4 ms·

I could dump loads of academic research on you about this topic, but it seems like you’re unwilling to engage.

by ch4s3 9mo ago

cyberax 9mo ago
I read most of the research on this topic. And it's all basically "overdiagnosing". We had the same story about prostate cancer screening: "overdiagnosing", "people die with prostate cancer but not of prostate cancer", blah blah blah. It turned out that simply adjusting the aggressiveness of follow-up was enough to make prostate cancer result in significantly fewer deaths. From my point of view: MRI is the ONLY tool that can catch things like pancreatic cancer before it's lethal.
- ch4s3 9mo ago
  Sure but you have to scale that prostate intervention change across literally everything in every kind of internal medicine. There's just no way to justify the cost of doing this regularly for most people.
  - cyberax 9mo ago
    Just imagine the same argument, but for bloodwork. You're literally saying: "We didn't have to deal with these pesky MRIs before, so go away". We will need some additional radiologist training, and the primary care doctors will need to learn when to escalate and/or require followup scans. But that's really about it. MRIs are _cheap_ these days. The true cost of a scan is around $1000, including the radiologist's reading. They don't have to be reserved as a tool of the last resort.
    - ch4s3 9mo ago
      I can make the same argument. Functional “medicine” quacks order loads of unnecessary blood tests with no diagnostic power to sell you supplements. I actually know someone who was was injured by one of those “supplements” after such a blood test. No I’m saying for most people there’s more noise than signal and iatrogenesis is real. Pretending it’s not is foolish.
      - cyberax 9mo ago
        To put it in perspective, the real worry about MRIs is that people would want to do biopsies or a PET scan if they find something that looks like cancer. That's really the main concern. And we can fix that by doing a follow-up scan several months later to look for any changes. It also has a nice side-effect of reassuring hypochondriacs that they _don't_ have cancer.

I could dump loads of academic research on you about this topic, but it seems like you’re unwilling to engage.

by ch4s3 9mo ago

I could dump loads of academic research on you about this topic, but it seems like you’re unwilling to engage.

I read most of the research on this topic. And it's all basically "overdiagnosing". We had the same story about prostate cancer screening: "overdiagnosing", "people die with prostate cancer but not of prostate cancer", blah blah blah. It turned out that simply adjusting the aggressiveness of follow-up was enough to make prostate cancer result in significantly fewer deaths. From my point of view: MRI is the ONLY tool that can catch things like pancreatic cancer before it's lethal.

ch4s3 9mo ago
Sure but you have to scale that prostate intervention change across literally everything in every kind of internal medicine. There's just no way to justify the cost of doing this regularly for most people.
- cyberax 9mo ago
  Just imagine the same argument, but for bloodwork. You're literally saying: "We didn't have to deal with these pesky MRIs before, so go away". We will need some additional radiologist training, and the primary care doctors will need to learn when to escalate and/or require followup scans. But that's really about it. MRIs are _cheap_ these days. The true cost of a scan is around $1000, including the radiologist's reading. They don't have to be reserved as a tool of the last resort.
  - ch4s3 9mo ago
    I can make the same argument. Functional “medicine” quacks order loads of unnecessary blood tests with no diagnostic power to sell you supplements. I actually know someone who was was injured by one of those “supplements” after such a blood test. No I’m saying for most people there’s more noise than signal and iatrogenesis is real. Pretending it’s not is foolish.
    - cyberax 9mo ago
      To put it in perspective, the real worry about MRIs is that people would want to do biopsies or a PET scan if they find something that looks like cancer. That's really the main concern. And we can fix that by doing a follow-up scan several months later to look for any changes. It also has a nice side-effect of reassuring hypochondriacs that they _don't_ have cancer.