6 ms·

Half the posts in this thread bring back the old SlashDot adage: The plural of anecdote is not data. I am not sure what the point this article is trying to mak

Half the posts in this thread bring back the old SlashDot adage: The plural of anecdote is not data. I am not sure what the point this article is trying to make is. I do not feel more informed for having read it. It seems a populist appeal to the idea that the medical institution has no idea what it is doing. Is it good, is it bad? It doesn't matter. The end result is damaged institutional trust. How many people would read this article and go "yeah doctors have no idea what they are doing," then go to their alternative medicine to spend $100 on a dubious "medicine"? How many people here are actually equipped to have a meaningful understanding of the information presented? Why did the author not present the institutional position or data supporting yearly checkups and why it's misleading? As long as billionaires are able to influence people to fight about anything other than wealth disparity, they win. We are not experts, we should leave decision making to people who know what they don't know rather than to people who don't know what they don't know (us).

mrangle 4y ago
This post is an amalgam of barely formed thoughts followed by..."but fight a class war". It's nonsense from beginning to end. Why is critical data "populist"? Why is undamaged institutional trust your goal? Are institutions inherently trustworthy, or is it that they aren't but should be presented as such? Why are you concerned with the literacy of the audience rather than the content of the article? In your mind, why is is every author's duty to present two arguments (which is not a research mandate, the article being a research summary presented in popular article format). Anointing "experts" is not how science works. Again, the article being equivalent to a research abstract and research being the basis for science. We removed science from the unquestionable "expertise" of the Church many centuries ago. At which point we placed in the hands of research and its critique.
- deleted 4y ago
  [deleted]
valdiorn 4y ago
> The plural of anecdote is not data. Except it literally is. How do you think rare vaccine side effects have been discovered and recorded? By collecting thousands of "anecdotes" from individuals reporting anomalous symptoms. How do you think illicit drug harm is measured? They can't exactly pump people full of cocaine and ketamine in a lab to study overdose effects - you collect anecdotes (individual cases), catalog them, aggregate and adjust for sample bias. Anecdotes are individual, cherry-picked testimonies. When you collect enough of them you get a statistically significant data point. It may be biased based on how your data was collected but the same can be said for many scientific studies that turned out to be flawed in their data collection. As long as you are aware of what the possible bias is, you have data.
pseudotrash 4y ago
My best friend is diagnosed with a disease nobody has a cure, his wife, Krohns disease, his son on the spectrum. They visit the doctor every 3 months (each) since 2015. And each time they go it's more decay and more confusion. I'm not anti science but there are echos from nntaleb Antifragile in this.
user3939382 4y ago
We can’t have faith in any of our society’s major institutions because they’re all corrupt https://youtu.be/z6IO2DZjOkY https://youtu.be/z6IO2DZjOkY
- deleted 4y ago
  [deleted]
- hayst4ck 4y ago
  Institutional corruption will not be solved by losing trust in the institutions. When the institution dies because nobody trusts it you don't all of a sudden get good health care. So if you believe that our medical institutions are corrupted, anger at the institution itself is misdirected. The corruptive force is billionaires and the measurement for the level of corruption is wealth disparity.
  - aj7 4y ago
    Well put.
  - jjcon 4y ago
    So when the US FDA is shilling for obesity drugs, says that being obese isn’t a lifestyle problem but is purely genetic. Medical schools are lowering/removing certain standards for admission under the guise of ‘equity’ - thats all just some billionaires faults? Sorry, I don’t buy it. The medical and pharmaceutical industries have been rotting for decades in the US and protecting them, “because it would be better for our healthcare system” is exactly the mentality that gets you into this mess to begin with. State the problem, state it clearly. Don’t shift blame around to invisible boogeymen.
    - nemothekid 4y ago
      >So when the US FDA is shilling for obesity drugs, says that being obese isn’t a lifestyle problem but is purely genetic The FDA has never claimed obesity is purely genetic and it's own guidelines state multiple factors for obesity and stringent guidelines for the approval of drugs that target specific genetic disorders. >Medical schools are lowering/removing certain standards for admission under the guise of ‘equity’ This doesn't seem true at all, and seems like an extension of the "woke" boogeyman we see in undergrad. The problem with this kind of thinking is it's hard to assign anysort of motivation for these actions without sounding cartoonish. The FDA wants to say obesity is a purely genetic for what reason? Who is enriched when the FDA says this? Does the FDA get some kickback every time there's a new obese person? >State the problem, state it clearly. Don’t shift blame around to invisible boogeymen. The for-profit medical system has created a two-tier treatment system that is incentivized to protect profits over providing adequate care. This includes both providing poor treatment to those who cannot pay as well as providing ineffective treatment to wealthier americans in order to sell more expensive, patented drugs. Any political action to change this system is effectively stonewalled due to "invisible boogeymen" who all happen to have the same political interests in keeping current profitable system and are able to easily buy politicians to prevent any radical change from going through. The incentive is clear - to protect profit margins.
deleted 4y ago
[deleted]
kornhole 4y ago
This article gives people things to consider and does not dare give specific advice. Everybody is different. Some people are in touch with their bodies and can detect if something is going wrong, and others are not. Institutions and pharmaceutical companies can adversely affect our health if they are able to influence doctors to advise us wrongly in a for profit health care industry. If you look at the health of the US population with a declining life expectancy, rising obesity, immunological diseases, and cancer, some self learning seems like a good thing rather than to leave your health up to institutions, companies, and doctors.
- cuteboy19 4y ago
  >Some people are in touch with their bodies and can detect if something is going wrong and how does one come to know this? > If you look at the health of the US population with a declining life expectancy, rising obesity, immunological diseases, and cancer, some self learning seems like a good thing rather than to leave your health up to institutions, companies, and doctors Could you show your work? Some steps are clearly missing between the premise and the conclusion
  - kornhole 4y ago
    >Could you show your work? Some steps are clearly missing between the premise and the conclusion Life expectancy is dropping in the US according to official studies you can easily find. It is now lower than China. Obesity, immunological diseases, and cancer have also been rising over the decades. I am not going to pin anything to specific causes as that will spur a debate too long for my attention. IMO the system is generally failing us. Without your health, you have nothing. It is too important for me to completely trust to others especially with how our system is currently incentivized.
  - nradov 4y ago
    This is an issue that is by nature difficult to study in a rigorous, controlled manner. I can tell you that it is a real phenomenon but probably can't prove it in a way you would consider satisfactory. We see the highest levels of this internal body awareness among people who have spent many years using their bodies at peak performance levels. They do their normal daily training and something feels a little "off" before any obvious signs or symptoms appear. But if you only associate with sedentary office workers then you might be skeptical. A lot of people feel like crap so often that to them it begins to feel normal.
yesbut 4y ago
I don't think the solution is just leaving our complex decisions over to others. I think the solution is that we all need to be better informed. A doctor doesn't decide to do something for us unless we're incapacitated. The doctor informs us of our options and risks and we get to make the decisions ourselves. In the same vein (vain pun would have been better), we need more opportunities to decide for ourselves than we currently do, not fewer. Why should any other major decision a country makes be any different? We hand over the decision making over too often when we should be turning those situations into more opportunities to let democracy to rule. Inform the public and let them decide. Allowing others to decide for us has been a shit show.
- hayst4ck 4y ago
  What you are arguing is that we should be a low trust society: https://en.wikipedia.org/wiki/High_trust_and_low_trust_societies https://en.wikipedia.org/wiki/High_trust_and_low_trust_socie... No. The government should provide consequences for those who violate trust promoting the idea that I can trust someone else who is from the same society I am. Here is a game that shows what happens at a societal level when doctors lie or mechanics over charge: https://ncase.me/trust/ https://ncase.me/trust/ In the game of prisoners dilemma, society itself must ensure that defection is a losing strategy. This idea has a name: rule of law.
  - yesbut 4y ago
    The government is us. Not some aliens. We should be democratically deciding what is correct and what is a violation and what the consequences for violating trust are. We should not hand that decision over to a few elected representatives. This should be a collective democratic process. * legalize abortion? yes or no * go to war? yes or no * arm teachers? yes or no * corporate news outlet allowed to sell ad time to corporations they report on? yes or no * nondemocratically run businesseses allowed to function as a news outlet? yes or no More democracy, not less.
    - hayst4ck 4y ago
      How do "we" decide something? It sounds like you are advocating for mob rule but calling it democracy. Help me understand how that is not what you are saying. What is the "collective democratic process" you are advocating for? How does a law get made and how does a law get enforced?
holbrad 4y ago
"yeah doctors have no idea what they are doing" isn't really that far off the mark for a lot of things. The health of the average person in the west (And globally) is in decline. Obesity, diabetes, heart disease and cancer are all massively massively increased from where they were 100 years ago. If the standard advice given isn't working for people (And it most obviously is not) then looking for alternatives really is the only thing people feel they can do. In todays age being average in health is a poor decision.
- thfuran 4y ago
  >The health of the average person in the west (And globally) is in decline. Obesity, diabetes, heart disease and cancer are all massively massively increased from where they were 100 years ago. In the US, life expectancy has increased by 30 years since 1900. People weren't dying of cancer and heart disease as frequently because 24% of them had already died by the age of five.
- aj7 4y ago
  The above is all nonsense, especially for Hacker News readers. Someone here in their early 30’s has a mean life expectancy of almost 90. Many people opt to commit slow suicide. That’s what you’re seeing.
  - ifyoubuildit 4y ago
    Possibly dumb question: can an early 30 something trust that number to apply to them? I'd imagine the calculation is more sophisticated than I can imagine, but can it take into account things that haven't necessarily had their full impact yet? Like potential world war, deep recession/depression, massive unrest, things like microplastics, forever chemicals, dropping testosterone, the after effects of covid itself as well as everything around it.
hotpathdev 4y ago
> Half the posts in this thread bring back the old SlashDot adage: The plural of anecdote is not data. I find the application of this logic to be entirely one-sided. Positive anecdotes are data, negative anecdotes are wives tales. Simplifying medical information into data points is a dangerous practice which by now should be revealing itself as entirely fraudulent. Anecdotes provide context which doctors and science love to dismiss. I'll take a handful of anecdotes and appreciate all the context they provide, meanwhile the context-free "science" will go back and forth never getting anywhere nearer to better health outcomes.
Someone 4y ago
> It seems a populist appeal to the idea that the medical institution has no idea what it is doing. Isn’t at least the section about false positives an indication that doctors know what they’re doing, and know what they cannot do? > Why did the author not present the institutional position or data supporting yearly checkups and why it's misleading? Because it’s not a scientific article? The article mentions the arguments and has links to a paper in the BMJ (paywalled, unfortunately) > We are not experts, we should leave decision making to people who know what they don't know rather than to people who don't know what they don't know (us). So, why do you want this article to show data supporting its claims?
stu2b50 4y ago
The point I got from the article is to bias against medical interventions. That doesn't mean never consider them, but they really need to have a serious reason to occur. It doesn't have to that doctors are bad at their jobs, but rather that they're humans, and humans are hardwired to try to make other humans happy, and patients like being actively given treatment as opposed to "have you considered sleeping well, eating well, and just letting your body do its thing?" The sources that the article has, an article in the BMJ[0] and Cochrane[1], are actually targeted at primary care physicians (after all, random laypeople don't read medical journals!), to basically tell them to chill, and tell their patients to just let themselves be. [0] https://www.bmj.com/content/348/bmj.g3680 https://www.bmj.com/content/348/bmj.g3680 [1] https://www.cochrane.org/news/featured-review-are-general-health-checks-beneficial https://www.cochrane.org/news/featured-review-are-general-he...
- Ntrails 4y ago
  > The point I got from the article is to bias against medical interventions. I will always regret not asking what the difference in outcome was from a surgery on a ligament in my ankle. I feel like the surgeon saw a thing they could fix and said they should do so. I don't think they had an internal monologue of does it matter and I never checked. Not a major mistake, but not one i would make again
rurp 4y ago
I think this is unnecessarily conspiratorial. Medical tests often have much more uncertainty than most expect, and many interventions are net negative on average. This particular research was new to me but I have seen a number of studies of cancer screenings and treatment showing the same or even worse effects. The recommended standards for some cancer screenings have been updated in recent years to be more restrained since it was shown they were having a negative effect in certain cases. Many tests have fairly high false positive rates. This leads to a lot of unnecessary treatment with negative health consequences. There are also a number of scenarios where treatment reduces the mortality rate from one specific issue, but increases mortality overall because of the associated harm of treatment. This isn't some homeopothy plug -- that stuff is nonsense. But I would suggest being somewhat skeptical of boilerplate medical advice.
- Jimmc414 4y ago
  > I think this is unnecessarily conspiratorial. Medical tests often have much more uncertainty than most expect, and many interventions are net negative on average. If a crucial test is giving false positives, rather than dismissing the test altogether, it would be more beneficial to adjust the response protocols, invest in improving the test's accuracy, or focus on better informing patients about the potential risks and benefits. Discarding a test entirely could lead to missed opportunities for early detection and intervention, which can be crucial for certain conditions. There has to be some balance between skepticism and the potential value of medical tests and screenings.

mrangle 4y ago

This post is an amalgam of barely formed thoughts followed by..."but fight a class war". It's nonsense from beginning to end. Why is critical data "populist"? Why is undamaged institutional trust your goal? Are institutions inherently trustworthy, or is it that they aren't but should be presented as such? Why are you concerned with the literacy of the audience rather than the content of the article? In your mind, why is is every author's duty to present two arguments (which is not a research mandate, the article being a research summary presented in popular article format). Anointing "experts" is not how science works. Again, the article being equivalent to a research abstract and research being the basis for science. We removed science from the unquestionable "expertise" of the Church many centuries ago. At which point we placed in the hands of research and its critique.

deleted 4y ago
[deleted]

valdiorn 4y ago

> The plural of anecdote is not data. Except it literally is. How do you think rare vaccine side effects have been discovered and recorded? By collecting thousands of "anecdotes" from individuals reporting anomalous symptoms. How do you think illicit drug harm is measured? They can't exactly pump people full of cocaine and ketamine in a lab to study overdose effects - you collect anecdotes (individual cases), catalog them, aggregate and adjust for sample bias. Anecdotes are individual, cherry-picked testimonies. When you collect enough of them you get a statistically significant data point. It may be biased based on how your data was collected but the same can be said for many scientific studies that turned out to be flawed in their data collection. As long as you are aware of what the possible bias is, you have data.

pseudotrash 4y ago

My best friend is diagnosed with a disease nobody has a cure, his wife, Krohns disease, his son on the spectrum. They visit the doctor every 3 months (each) since 2015. And each time they go it's more decay and more confusion. I'm not anti science but there are echos from nntaleb Antifragile in this.

user3939382 4y ago

We can’t have faith in any of our society’s major institutions because they’re all corrupt https://youtu.be/z6IO2DZjOkY https://youtu.be/z6IO2DZjOkY

deleted 4y ago
[deleted]
hayst4ck 4y ago
Institutional corruption will not be solved by losing trust in the institutions. When the institution dies because nobody trusts it you don't all of a sudden get good health care. So if you believe that our medical institutions are corrupted, anger at the institution itself is misdirected. The corruptive force is billionaires and the measurement for the level of corruption is wealth disparity.
- aj7 4y ago
  Well put.
- jjcon 4y ago
  So when the US FDA is shilling for obesity drugs, says that being obese isn’t a lifestyle problem but is purely genetic. Medical schools are lowering/removing certain standards for admission under the guise of ‘equity’ - thats all just some billionaires faults? Sorry, I don’t buy it. The medical and pharmaceutical industries have been rotting for decades in the US and protecting them, “because it would be better for our healthcare system” is exactly the mentality that gets you into this mess to begin with. State the problem, state it clearly. Don’t shift blame around to invisible boogeymen.
  - nemothekid 4y ago
    >So when the US FDA is shilling for obesity drugs, says that being obese isn’t a lifestyle problem but is purely genetic The FDA has never claimed obesity is purely genetic and it's own guidelines state multiple factors for obesity and stringent guidelines for the approval of drugs that target specific genetic disorders. >Medical schools are lowering/removing certain standards for admission under the guise of ‘equity’ This doesn't seem true at all, and seems like an extension of the "woke" boogeyman we see in undergrad. The problem with this kind of thinking is it's hard to assign anysort of motivation for these actions without sounding cartoonish. The FDA wants to say obesity is a purely genetic for what reason? Who is enriched when the FDA says this? Does the FDA get some kickback every time there's a new obese person? >State the problem, state it clearly. Don’t shift blame around to invisible boogeymen. The for-profit medical system has created a two-tier treatment system that is incentivized to protect profits over providing adequate care. This includes both providing poor treatment to those who cannot pay as well as providing ineffective treatment to wealthier americans in order to sell more expensive, patented drugs. Any political action to change this system is effectively stonewalled due to "invisible boogeymen" who all happen to have the same political interests in keeping current profitable system and are able to easily buy politicians to prevent any radical change from going through. The incentive is clear - to protect profit margins.

deleted 4y ago

[deleted]

kornhole 4y ago

This article gives people things to consider and does not dare give specific advice. Everybody is different. Some people are in touch with their bodies and can detect if something is going wrong, and others are not. Institutions and pharmaceutical companies can adversely affect our health if they are able to influence doctors to advise us wrongly in a for profit health care industry. If you look at the health of the US population with a declining life expectancy, rising obesity, immunological diseases, and cancer, some self learning seems like a good thing rather than to leave your health up to institutions, companies, and doctors.

cuteboy19 4y ago
>Some people are in touch with their bodies and can detect if something is going wrong and how does one come to know this? > If you look at the health of the US population with a declining life expectancy, rising obesity, immunological diseases, and cancer, some self learning seems like a good thing rather than to leave your health up to institutions, companies, and doctors Could you show your work? Some steps are clearly missing between the premise and the conclusion
- kornhole 4y ago
  >Could you show your work? Some steps are clearly missing between the premise and the conclusion Life expectancy is dropping in the US according to official studies you can easily find. It is now lower than China. Obesity, immunological diseases, and cancer have also been rising over the decades. I am not going to pin anything to specific causes as that will spur a debate too long for my attention. IMO the system is generally failing us. Without your health, you have nothing. It is too important for me to completely trust to others especially with how our system is currently incentivized.
- nradov 4y ago
  This is an issue that is by nature difficult to study in a rigorous, controlled manner. I can tell you that it is a real phenomenon but probably can't prove it in a way you would consider satisfactory. We see the highest levels of this internal body awareness among people who have spent many years using their bodies at peak performance levels. They do their normal daily training and something feels a little "off" before any obvious signs or symptoms appear. But if you only associate with sedentary office workers then you might be skeptical. A lot of people feel like crap so often that to them it begins to feel normal.

yesbut 4y ago

I don't think the solution is just leaving our complex decisions over to others. I think the solution is that we all need to be better informed. A doctor doesn't decide to do something for us unless we're incapacitated. The doctor informs us of our options and risks and we get to make the decisions ourselves. In the same vein (vain pun would have been better), we need more opportunities to decide for ourselves than we currently do, not fewer. Why should any other major decision a country makes be any different? We hand over the decision making over too often when we should be turning those situations into more opportunities to let democracy to rule. Inform the public and let them decide. Allowing others to decide for us has been a shit show.

hayst4ck 4y ago
What you are arguing is that we should be a low trust society: https://en.wikipedia.org/wiki/High_trust_and_low_trust_societies https://en.wikipedia.org/wiki/High_trust_and_low_trust_socie... No. The government should provide consequences for those who violate trust promoting the idea that I can trust someone else who is from the same society I am. Here is a game that shows what happens at a societal level when doctors lie or mechanics over charge: https://ncase.me/trust/ https://ncase.me/trust/ In the game of prisoners dilemma, society itself must ensure that defection is a losing strategy. This idea has a name: rule of law.
- yesbut 4y ago
  The government is us. Not some aliens. We should be democratically deciding what is correct and what is a violation and what the consequences for violating trust are. We should not hand that decision over to a few elected representatives. This should be a collective democratic process. * legalize abortion? yes or no * go to war? yes or no * arm teachers? yes or no * corporate news outlet allowed to sell ad time to corporations they report on? yes or no * nondemocratically run businesseses allowed to function as a news outlet? yes or no More democracy, not less.
  - hayst4ck 4y ago
    How do "we" decide something? It sounds like you are advocating for mob rule but calling it democracy. Help me understand how that is not what you are saying. What is the "collective democratic process" you are advocating for? How does a law get made and how does a law get enforced?

holbrad 4y ago

"yeah doctors have no idea what they are doing" isn't really that far off the mark for a lot of things. The health of the average person in the west (And globally) is in decline. Obesity, diabetes, heart disease and cancer are all massively massively increased from where they were 100 years ago. If the standard advice given isn't working for people (And it most obviously is not) then looking for alternatives really is the only thing people feel they can do. In todays age being average in health is a poor decision.

thfuran 4y ago
>The health of the average person in the west (And globally) is in decline. Obesity, diabetes, heart disease and cancer are all massively massively increased from where they were 100 years ago. In the US, life expectancy has increased by 30 years since 1900. People weren't dying of cancer and heart disease as frequently because 24% of them had already died by the age of five.
aj7 4y ago
The above is all nonsense, especially for Hacker News readers. Someone here in their early 30’s has a mean life expectancy of almost 90. Many people opt to commit slow suicide. That’s what you’re seeing.
- ifyoubuildit 4y ago
  Possibly dumb question: can an early 30 something trust that number to apply to them? I'd imagine the calculation is more sophisticated than I can imagine, but can it take into account things that haven't necessarily had their full impact yet? Like potential world war, deep recession/depression, massive unrest, things like microplastics, forever chemicals, dropping testosterone, the after effects of covid itself as well as everything around it.

hotpathdev 4y ago

> Half the posts in this thread bring back the old SlashDot adage: The plural of anecdote is not data. I find the application of this logic to be entirely one-sided. Positive anecdotes are data, negative anecdotes are wives tales. Simplifying medical information into data points is a dangerous practice which by now should be revealing itself as entirely fraudulent. Anecdotes provide context which doctors and science love to dismiss. I'll take a handful of anecdotes and appreciate all the context they provide, meanwhile the context-free "science" will go back and forth never getting anywhere nearer to better health outcomes.

Someone 4y ago

> It seems a populist appeal to the idea that the medical institution has no idea what it is doing. Isn’t at least the section about false positives an indication that doctors know what they’re doing, and know what they cannot do? > Why did the author not present the institutional position or data supporting yearly checkups and why it's misleading? Because it’s not a scientific article? The article mentions the arguments and has links to a paper in the BMJ (paywalled, unfortunately) > We are not experts, we should leave decision making to people who know what they don't know rather than to people who don't know what they don't know (us). So, why do you want this article to show data supporting its claims?

stu2b50 4y ago

The point I got from the article is to bias against medical interventions. That doesn't mean never consider them, but they really need to have a serious reason to occur. It doesn't have to that doctors are bad at their jobs, but rather that they're humans, and humans are hardwired to try to make other humans happy, and patients like being actively given treatment as opposed to "have you considered sleeping well, eating well, and just letting your body do its thing?" The sources that the article has, an article in the BMJ[0] and Cochrane[1], are actually targeted at primary care physicians (after all, random laypeople don't read medical journals!), to basically tell them to chill, and tell their patients to just let themselves be. [0] https://www.bmj.com/content/348/bmj.g3680 https://www.bmj.com/content/348/bmj.g3680 [1] https://www.cochrane.org/news/featured-review-are-general-health-checks-beneficial https://www.cochrane.org/news/featured-review-are-general-he...

Ntrails 4y ago
> The point I got from the article is to bias against medical interventions. I will always regret not asking what the difference in outcome was from a surgery on a ligament in my ankle. I feel like the surgeon saw a thing they could fix and said they should do so. I don't think they had an internal monologue of does it matter and I never checked. Not a major mistake, but not one i would make again

rurp 4y ago

I think this is unnecessarily conspiratorial. Medical tests often have much more uncertainty than most expect, and many interventions are net negative on average. This particular research was new to me but I have seen a number of studies of cancer screenings and treatment showing the same or even worse effects. The recommended standards for some cancer screenings have been updated in recent years to be more restrained since it was shown they were having a negative effect in certain cases. Many tests have fairly high false positive rates. This leads to a lot of unnecessary treatment with negative health consequences. There are also a number of scenarios where treatment reduces the mortality rate from one specific issue, but increases mortality overall because of the associated harm of treatment. This isn't some homeopothy plug -- that stuff is nonsense. But I would suggest being somewhat skeptical of boilerplate medical advice.

Jimmc414 4y ago
> I think this is unnecessarily conspiratorial. Medical tests often have much more uncertainty than most expect, and many interventions are net negative on average. If a crucial test is giving false positives, rather than dismissing the test altogether, it would be more beneficial to adjust the response protocols, invest in improving the test's accuracy, or focus on better informing patients about the potential risks and benefits. Discarding a test entirely could lead to missed opportunities for early detection and intervention, which can be crucial for certain conditions. There has to be some balance between skepticism and the potential value of medical tests and screenings.