3 ms·

What are the risks involved with getting an MRI?

sawert 3y ago
I believe they're saying that this type of comprehensive early detection leads to subsequent interventions on issues that would never develop into anything serious where they left alone. by increasing the number of interventions happening you could actually be making the patient worse off
- foogazi 3y ago
  > early detection leads to subsequent interventions on issues that would never develop into anything serious where they left alone. Then wouldn’t these be left alone ? The more research and procedures done the more info gathered on the evidence
  - rawgabbit 3y ago
    At least in the US, that's not how the healthcare system works. Some blame CYA. Some blame the fact that the system only makes money per procedure. The GP is saying in the US, patients often get procedures that are not worth the risk.
    - ch4s3 3y ago
      No, I'm saying that anywhere in the world you might get an unnecessary procedure. It is impossible to know in many cases if small tumors will become malignant, so judgement calls must be made. Finding more of them inevitably leads to more unnecessary procedures across a population. This is well established in European and American public health literature. This is why screening guidelines exist.
  - ch4s3 3y ago
    On an individual level, lets assume a polyp in the colon, there's no way to know which may become individually cancerous and which will remain small and benign. The genes are the same, the size and appearance may be the same. You can't know. At a population level its well established that beyond a certain point you're injuring more people than you are helping by doing the colonoscopies at all. Where to draw that line is where the debate is playing out. The problem is well known, and I'm not aware of ANYONE seriously suggesting that it's possible to eliminate this problem.
  - SketchySeaBeast 3y ago
    If the MRI finds a dozen indicators in your body in a bunch of different locations that might be cancer, all with different likelihoods where would you draw the line on getting them biopsied? Would you be comfortable having heterogeneous masses in your body that have a minor chance of being cancer? Because the MRI is going to say "might be", not "is".
  - pdonis 3y ago
    > Then wouldn’t these be left alone ? The problem is that you don't know which ones would never develop into anything if left alone. The reason they're left alone now is that you don't know they're there, because you never do any test that shows them being there. But once you do a test that shows that something is there, it's a lot harder to just leave it alone. Something is there, and you don't know that it's never going to be a problem, so you end up not leaving it alone. If you were going to leave the thing alone anyway regardless of what the first test showed, there's no point in doing the first test at all.
- jstummbillig 3y ago
  After getting another answer from them further below in this thread, I am under the impression that they are not entirely forthright about what it is they are claiming, or not claiming.
ch4s3 3y ago
It is well established that more MRI lead to more procedures that are ultimately themselves risky and useless. This is extremely difficult to parse out on an individual level but obvious in the data at a population level. Colonoscopies are a great example. As their use increases past a threshold more people are injured by additional surgery than you actually help. This is again at a population level.
- jstummbillig 3y ago
  Are you claiming that, at population level, the amount of false positives MRIs produce outweigh the benefits in terms of human health benefits?
  - ch4s3 3y ago
    Beyond a certain point all scans will produce more unnecessary procedures than beneficial ones. It's the nature of treating illnesses with uncertain presentations. Everyone has lots of odd bits and small benign tumors that are harmless. But these often look indistinguishable from the early stages of something serious. Even biopsy isn't without risk. There's no free lunch here.

I believe they're saying that this type of comprehensive early detection leads to subsequent interventions on issues that would never develop into anything serious where they left alone. by increasing the number of interventions happening you could actually be making the patient worse off

foogazi 3y ago
> early detection leads to subsequent interventions on issues that would never develop into anything serious where they left alone. Then wouldn’t these be left alone ? The more research and procedures done the more info gathered on the evidence
- rawgabbit 3y ago
  At least in the US, that's not how the healthcare system works. Some blame CYA. Some blame the fact that the system only makes money per procedure. The GP is saying in the US, patients often get procedures that are not worth the risk.
  - ch4s3 3y ago
    No, I'm saying that anywhere in the world you might get an unnecessary procedure. It is impossible to know in many cases if small tumors will become malignant, so judgement calls must be made. Finding more of them inevitably leads to more unnecessary procedures across a population. This is well established in European and American public health literature. This is why screening guidelines exist.
- ch4s3 3y ago
  On an individual level, lets assume a polyp in the colon, there's no way to know which may become individually cancerous and which will remain small and benign. The genes are the same, the size and appearance may be the same. You can't know. At a population level its well established that beyond a certain point you're injuring more people than you are helping by doing the colonoscopies at all. Where to draw that line is where the debate is playing out. The problem is well known, and I'm not aware of ANYONE seriously suggesting that it's possible to eliminate this problem.
- SketchySeaBeast 3y ago
  If the MRI finds a dozen indicators in your body in a bunch of different locations that might be cancer, all with different likelihoods where would you draw the line on getting them biopsied? Would you be comfortable having heterogeneous masses in your body that have a minor chance of being cancer? Because the MRI is going to say "might be", not "is".
- pdonis 3y ago
  > Then wouldn’t these be left alone ? The problem is that you don't know which ones would never develop into anything if left alone. The reason they're left alone now is that you don't know they're there, because you never do any test that shows them being there. But once you do a test that shows that something is there, it's a lot harder to just leave it alone. Something is there, and you don't know that it's never going to be a problem, so you end up not leaving it alone. If you were going to leave the thing alone anyway regardless of what the first test showed, there's no point in doing the first test at all.
jstummbillig 3y ago
After getting another answer from them further below in this thread, I am under the impression that they are not entirely forthright about what it is they are claiming, or not claiming.

ch4s3 3y ago

It is well established that more MRI lead to more procedures that are ultimately themselves risky and useless. This is extremely difficult to parse out on an individual level but obvious in the data at a population level. Colonoscopies are a great example. As their use increases past a threshold more people are injured by additional surgery than you actually help. This is again at a population level.

jstummbillig 3y ago
Are you claiming that, at population level, the amount of false positives MRIs produce outweigh the benefits in terms of human health benefits?
- ch4s3 3y ago
  Beyond a certain point all scans will produce more unnecessary procedures than beneficial ones. It's the nature of treating illnesses with uncertain presentations. Everyone has lots of odd bits and small benign tumors that are harmless. But these often look indistinguishable from the early stages of something serious. Even biopsy isn't without risk. There's no free lunch here.