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But isn't this an opportunity to have a "pre-test" and the doctor can say "ok, you had this result from an unverified lab, let's do a more thorough test and see

But isn't this an opportunity to have a "pre-test" and the doctor can say "ok, you had this result from an unverified lab, let's do a more thorough test and see what we find". The public need to be educated that these tests are a lower cost "pre-test". In Australia, we are given an FIT test for colon cancer when we turn 50. This test is 79% accurate. This is a simple at home test, no doctors involved, just mail in your sample, get a result, and then if the result is positive, go to a doctor for follow-up.

quantumwoke 2y ago
These types of services are incentivised to over test and you may find many spurious results when you over test. Look up the term "incidentaloma". If you have to get a real doctor to interpret and re order these tests, you are contributing to the burden of the system rather than a "pre test". The specific example you mention is apples and oranges, since the FIT test is a specific validated screening test provided by government rather than a profit driven private lab. There is evidence it's not even that helpful as a screening test.
Zenzero 2y ago
> But isn't this an opportunity to have a "pre-test We call these screening tests. > doctor can say "ok, you had this result from an unverified lab, let's do a more thorough test and see what we find" The more likely scenario is that this is the 10th patient this week presenting for suspected cancer based on an at home administration kit with a low specificity (under ideal conditions), and it turns out it's not. Conducting such tests indiscriminately (voluntary and self administered) is going to waste a ton of doctor time that we don't have. > The public need to be educated that these tests are a lower cost "pre-test" Anything that requires education of the public about anything is unfortunately a losing battle. > we are given an FIT test for colon cancer when we turn 50. This test is 79% accurate. This is a simple at home test, no doctors involved This can work with a structured protocol. The problem is that at least in the US, we will have direct to consumer labs chasing next quarter's revenue numbers, so everyone will be shown commercials and be grabbing them off of shelves to avoid seeing expensive doctors that they don't trust. It's a recipe for a lot of unnecessary anxiety and time wasted.

quantumwoke 2y ago

These types of services are incentivised to over test and you may find many spurious results when you over test. Look up the term "incidentaloma". If you have to get a real doctor to interpret and re order these tests, you are contributing to the burden of the system rather than a "pre test". The specific example you mention is apples and oranges, since the FIT test is a specific validated screening test provided by government rather than a profit driven private lab. There is evidence it's not even that helpful as a screening test.

Zenzero 2y ago

> But isn't this an opportunity to have a "pre-test We call these screening tests. > doctor can say "ok, you had this result from an unverified lab, let's do a more thorough test and see what we find" The more likely scenario is that this is the 10th patient this week presenting for suspected cancer based on an at home administration kit with a low specificity (under ideal conditions), and it turns out it's not. Conducting such tests indiscriminately (voluntary and self administered) is going to waste a ton of doctor time that we don't have. > The public need to be educated that these tests are a lower cost "pre-test" Anything that requires education of the public about anything is unfortunately a losing battle. > we are given an FIT test for colon cancer when we turn 50. This test is 79% accurate. This is a simple at home test, no doctors involved This can work with a structured protocol. The problem is that at least in the US, we will have direct to consumer labs chasing next quarter's revenue numbers, so everyone will be shown commercials and be grabbing them off of shelves to avoid seeing expensive doctors that they don't trust. It's a recipe for a lot of unnecessary anxiety and time wasted.