3 ms·

It's not just the anxiety and psychological distress either. If we scanned everyone all the time, you would find literally millions of conditions that would nev

It's not just the anxiety and psychological distress either. If we scanned everyone all the time, you would find literally millions of conditions that would never cause symptoms or major health issues, but would nevertheless be treated unnecessarily, incurring massive additional costs and needless interventions with their own risks. It would be a nightmare.

shiftpgdn 3y ago
This doesn't make any sense to me. It's either a problem or it isn't unless doctors are willing to admit they perform lots of unnecessary procedures already.
- ch4s3 3y ago
  Most doctors will freely admit that they sometimes do unnecessary procedures out of an abundance of caution.
- duxup 3y ago
  >It's either a problem or it isn't Try looking at a full body scan and make that call.
- BeetleB 3y ago
  > It's either a problem or it isn't That's vacuously true. The problem is that we humans can't always discern the truth of the situation. Not even doctors. They perform a lot of unnecessary procedures. It's well known and not a conspiracy. Sometimes they do it to make money. Other times it's so they don't get sued. Scan the comments here and you'll see sentiments of people upset that their doctor didn't do a procedure and blaming them for adverse health problems.
- devilbunny 3y ago
  Let's say you have a mass at the head of the pancreas that is incidentally detected on a scan. Let's further stipulate that the mass does not have anything that clearly indicates that it's pancreatic cancer - but also does not have signs of being a benign cyst. What do you do about it? Well, you can do nothing, and just follow it up with repeat scans. Or you can go to surgery. Both cost money and time. But if you have pancreatic cancer, aggressive resection is essentially the only chance of a cure. So both patients and doctors are highly incentivized to go straight to surgery. If it turns out, once the mass has been resected, that it's actually a completely benign tumor, was the procedure really "unnecessary"? Because taking a piece of it and looking at it under a microscope is the only way you'll ever know for sure. Would you like to try live your life normally with that sword of Damocles hanging over your head? I wouldn't.
  - shiftpgdn 3y ago
    This is a better philosophical test than the trolly problem.
madacol 3y ago
Your argument implies that having less information is better. Why?
- TaupeRanger 3y ago
  Because sometimes it is. This is widely understood in health epidemiology. There are no screenings or interventions with zero risk: https://www.bmj.com/content/352/bmj.h6080 https://www.bmj.com/content/352/bmj.h6080
- prepend 3y ago
  Information’s value is based on the value of decisions made from that information. That’s how procedures can have negative value. This isn’t even just the cost of storing and retrieving useless info. Sometimes decisions get harder the more irrelevant information you have. So it’s better to act on less information than to get more bad information. In the case of body scans, the harm comes from more expensive followups or treatments to rule out false positives. Most things that have net value from screenings are already recommended so if it saved lives, it’s usually already recommended until new research changes the calculations.
  - madacol 3y ago
    > In the case of body scans, the harm comes from more expensive followups or treatments to rule out false positives. That's not a problem with body scans, it's a problem with the medical system overreacting to the new information. Avoiding scans is a distraction from the real problem of the medical system not knowing what to do with the new information of a full-body MRI scans.
    - prepend 3y ago
      It’s a problem with getting body scans. I think it’s useful to look at the overall behavior change that happens with a thing. I mean I guess lung cancer isn’t a problem with cigarettes, it’s a problem with people smoking lots of them. Body scans don’t provide useful information due to their false positives. Maybe eventually this gets better, or it may be a limitation of this type of scan. But I’ve talked with many doctors who say that MRI just isn’t actionable enough due to the limitation of imaging. But for our purposes, full body MRI scans, done without a specific cause, are net harmful and should be avoided. I mean, it’s legal and people can spend their money on whatever they like. But people spend money on all sorts of unproven “health” expenses. I don’t think MRI scans are as bad as homeopathy, but it’s in that same area. This, of course, is different from diagnostic scans. MRIs are valuable tools and it’s not the scan is bad, just how they are used sometimes.

shiftpgdn 3y ago

This doesn't make any sense to me. It's either a problem or it isn't unless doctors are willing to admit they perform lots of unnecessary procedures already.

ch4s3 3y ago
Most doctors will freely admit that they sometimes do unnecessary procedures out of an abundance of caution.
duxup 3y ago
>It's either a problem or it isn't Try looking at a full body scan and make that call.
BeetleB 3y ago
> It's either a problem or it isn't That's vacuously true. The problem is that we humans can't always discern the truth of the situation. Not even doctors. They perform a lot of unnecessary procedures. It's well known and not a conspiracy. Sometimes they do it to make money. Other times it's so they don't get sued. Scan the comments here and you'll see sentiments of people upset that their doctor didn't do a procedure and blaming them for adverse health problems.
devilbunny 3y ago
Let's say you have a mass at the head of the pancreas that is incidentally detected on a scan. Let's further stipulate that the mass does not have anything that clearly indicates that it's pancreatic cancer - but also does not have signs of being a benign cyst. What do you do about it? Well, you can do nothing, and just follow it up with repeat scans. Or you can go to surgery. Both cost money and time. But if you have pancreatic cancer, aggressive resection is essentially the only chance of a cure. So both patients and doctors are highly incentivized to go straight to surgery. If it turns out, once the mass has been resected, that it's actually a completely benign tumor, was the procedure really "unnecessary"? Because taking a piece of it and looking at it under a microscope is the only way you'll ever know for sure. Would you like to try live your life normally with that sword of Damocles hanging over your head? I wouldn't.
- shiftpgdn 3y ago
  This is a better philosophical test than the trolly problem.

madacol 3y ago

Your argument implies that having less information is better. Why?

TaupeRanger 3y ago
Because sometimes it is. This is widely understood in health epidemiology. There are no screenings or interventions with zero risk: https://www.bmj.com/content/352/bmj.h6080 https://www.bmj.com/content/352/bmj.h6080
prepend 3y ago
Information’s value is based on the value of decisions made from that information. That’s how procedures can have negative value. This isn’t even just the cost of storing and retrieving useless info. Sometimes decisions get harder the more irrelevant information you have. So it’s better to act on less information than to get more bad information. In the case of body scans, the harm comes from more expensive followups or treatments to rule out false positives. Most things that have net value from screenings are already recommended so if it saved lives, it’s usually already recommended until new research changes the calculations.
- madacol 3y ago
  > In the case of body scans, the harm comes from more expensive followups or treatments to rule out false positives. That's not a problem with body scans, it's a problem with the medical system overreacting to the new information. Avoiding scans is a distraction from the real problem of the medical system not knowing what to do with the new information of a full-body MRI scans.
  - prepend 3y ago
    It’s a problem with getting body scans. I think it’s useful to look at the overall behavior change that happens with a thing. I mean I guess lung cancer isn’t a problem with cigarettes, it’s a problem with people smoking lots of them. Body scans don’t provide useful information due to their false positives. Maybe eventually this gets better, or it may be a limitation of this type of scan. But I’ve talked with many doctors who say that MRI just isn’t actionable enough due to the limitation of imaging. But for our purposes, full body MRI scans, done without a specific cause, are net harmful and should be avoided. I mean, it’s legal and people can spend their money on whatever they like. But people spend money on all sorts of unproven “health” expenses. I don’t think MRI scans are as bad as homeopathy, but it’s in that same area. This, of course, is different from diagnostic scans. MRIs are valuable tools and it’s not the scan is bad, just how they are used sometimes.