4 ms·

This is not about early detection in general, but rather a specific test of dubious utility, specifically full-body MRI, which often leads to tons of follow-on

This is not about early detection in general, but rather a specific test of dubious utility, specifically full-body MRI, which often leads to tons of follow-on tests and invasive procedures that may have zero benefit. For a test with high enough specificity and sensitivity for early detection, it's likely that it would be quickly adopted, and then studied to show that it actually improves outcomes without undue cost (not merely dollar cost but also health cost) to people in terms of treatment and its side effects.

zero-sharp 2y ago
They specifically talk about using the fully body MRI for the purpose of detecting cancers. I'm not sure how you missed that. You literally had to watch 10 seconds of the clip. It's interesting because they explicitly talk about follow up testing (@2:10) which is to say that multiple methods are used if the MRI indicates a problem. So yes, the initial MRI may produce a misdiagnosis and that is a defect of the test. But the commentary in the video obviously suggests that additional testing for early detection is done. That's partly a problem as you pointed out, but then it clearly also indicates the scope of the conversation is more broad.
- ceejayoz 2y ago
  They didn't miss it at all. You've misunderstood the comment's point, which is "just because prospective full-body MRI is bad doesn't mean all diagnostics are".
  - zero-sharp 2y ago
    It's true that some of the commentary is specific to the full body MRI itself (such as misdiagnosis due to an imaging artifact), however many of the claims in the video are very general. And the scientific study they referenced at 6:30 has nothing to do with fully body MRIs. The study is in regards to thyroid cancer overdiagnosis due to screening (using ultrasound and not MRI). This is clearly a statement regarding the effectiveness of screening. And, yes, it is specific to the cancer. I'm not saying anything that the studies aren't saying. For some kinds of cancers and for some kinds of screening methods, screening can result in overdiagnosis.
    - ceejayoz 2y ago
      OK, so you had to watch a little more than ten seconds. There's no doubt that some diagnostic tests - like getting a full-body MRI as a precaution - may do more harm than good. Your apparent mistake is thinking that means all diagnostic tests probaby do. We'll have to figure out which one this is; it's a start of that process. We've demonstrated we can do it; now we have to figure out if we can distinguish between "big bad scary" cancer and "whatever it won't kill you" cancer.
    - epistasis 2y ago
      At 6:30 it's about a specific test for thyroid cancer, which as discussed in my second paragraph, was not found to actually improve outcomes for that specific type of cancer, not cancer in general. However, early detection is responsible for greatly improving outcomes in many specific cancers. Full body MRI is not the test to achieve that. GRAIL's gallery test might be one to do it for many classes of cancer, but that still remains to be fully seen. The general of idea of early detection is still an extremely promising one for most types of cancer, and in particular for some of the deadliest, like ovarian and pancreatic cancer.

zero-sharp 2y ago

They specifically talk about using the fully body MRI for the purpose of detecting cancers. I'm not sure how you missed that. You literally had to watch 10 seconds of the clip. It's interesting because they explicitly talk about follow up testing (@2:10) which is to say that multiple methods are used if the MRI indicates a problem. So yes, the initial MRI may produce a misdiagnosis and that is a defect of the test. But the commentary in the video obviously suggests that additional testing for early detection is done. That's partly a problem as you pointed out, but then it clearly also indicates the scope of the conversation is more broad.

ceejayoz 2y ago
They didn't miss it at all. You've misunderstood the comment's point, which is "just because prospective full-body MRI is bad doesn't mean all diagnostics are".
- zero-sharp 2y ago
  It's true that some of the commentary is specific to the full body MRI itself (such as misdiagnosis due to an imaging artifact), however many of the claims in the video are very general. And the scientific study they referenced at 6:30 has nothing to do with fully body MRIs. The study is in regards to thyroid cancer overdiagnosis due to screening (using ultrasound and not MRI). This is clearly a statement regarding the effectiveness of screening. And, yes, it is specific to the cancer. I'm not saying anything that the studies aren't saying. For some kinds of cancers and for some kinds of screening methods, screening can result in overdiagnosis.
  - ceejayoz 2y ago
    OK, so you had to watch a little more than ten seconds. There's no doubt that some diagnostic tests - like getting a full-body MRI as a precaution - may do more harm than good. Your apparent mistake is thinking that means all diagnostic tests probaby do. We'll have to figure out which one this is; it's a start of that process. We've demonstrated we can do it; now we have to figure out if we can distinguish between "big bad scary" cancer and "whatever it won't kill you" cancer.
  - epistasis 2y ago
    At 6:30 it's about a specific test for thyroid cancer, which as discussed in my second paragraph, was not found to actually improve outcomes for that specific type of cancer, not cancer in general. However, early detection is responsible for greatly improving outcomes in many specific cancers. Full body MRI is not the test to achieve that. GRAIL's gallery test might be one to do it for many classes of cancer, but that still remains to be fully seen. The general of idea of early detection is still an extremely promising one for most types of cancer, and in particular for some of the deadliest, like ovarian and pancreatic cancer.