaeli 4y ago
MRI isn't ionizing radiation, so much lower risk profile there. You may be thinking of CT scans?
- SemanticStrengh 4y ago
  The idea that only ionizing radiations induce damage has to stop bruh https://pubmed.ncbi.nlm.nih.gov/35237875/ https://pubmed.ncbi.nlm.nih.gov/35237875/ I mean it's much safer but still a concern.
  - hfsh 4y ago
    That has nothing to do with NAC. NAC supposedly helps protect against possible kidney damage caused by the contrast agent, nothing to do with radiation, ionizing or otherwise. Doesn't seem to be a clear indication that it actually helps for that, but it's used for quite a lot of other things, like treating paracetamol overdose.
    - SemanticStrengh 4y ago
      > nothing to do with radiation, ionizing or otherwise. bruh radiations induce oxidative stress and free radicals which is the major cause of damage, which the antioxidant GSH (NAC) prevents/reduce

throwaway18451 4y ago

I want to get regular imaging; I've never done it. I don't even have a PCP, I've been frustrated with previous PCPs not paying attention to detail or waving my symptoms as psychosomatic. I'm not sure how to assess whether a doctor ahead of time would actually be willing to work with me rather than say things that they think make me feel better. These doctors keep running me against the 99% heuristic [https://astralcodexten.substack.com/p/heuristics-that-almost-always-work https://astralcodexten.substack.com/p/heuristics-that-almost...]. Now I have real money for the first time, I'm sure that makes access easier, but I'm not sure how to search and assess for quality medical care. It seems like search engines are not the way and it's mostly word-of-mouth. I guess I'll go around my office asking coworkers if their pcp is any good / has an opening... I just want to go into a lab where I can have the imaging / diagnostics run, no question, have the ability to look at the charts myself and send them to whatever doctor -- rather than convincing a doctor to do imaging tests in the first place. Are you in the US? How are you able to request MRI scans without an immediate cause?