5 ms·

I find this to be dubious and honestly a little insulting. Here in the UK there is a not insignificant number of people that die from cancers because their loca

I find this to be dubious and honestly a little insulting. Here in the UK there is a not insignificant number of people that die from cancers because their local health practice ignored or even refused to listen to a patient. The idea of a yearly checkup is totally foreign here unless you are going private.

masfuerte 4y ago
There's no contradiction. Ignoring symptoms is foolish. Yearly checkups may do more harm than good. Both of these things can be true.
- armitron 4y ago
  A lot of cancers have no symptoms at the beginning, but they can be flagged in blood tests performed as part of general health checkups.
  - kevinmchugh 4y ago
    I think the optimal move might be regular (possibly more than annual) blood work and only talking to a doctor when there's symptoms.
    - soco 4y ago
      And if the results look dramatic, get a second or third opinion (and check) before doing anything.
  - remexre 4y ago
    Do annual checkups involve blood tests where you are? I've only had blood taken as part of one once, and that was in direct response to a new diagnosis of a health condition in a grandparent.
    - adastra22 4y ago
      Mine do, yes. Kaiser in Northern California region.
    - armitron 4y ago
      Of course, blood and urine. I do them every six months, even though my insurance only covers once a year, I'm happy to pay out of pocket for the second.
tetromino_ 4y ago
I think the idea is this: even accurate tests have false positives. For patients in a low-risk group, virtually all positive results in the checkup will be false positives. When the low-risk group is large (the entirety of a nation's healthy 20-30 year olds), the number of such false positives will also be large. The positive results, regardless of whether they are true or false, will have some sort of follow-up. Maybe a second, more invasive test, maybe even starting on a drug straight away if the numbers look bad. And like for any medical procedure, there is a chance that this follow-up will harm this person's health: they will get an infection from a badly done second test, they will have an adverse reaction to the drug, etc. And the question is whether it is ethical or worthwhile to expose patients to the risk of harming their health through the follow up, given that the chances of them having the condition (and thus of the follow-up being at all useful) are extremely low regardless of what the checkup result says.
- waterhouse 4y ago
  > whether it is ethical or worthwhile to expose patients to the risk of harming their health through the follow up So you seem to be saying that, in certain cases, if you have a positive test result, then the expected value of taking certain follow-up actions is negative. It follows that a rational actor, knowing this, would not take those actions in that situation. Then isn't the solution for doctors to update their procedures so that they don't take those follow-up actions in those situations (and explain the odds to patients who care)? The phrasing "expose patients to the risk of harming their health through the follow up" makes it sound like the follow-up is something that automatically and unavoidably just happens, as if no one has any agency in the matter. If that's true, due to some kind of regulations or rules or liability rulings, then that sounds like a problem. To some extent this is resolved by backpropagating: if the test is just a two-value "positive"/"negative" thing, and you plan to take the same action (i.e. nothing) regardless of the result, then there's no point in taking the test. However, I expect there are also other tests where, say, the test has a "super positive" value (or value range) where you should take action, and a "technically positive" value where you shouldn't act (plus a "negative" value); and the test is worth taking because of the likelihood of "super positive", but that means you do sometimes end up with the "technically positive" result, and must solve the problem of knowing when not to act.
deleted 4y ago
[deleted]
908B64B197 4y ago
[flagged]
- scrose 4y ago
  Private healthcare is optional in the UK, and that’s what the OP was referring to.
astura 4y ago
>their local health practice ignored or even refused to listen to a patient. This is not at all what this article is talking about. This article is about people with no symptoms, experiencing no medical problems, going to the doctor to get medical tests.

masfuerte 4y ago

There's no contradiction. Ignoring symptoms is foolish. Yearly checkups may do more harm than good. Both of these things can be true.

armitron 4y ago
A lot of cancers have no symptoms at the beginning, but they can be flagged in blood tests performed as part of general health checkups.
- kevinmchugh 4y ago
  I think the optimal move might be regular (possibly more than annual) blood work and only talking to a doctor when there's symptoms.
  - soco 4y ago
    And if the results look dramatic, get a second or third opinion (and check) before doing anything.
- remexre 4y ago
  Do annual checkups involve blood tests where you are? I've only had blood taken as part of one once, and that was in direct response to a new diagnosis of a health condition in a grandparent.
  - adastra22 4y ago
    Mine do, yes. Kaiser in Northern California region.
  - armitron 4y ago
    Of course, blood and urine. I do them every six months, even though my insurance only covers once a year, I'm happy to pay out of pocket for the second.

tetromino_ 4y ago

I think the idea is this: even accurate tests have false positives. For patients in a low-risk group, virtually all positive results in the checkup will be false positives. When the low-risk group is large (the entirety of a nation's healthy 20-30 year olds), the number of such false positives will also be large. The positive results, regardless of whether they are true or false, will have some sort of follow-up. Maybe a second, more invasive test, maybe even starting on a drug straight away if the numbers look bad. And like for any medical procedure, there is a chance that this follow-up will harm this person's health: they will get an infection from a badly done second test, they will have an adverse reaction to the drug, etc. And the question is whether it is ethical or worthwhile to expose patients to the risk of harming their health through the follow up, given that the chances of them having the condition (and thus of the follow-up being at all useful) are extremely low regardless of what the checkup result says.

waterhouse 4y ago
> whether it is ethical or worthwhile to expose patients to the risk of harming their health through the follow up So you seem to be saying that, in certain cases, if you have a positive test result, then the expected value of taking certain follow-up actions is negative. It follows that a rational actor, knowing this, would not take those actions in that situation. Then isn't the solution for doctors to update their procedures so that they don't take those follow-up actions in those situations (and explain the odds to patients who care)? The phrasing "expose patients to the risk of harming their health through the follow up" makes it sound like the follow-up is something that automatically and unavoidably just happens, as if no one has any agency in the matter. If that's true, due to some kind of regulations or rules or liability rulings, then that sounds like a problem. To some extent this is resolved by backpropagating: if the test is just a two-value "positive"/"negative" thing, and you plan to take the same action (i.e. nothing) regardless of the result, then there's no point in taking the test. However, I expect there are also other tests where, say, the test has a "super positive" value (or value range) where you should take action, and a "technically positive" value where you shouldn't act (plus a "negative" value); and the test is worth taking because of the likelihood of "super positive", but that means you do sometimes end up with the "technically positive" result, and must solve the problem of knowing when not to act.

deleted 4y ago

[deleted]

908B64B197 4y ago

[flagged]

scrose 4y ago
Private healthcare is optional in the UK, and that’s what the OP was referring to.

astura 4y ago

>their local health practice ignored or even refused to listen to a patient. This is not at all what this article is talking about. This article is about people with no symptoms, experiencing no medical problems, going to the doctor to get medical tests.