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Wouldn’t the skill of analyzing scans improve if they were done more frequently? It seems like you’re promoting a self fulfilling prophecy. Doctors aren’t good

Wouldn’t the skill of analyzing scans improve if they were done more frequently? It seems like you’re promoting a self fulfilling prophecy. Doctors aren’t good at reading scans, so scans will cause false positives. But doctors are capable of learning and improving their skills. They will surely rapidly learn to screen a lot of false positives, thereby saving lives.

MauranKilom 4y ago
You seem to assume that radiologists currently see patient scans too rarely to deliver accurate diagnosis. That seems very unfounded to me. "More frequent scans per patient" != "More scans seen per clinician". You would just end up having to hire more clinicians. (Yes, your family doctor might end up seeing more scans in this scheme, but it is implausible that they would be better at evaluating them than a trained radiologist, which is who this would almost surely be deferred to anyway.)
- landryraccoon 4y ago
  Is the argument then that scans are intrinsically error prone, as in the noise level is so high that even a team of highly trained radiologists can’t accurately determine if cancer is present from a scan?
  - MauranKilom 4y ago
    It's not the quality of the scan (although that can certainly be a factor). It's that there is a lot of variation in human anatomy, and "these pixels are brighter than the rest" can mean any of many things. Relatedly, for many types of brain tumors, you simply don't know what exact kind of tumor it is until you actually do a biopsy (= you undergo surgery). This can be important information ("how aggressive is it?"), so in some hospitals it is common practice to send a tissue sample for identification and get back the result while the surgery is still going on.
moonchrome 4y ago
This is a very naive argument, it assumes the entire problem is lack of skill and that early intervention on positive diagnosis is always a good thing. Mammography is a really good candidate for random screening and it's still debated because of false positives and the impacts of misdiagnosis.

MauranKilom 4y ago

You seem to assume that radiologists currently see patient scans too rarely to deliver accurate diagnosis. That seems very unfounded to me. "More frequent scans per patient" != "More scans seen per clinician". You would just end up having to hire more clinicians. (Yes, your family doctor might end up seeing more scans in this scheme, but it is implausible that they would be better at evaluating them than a trained radiologist, which is who this would almost surely be deferred to anyway.)

landryraccoon 4y ago
Is the argument then that scans are intrinsically error prone, as in the noise level is so high that even a team of highly trained radiologists can’t accurately determine if cancer is present from a scan?
- MauranKilom 4y ago
  It's not the quality of the scan (although that can certainly be a factor). It's that there is a lot of variation in human anatomy, and "these pixels are brighter than the rest" can mean any of many things. Relatedly, for many types of brain tumors, you simply don't know what exact kind of tumor it is until you actually do a biopsy (= you undergo surgery). This can be important information ("how aggressive is it?"), so in some hospitals it is common practice to send a tissue sample for identification and get back the result while the surgery is still going on.

moonchrome 4y ago

This is a very naive argument, it assumes the entire problem is lack of skill and that early intervention on positive diagnosis is always a good thing. Mammography is a really good candidate for random screening and it's still debated because of false positives and the impacts of misdiagnosis.