3 ms·

I have some familiarity with diagnostic imaging - a lot of the time with these scans there's enough to say "yes, there is something there you should definitely

I have some familiarity with diagnostic imaging - a lot of the time with these scans there's enough to say "yes, there is something there you should definitely get checked out" but you can't make a full assessment without a biopsy. The MRI is going to find things you need to investigate further. It'll also reveal a bunch of stuff you didn't need to know. Do you want to know about that minor slipped disc in your back that wasn't bothering you before? The nocebo effect is very real.

kragen 3y ago
if investigating it further isn't worth the risk, you don't need to investigate further if investigating it further is worth the risk, then it's a good thing you did the scan this superstitious ideology that ignorance is good for you has always been popular; what's surprising is that some people still hold to it despite the industrial and scientific revolutions knowing about the minor slipped disc in your back might be important information if it starts hurting; you'll know it isn't a metastatic bone cancer. you might also be well advised to avoid taking up olympic weightlifting
- SketchySeaBeast 3y ago
  > if investigating it further isn't worth the risk, you don't need to investigate further How do you make that call? What do you, as an eager but uneducated layman, use to decide that? You now know there's a heterogeneous cyst in your abdomen that the doctor says is super unlikely to be cancerous but it's not impossible that it could be. How do you evaluate your odds? Are you opting for the biopsy? If there's a dozen of such cysts in all corners of your body? Again, the MRI is a tool to help spot a problem, it's not going to give you the diagnosis.
  - kragen 3y ago
    usually i read the wikipedia articles about the disease and the common treatments, a couple dozen papers starting from google scholar via pubmed and sci-hub, maybe a relevant medical textbook via libgen. also talk to family members and friends about the issue. you can also find papers in medical journals and the mmwr on the prevalence of possible complications from different kinds of biopsies this takes a little longer than undergoing the biopsy, but it's enormously more pleasant, and it lets you know when doctors are ignorant or lying, which is perhaps even more important information. it's orders of magnitude easier than undergoing chemo and radiation so i don't know why 'eager but uneducated' laypeople don't always do it. maybe they're too used to living in a world without sci-hub and libgen it's also easier when it's not the first time it's never impossible that any part of your body could be cancerous, so 'super unlikely to be cancerous but it's not impossible that it could be' is a terrible justification for taking action
    - SketchySeaBeast 3y ago
      > it's never impossible that any part of your body could be cancerous, so 'super unlikely to be cancerous but it's not impossible that it could be' is a terrible justification for taking action If you knew that you or your spouse had something that could be an issue but was unlikely to be - and it's nearly guaranteed that somewhere in your body right now you have stuff that would come back as "possibly a problem" in imaging - you'd be comfortable not taking action? I doubt that's how most people would response.
      - kragen 3y ago
        yes, i have in fact done this i'm not here to protect most people from the consequences of their own bad decisions and i don't want to be subjected to a medical system that's oriented toward doing that to me
  - abletonlive 3y ago
    > You now know there's a heterogeneous cyst in your abdomen that the doctor says is super unlikely to be cancerous but it's not impossible that it could be. That's up to the individual to decide - blanketing people in ignorance and leaving it up to chance should not be the only option.
    - SketchySeaBeast 3y ago
      But you're still making decisions out of ignorance and you're biased towards worst case outcomes because it's you. People are going to make the choice out of fear and that will lead to a ton of extra procedures and those people possibly having a worse quality of life as a consequence of all the elective procedures.
      - abletonlive 3y ago
        I would say you're biased because it's not you. You've turned everybody into a statistic to make your decisions based on the idea that it's more important to keep your percentages in line with expectations created in a broken health care environment where reactionary medicine is preferred over preventative medicine. How are we supposed to ever make progress here if that's your mindset? This is the medical system that fears its own incompetence so much that it would prefer to NOT have data. How silly is that? What other industry operates this way? Can you imagine an engineer doing maintenance on a plane and saying "hey actually, we have no idea what we are doing so it's better if we don't do an inspection so we don't mess it up even more by trying to fix something that might not be a problem."
  - wiml 3y ago
    > What do you, as an eager but uneducated layman, use to decide that? Is this a trick question? I use my doctor's expertise and advice, obviously. Just like I do for any other nontrivial medical question. This has happened to me a number of times throughout my life. I have some problem, my doctor requests a scan (or x-ray or ultrasound or...), it turns up some anomalies, and my doctor has to evaluate them to decide if they are relevant to anything. For many of them the answer is, no, they're not. Now I know that I have a cyst here and some slightly misaligned vertebræ there and ... that's fine. They weren't causing the problem I had and they're probably not causing any other problems either. The argument that we must not look at ourselves because if we do, we'll be compelled by some mysterious force to take dangerous interventions is silly and just seems like an excuse for medical incompetence or laziness.

kragen 3y ago

if investigating it further isn't worth the risk, you don't need to investigate further if investigating it further is worth the risk, then it's a good thing you did the scan this superstitious ideology that ignorance is good for you has always been popular; what's surprising is that some people still hold to it despite the industrial and scientific revolutions knowing about the minor slipped disc in your back might be important information if it starts hurting; you'll know it isn't a metastatic bone cancer. you might also be well advised to avoid taking up olympic weightlifting

SketchySeaBeast 3y ago
> if investigating it further isn't worth the risk, you don't need to investigate further How do you make that call? What do you, as an eager but uneducated layman, use to decide that? You now know there's a heterogeneous cyst in your abdomen that the doctor says is super unlikely to be cancerous but it's not impossible that it could be. How do you evaluate your odds? Are you opting for the biopsy? If there's a dozen of such cysts in all corners of your body? Again, the MRI is a tool to help spot a problem, it's not going to give you the diagnosis.
- kragen 3y ago
  usually i read the wikipedia articles about the disease and the common treatments, a couple dozen papers starting from google scholar via pubmed and sci-hub, maybe a relevant medical textbook via libgen. also talk to family members and friends about the issue. you can also find papers in medical journals and the mmwr on the prevalence of possible complications from different kinds of biopsies this takes a little longer than undergoing the biopsy, but it's enormously more pleasant, and it lets you know when doctors are ignorant or lying, which is perhaps even more important information. it's orders of magnitude easier than undergoing chemo and radiation so i don't know why 'eager but uneducated' laypeople don't always do it. maybe they're too used to living in a world without sci-hub and libgen it's also easier when it's not the first time it's never impossible that any part of your body could be cancerous, so 'super unlikely to be cancerous but it's not impossible that it could be' is a terrible justification for taking action
  - SketchySeaBeast 3y ago
    > it's never impossible that any part of your body could be cancerous, so 'super unlikely to be cancerous but it's not impossible that it could be' is a terrible justification for taking action If you knew that you or your spouse had something that could be an issue but was unlikely to be - and it's nearly guaranteed that somewhere in your body right now you have stuff that would come back as "possibly a problem" in imaging - you'd be comfortable not taking action? I doubt that's how most people would response.
    - kragen 3y ago
      yes, i have in fact done this i'm not here to protect most people from the consequences of their own bad decisions and i don't want to be subjected to a medical system that's oriented toward doing that to me
- abletonlive 3y ago
  > You now know there's a heterogeneous cyst in your abdomen that the doctor says is super unlikely to be cancerous but it's not impossible that it could be. That's up to the individual to decide - blanketing people in ignorance and leaving it up to chance should not be the only option.
  - SketchySeaBeast 3y ago
    But you're still making decisions out of ignorance and you're biased towards worst case outcomes because it's you. People are going to make the choice out of fear and that will lead to a ton of extra procedures and those people possibly having a worse quality of life as a consequence of all the elective procedures.
    - abletonlive 3y ago
      I would say you're biased because it's not you. You've turned everybody into a statistic to make your decisions based on the idea that it's more important to keep your percentages in line with expectations created in a broken health care environment where reactionary medicine is preferred over preventative medicine. How are we supposed to ever make progress here if that's your mindset? This is the medical system that fears its own incompetence so much that it would prefer to NOT have data. How silly is that? What other industry operates this way? Can you imagine an engineer doing maintenance on a plane and saying "hey actually, we have no idea what we are doing so it's better if we don't do an inspection so we don't mess it up even more by trying to fix something that might not be a problem."
- wiml 3y ago
  > What do you, as an eager but uneducated layman, use to decide that? Is this a trick question? I use my doctor's expertise and advice, obviously. Just like I do for any other nontrivial medical question. This has happened to me a number of times throughout my life. I have some problem, my doctor requests a scan (or x-ray or ultrasound or...), it turns up some anomalies, and my doctor has to evaluate them to decide if they are relevant to anything. For many of them the answer is, no, they're not. Now I know that I have a cyst here and some slightly misaligned vertebræ there and ... that's fine. They weren't causing the problem I had and they're probably not causing any other problems either. The argument that we must not look at ourselves because if we do, we'll be compelled by some mysterious force to take dangerous interventions is silly and just seems like an excuse for medical incompetence or laziness.