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I'm surprised there are three responses to this comment, all starting with the word "no". I'm not arguing for scanning irrespective of the cost. I'm saying that

by sskates 14y ago

I'm surprised there are three responses to this comment, all starting with the word "no". I'm not arguing for scanning irrespective of the cost. I'm saying that if the cost were 0 then you should always scan. More information should always lead to better decisions and better outcomes. If it's the case that more information leads to worse decisions then it's indicative of a problem in your rule set, not a problem with your information. Imagine if taking someone's blood pressure was a multi-thousand dollar test that required specialized expertise to interpret, and could easily lead to misdiagnoses of heart problems. Now imagine that we just got the technology to do it cheaply and easily. It wouldn't make anyway sense to be afraid of testing blood pressure- it's just more information that can lead to a more complete picture of a patient's condition. But that's exactly what my sibling comments are arguing for now with MRI scans. Also see number 7 in a list of ambitious startup ideas: http://paulgraham.com/ambitious.html http://paulgraham.com/ambitious.html

aidenn0 14y ago
The parent post wasn't some theoretical awesome scan with no false-positives; it was specifically whole-body MRI. Even if you could do a whole-body MRI scan for say a nickel, and have automated software mark all new tumors, more people would die sooner than if you hadn't done this. Once you find a tumor you need to biopsy it before you can treat it. There is a small, but non-zero, chance of death from a biopsy. The number of tumors that won't kill you right away is so much greater than the number of tumors that will kill you right away, that this small chance of death multiplied by the large number of people with non-threatening tumors is a larger number than the small number of people with highly malignant tumors.
- sskates 14y ago
  So then it's a problem with the rule set- you shouldn't automatically biopsy every tumor. It's doesn't make sense that there's a rule in place (you must biopsy every tumor) such that people are afraid of getting more information because it will lead them to make worse decisions. More information should always lead to better decisions and better outcomes. Why are we forced to biopsy every tumor, even in the case where you agree it's suboptimal? Imagine if every time someone had really high blood pressure, we had a rule to perform bypass surgery. People would then avoid taking blood pressure because it might lead to surgery. That doesn't make sense- knowing someone's blood pressure isn't the problem, the problem is our suboptimal rule.
  - aidenn0 14y ago
    Well if a doctor finds a tumor, doesn't biopsy and the person dies, the doctor gets sued for huge sums of money.
    - sskates 14y ago
      Ah, so now we uncover the real problem- our legal system. I have to admit that that's a real shame. I hope cheap diagnostics become common place over the next twenty years so at least some countries can start taking advantage of more information to improve patient outcomes.
      - aidenn0 14y ago
        It's not a problem with the legal system, it's a problem with human nature. It is easier to blame someone for doing nothing, then to blame someone who does something and fails.
      - aidenn0 14y ago
        It's not a problem with the legal system, it's a problem with human nature. It is easier to blame someone for doing nothing, then to blame someone who does something and fails.

by sskates 14y ago

aidenn0 14y ago

The parent post wasn't some theoretical awesome scan with no false-positives; it was specifically whole-body MRI. Even if you could do a whole-body MRI scan for say a nickel, and have automated software mark all new tumors, more people would die sooner than if you hadn't done this. Once you find a tumor you need to biopsy it before you can treat it. There is a small, but non-zero, chance of death from a biopsy. The number of tumors that won't kill you right away is so much greater than the number of tumors that will kill you right away, that this small chance of death multiplied by the large number of people with non-threatening tumors is a larger number than the small number of people with highly malignant tumors.

sskates 14y ago
So then it's a problem with the rule set- you shouldn't automatically biopsy every tumor. It's doesn't make sense that there's a rule in place (you must biopsy every tumor) such that people are afraid of getting more information because it will lead them to make worse decisions. More information should always lead to better decisions and better outcomes. Why are we forced to biopsy every tumor, even in the case where you agree it's suboptimal? Imagine if every time someone had really high blood pressure, we had a rule to perform bypass surgery. People would then avoid taking blood pressure because it might lead to surgery. That doesn't make sense- knowing someone's blood pressure isn't the problem, the problem is our suboptimal rule.
- aidenn0 14y ago
  Well if a doctor finds a tumor, doesn't biopsy and the person dies, the doctor gets sued for huge sums of money.
  - sskates 14y ago
    Ah, so now we uncover the real problem- our legal system. I have to admit that that's a real shame. I hope cheap diagnostics become common place over the next twenty years so at least some countries can start taking advantage of more information to improve patient outcomes.
    - aidenn0 14y ago
      It's not a problem with the legal system, it's a problem with human nature. It is easier to blame someone for doing nothing, then to blame someone who does something and fails.
    - aidenn0 14y ago
      It's not a problem with the legal system, it's a problem with human nature. It is easier to blame someone for doing nothing, then to blame someone who does something and fails.