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These are all problems with doctors overreacting and oversharing. Collecting the information on a large scale to know what you are looking at next time seems l

by boxed 3y ago

These are all problems with doctors overreacting and oversharing. Collecting the information on a large scale to know what you are looking at next time seems like the sane approach.

michaelt 3y ago
There's also a statistical problem. Let's say 1% of patients have X, and you've got a test for X which is 99% accurate. You screen 10,000 patients; 100 have X and you identify 99 of them. 9,900 don't have X, and you raise 99 false alarms. But if you expand screening to cover Y which 0.1% of patients suffer from, and your test for Y is equally accurate, you'll identify 10 patients with Y - and get 100 false alarms. So the rarer the thing you're screening for, the better your test needs to be - unless you want to be buried in false alarms. As I understand things, this is why we don't generally screen for prostate cancer in the under-50s.
- boxed 3y ago
  That's not a statistical problem, it's a problem of doctors not knowing statistics. My point is that you could do these scannings on a broad scale and not look at the result per patient. Don't give it to their doctor to look at by default as that is the problem. Use it for basic science FIRST.
- thfuran 3y ago
  And sometimes the test itself can have rare adverse outcomes even ignoring the issues with false positives.
- zo1 3y ago
  I may be off base. But it sounds like the accuracy rate of those tests is off if it's based on an assumption that you'll only test people who have risk factors. I would have thought that by now, being the year 2024, we've gotten better than just guessing and statistically inferring stuff. This is where the big disconnect is, and why so many are starting to distrust the medical field. We assume doctors can diagnose stuff and not just go around making educated guesses. No wonder it's a giant government-enforced cartel that restricts competition.
bsder 3y ago
Nope. The problem is that there are four quadrants in statistics, not two. There are "found it and you have it", "found it and you don't have it", "didn't find it and you have it" and "didn't find it and you don't have it". Optimizing one of those quadrants deoptimizes the others. If you aren't looking for something specific because your Bayesian probability got bumped by other symptoms, you're going to pop the green jellybean. https://xkcd.com/882/ https://xkcd.com/882/ As someone who has been going through a lot of CT scans recently, I can tell you that they find a lot of inconsequential things. I can imagine that MRIs find even more. My doctors have been what seems to be unduly impressed with my ability to just shrug the reports off except for the specific thing that I need to get fixed. Apparently, most people freak out and they have to spend a lot of time talking them down. My response: "The CT scan results are basically saying "Sucks to get old, brah." There's only one alternative, and it's not very preferable. Now, let's get the thing we're monitoring fixed."
- boxed 3y ago
  > My doctors have been what seems to be unduly impressed with my ability to just shrug the reports off except for the specific thing that I need to get fixed. Apparently, most people freak out and they have to spend a lot of time talking them down. Why would the doctor even tell the patient that irrelevant stuff then? Seems like malpractice.
- tiahura 3y ago
  As an ambulance chaser who reads imaging reports everyday, I can confirm: if you're over 30, you've got at least one cyst somewhere in your body.

by boxed 3y ago

These are all problems with doctors overreacting and oversharing. Collecting the information on a large scale to know what you are looking at next time seems like the sane approach.

michaelt 3y ago

There's also a statistical problem. Let's say 1% of patients have X, and you've got a test for X which is 99% accurate. You screen 10,000 patients; 100 have X and you identify 99 of them. 9,900 don't have X, and you raise 99 false alarms. But if you expand screening to cover Y which 0.1% of patients suffer from, and your test for Y is equally accurate, you'll identify 10 patients with Y - and get 100 false alarms. So the rarer the thing you're screening for, the better your test needs to be - unless you want to be buried in false alarms. As I understand things, this is why we don't generally screen for prostate cancer in the under-50s.

boxed 3y ago
That's not a statistical problem, it's a problem of doctors not knowing statistics. My point is that you could do these scannings on a broad scale and not look at the result per patient. Don't give it to their doctor to look at by default as that is the problem. Use it for basic science FIRST.
thfuran 3y ago
And sometimes the test itself can have rare adverse outcomes even ignoring the issues with false positives.
zo1 3y ago
I may be off base. But it sounds like the accuracy rate of those tests is off if it's based on an assumption that you'll only test people who have risk factors. I would have thought that by now, being the year 2024, we've gotten better than just guessing and statistically inferring stuff. This is where the big disconnect is, and why so many are starting to distrust the medical field. We assume doctors can diagnose stuff and not just go around making educated guesses. No wonder it's a giant government-enforced cartel that restricts competition.

bsder 3y ago

Nope. The problem is that there are four quadrants in statistics, not two. There are "found it and you have it", "found it and you don't have it", "didn't find it and you have it" and "didn't find it and you don't have it". Optimizing one of those quadrants deoptimizes the others. If you aren't looking for something specific because your Bayesian probability got bumped by other symptoms, you're going to pop the green jellybean. https://xkcd.com/882/ https://xkcd.com/882/ As someone who has been going through a lot of CT scans recently, I can tell you that they find a lot of inconsequential things. I can imagine that MRIs find even more. My doctors have been what seems to be unduly impressed with my ability to just shrug the reports off except for the specific thing that I need to get fixed. Apparently, most people freak out and they have to spend a lot of time talking them down. My response: "The CT scan results are basically saying "Sucks to get old, brah." There's only one alternative, and it's not very preferable. Now, let's get the thing we're monitoring fixed."

boxed 3y ago
> My doctors have been what seems to be unduly impressed with my ability to just shrug the reports off except for the specific thing that I need to get fixed. Apparently, most people freak out and they have to spend a lot of time talking them down. Why would the doctor even tell the patient that irrelevant stuff then? Seems like malpractice.
tiahura 3y ago
As an ambulance chaser who reads imaging reports everyday, I can confirm: if you're over 30, you've got at least one cyst somewhere in your body.