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Brain biopsies on 'vulnerable' patients at Mt Sinai set off alarm bells at FDA
- coffeebeqn 2y agoSounds like a minor lobotomy
- escapecharacter 2y agoas a treat
- thiagoeh 2y agonot my area of experise, but I wouldn't call 2 pieces of up to 1 cubic centimeter "minor". Looks significant to me
- deleted 2y ago[deleted]
- jonnycomputer 2y agoApparently the IRB approval was for up to 1 cubic cm, but according to Mt. Sinai, the average actually obtained is 0.04cc, far less.
- GrantMoyer 2y agoNote that 0.04 cm³ is the volume of a cube with side length ≈ 0.34 cm, so in the way we usually think of scale, the average was about ⅓ of the approved maximum.
- jonnycomputer 2y agoYes, but its about 4% of the total maximum volume, not a third. Its just that the "sides" of the cube are about a third of the maximum. Like, if it had a constant density, it'd be 4% of the mass of the maximum, not a third.
- ars 2y agoAccording to the article the amount of brain tissue lost is the same either way. With this study they cut it out, remove, and study it, without the study they burn it away. If that's really the case, then this seems like a non story to me.
- jonnycomputer 2y agoI hate to ask this, but anyone have a non-paywalled link?
- deleted 2y ago[deleted]
- mikestew 2y agoNo offense intended, but you've been hanging out on HN for seven years and haven't figured out archive.ph? Where did you think those links come from? :-) https://archive.ph/1bwiw https://archive.ph/1bwiw
- dodox 2y agoArchive.ph has the paywalled version.
- onemoresoop 2y agoThis archived content cuts off exactly where the paywalled article does.
- advisedwang 2y agoNo offense intended, but did you look at the archive link you posted? It has the same paywall.
- hammock 2y agoThe researchers claimed the biopsies were low-risk, but the FDA found this was a "false justification" to obtain patient consent. Super important that doctors discuss the risks, even the rare ones, when severe, with patients before doing a procedure/jabbing them with something/putting them on a pharmaceutical
- gumby 2y agoIt's hard for people to evaluate risk. This morning my gf said she was "living in dread" of an upcoming procedure: 80% chance of success, almost 20% chance of doing nothing, <1% chance of things going very wrong. She's in a lot of pain so elected to do it. Her worry is affecting her sleep. This is despite the fact that her PhD was extremely statistics-heavy, and she still does statistical analysis in her job, not every day, but more than once a week. Admittedly she's not a medical statistician, but I don't think that should matter.
- kevinventullo 2y agoI mean how much < 1%? If it’s a 1 in 200 chance of things go south, I can sympathize with losing sleep over it. 1 in 100k, maybe not so much.
- uniqueuid 2y agoA big part of the problem is that as patients, we observe single discrete outcomes. For doctors an aggregate 1% chance is low, but the realization of the outcome in a single person is not a percentage, its binary bad side effects or not. Admittedly, doctors could usually do better in communicating risks (e.g. see the famous example of 1/3 risk of impotence, which patients interpret either as 1 out of 3 people, 1 out of 3 times having sex, or 1/3 of the time of sex).
- JohnFen 2y ago> For doctors an aggregate 1% chance is low Anybody who has played much D&D knows that a 1% chance isn't as low as it sounds.
- felipellrocha 2y agoH... House...? Is that you?
- deleted 2y ago[deleted]
- mistercheph 2y agoWe will look on the notions and practices of medical care in the present with as much mirth as the bloodletters, plague doctors, and humor examiners of the past have provided us.
- pakitan 2y agoYes, and future spaceships will travel 100x times the speed of light.
- snapcaster 2y agoYou really think we're up against fundamental limits of medicine? I'm struggling to understand your meaning here
- pakitan 2y agoI'm just making fun of the certainty with which the poster assumes that just because we had humongous progress in all areas of knowledge for the last 100 years, it's somehow guaranteed that the progress will continue at the same rate. Fundamental limits or not, we've already picked the lowest hanging fruit and further progress is painfully incremental, slow and expensive and Star Trek-like devices seem extremely unlikely.
- sfink 2y agoI think you're reading it backwards. If you look closely at how medicine is done today, you will see that there are many areas where it is wildly divorced from reality. So, the point was not "we'll be vastly better soon", it's more "we're in a bad place now". The current most wildly successful, heavily prescribed medicines today are statins. They help 1 in 104 people in terms of preventing heart attacks, 1 in 154 people in terms of preventing stroke. (Those are people without known heart disease, but they are the vast majority of people taking statins.) They harm 1 in 10 by causing muscle damage, 1 in 50 by causing diabetes. [1] That's the success story. (Sure, you can debate the details. Do they really cause diabetes? Unclear. Do they help anyone, ever, to not die sooner? Unclear.) It seems like the main reason they're considered so successful is that they do indeed lower an intermediate metric, namely blood cholesterol level. I am sure that bloodletting was successful at removing blood, and if you have an infection, you could even say at removing bad blood. And yes, I'm cherrypicking my definition of success. Modern medicine can indeed dramatically improve outcomes for a large set of problems (eg cancer). But doctors were successfully setting bones back in the bloodletting days, too. [1] https://thennt.com/nnt/statins-for-heart-disease-prevention-without-prior-heart-disease-2/ https://thennt.com/nnt/statins-for-heart-disease-prevention-...
- jonnycomputer 2y agoWithout being able to see through the paywall, its hard to know whether the "false justification" was a technicality or something serious and nefarious.
- derbOac 2y agoThe latter.
- jonnycomputer 2y agoI presume that you've read the article since your response is confident. Care to share details?
- moffkalast 2y ago> at a Mount Sinai medical facility in midtown Manhattan Not the actual mountain mind you, there you'd probably be diagnosed with an acute case of Shahed drone instead.
- selimthegrim 2y agoIn case you haven’t noticed Egypt and Iran haven’t been best buddies since approximately the Fatimid dynasty (and Iran wasn’t even Shiite then). You have to go back even further to find the last time Persia ruled Egypt
- moffkalast 2y agoI was thinking more about stray hits flying over in Israel's general direction since it's close by, but you do make a good point. They could just shoot at Egypt directly.
- selimthegrim 2y agoThere is or was a US run missile observation station in the Negev near Gaza but Iran’s not that stupid
- mkmk 2y agoSince this is so effectively paywalled, it's probably worthwhile to note that much of the story explained here in this tweet thread: https://twitter.com/KatherineEban/status/1785740414420422819 https://twitter.com/KatherineEban/status/1785740414420422819
- justinclift 2y agoThat just gives an error when I try to visit it: Something went wrong, but don’t fret — let’s give it another shot. Repeatedly, never loading the expected content.
- itscrush 2y agohttps://threadreaderapp.com/thread/1785740414420422819.html https://threadreaderapp.com/thread/1785740414420422819.html appeared to work for me
- mewse-hn 2y agoI don't have a twitter account but was able to read the thread here: https://threadreaderapp.com/thread/1785740414420422819.html https://threadreaderapp.com/thread/1785740414420422819.html
- justinclift 2y agoThanks, that worked. :)
- ineedaj0b 2y agoworks for me!
- angoragoats 2y agoFYI, this is just as useless as the original article for those without a Twitter account.
- elzbardico 2y agoPaywalled article not accessible through archive.
- tapper 2y agoI hate paywalls!
- LeroyRaz 2y agoIs there a non-paywalled version of this article?