6 ms·
If 99% of adults have an abnormality, it ceases to be abnormal regardless of its effects
by mghackerlady 8mo ago
If 99% of adults have an abnormality, it ceases to be abnormal regardless of its effects
- deleted 8mo ago[deleted]
- francisofascii 8mo agoonly if the abnormality is in the same spot
- ASalazarMX 8mo ago"1% of adults over 40 have abnormally normal shoulders" But seriously, the article addressed that > The authors argue that the findings suggest clinicians should rethink MRI findings, changing not just how they’re used, but also how they’re explained to patients. The language in particular should change given that “abnormalities” are ubiquitous—thus normal—and shouldn’t be described in terms that indicate a need for repair, like “tear.”
- Insanity 8mo agoThat's actually what the article points out. But I do think the language of normal vs abnormal obfuscates some of the intent. It's a 'deviation from healthy baseline' that they're talking about, and there are multiple such deviations in the grouped 'anomalies'. From the article: The language in particular should change given that “abnormalities” are ubiquitous—thus normal—and shouldn’t be described in terms that indicate a need for repair, like “tear.”
- brandall10 8mo agoRight, it's clearly aging related deterioration. It's like saying facial wrinkles are an abnormality.
- cies 8mo agoDunno man. When enough people overweight, 1-2 alcoholic drink become healthy (alcohol is a blood thinner): this happened, but as we know now it's not true.
- Qem 8mo ago> alcohol is a blood thinner Source?
- hinkley 8mo agoAlcohol reduces clotting factors in the blood. This is known. Doctors mostly tell you not to drink because it’ll fuck with the anesthesia math and bad anesthesia doses can kill you just as dead as a surgical mistake and probably moreso. But it’ll also make you bleed more. If you need courage to show up to surgery they’ll give you a prescription for a single dose of a benzo. Which is better than liquid courage anyway.
- thomasfedb 8mo agoA patient being drunk wouldn’t make it any harder for me to anaesthetise them. But if they’re drunk they wouldn’t legally be able to confirm they consent to the anaesthetic immediately prior.
- hinkley 8mo agoGiven the multiplicative effect of sedatives and depressants, do you have to factor in inebriation, for instance for a DUI in the ER? Or are the safety margins sufficient?
- devilbunny 8mo agoGenerally additive, not multiplicative, and we are used to it. “Titrate to effect” is pretty standard in anesthesia, and we are watching you far more closely than average. Continuous monitoring of oxygenation, breathing, and cardiac rhythm, with no more than 5 minutes between blood pressure readings.
- mothballed 8mo agoCan you not consent to have something done to you while drunk, while you're sober beforehand? I mean you can sign beforehand to have surgery performed while you're knocked out, that's a bit more inebriated than most sorts of drunk.
- diydsp 8mo agoYes in one sense, but it also points to the insufficency of "normalness". See also: The Average Soldier.
- hinkley 8mo agoThere’s a famous case study in design about the Average Pilot - they were making airplanes than nobody could fly well because nobody was average enough in all physical dimensions to be comfortable in the aircraft. They had to design for ranges that the equipment could adjust through. Even then when I was a kid I knew a guy who wanted to join the air force and he had a growth spurt that made him too tall.
- alistairSH 8mo agoMore of the history of "avenge pilots" here: https://99percentinvisible.org/episode/on-average/ https://99percentinvisible.org/episode/on-average/
- hinkley 8mo ago> Daniels realized that none of the pilots he measured was average on all ten dimensions. Not a single one. When he looked at just three dimensions, less than five percent were average. Daniels realized that by designing something for an average pilot, it was literally designed to fit nobody.
- amelius 8mo ago99% of adults have abnormal faces, they all look different!
- leni536 8mo agoExcept that one guy.
- newsclues 8mo agoEveryone is abnormal compared to yourself.
- pinkmuffinere 8mo agoDude I know exactly who you're talking about, that guy without a unique face! Weird as hell that he's the only one...
- mghackerlady 8mo agoOk, in that case it's safe to say that the normal is highly variant but generally follows a pattern. People generally have a nose in the center of their face so that'd be normal, but one on the forehead would be abnormal unless everyone suddenly also had forehead noses
- iso1631 8mo agoRelevant history from the US Airforce in the 1940s when they tried to build a cockpit for the average pilot and failed I find this an interesting take on the story https://polkas.github.io/posts/cursedim/ https://polkas.github.io/posts/cursedim/
- deleted 8mo ago[deleted]
- amelius 8mo agoThis is also a good argument why "opinionated" designs like from Apple are a bad idea. The average user does not exist. Stop trying to turn us into one!
- deleted 8mo ago[deleted]
- deleted 8mo ago[deleted]
- dijit 8mo agoI think the conclusion they're eluding to in the article is that: "if MRI says 99% of people have abnormalities, MRI is not trustworthy".
- CGMthrowaway 8mo agoAbnominal (not abdominal)
- kingkawn 8mo agoNot if they are all different and produce negative effects
- crazygringo 8mo agoOn the one hand, that's the point of the article. That it ceases to be a useful diagnostic indicator. On the other hand, if there are 100 places in the shoulder where you can have an abnormality, and most people have just one or a couple but the other 98-99 are normal, then each one individually really is abnormal. So it's complicated, and then it becomes important to figure out which abnormalities are medically relevant, in which combinations, etc.
- ratelimitsteve 8mo agoif they all have the same abnormality yeah but if they all have different abnormalities then they're still abnormalities.
- kstrauser 8mo agoI went to a doctor for something unrelated and ended up getting an MRI that happened to show my upper spine. The neurologist read it and determined that I have a Chiari I malformation[0]. I have no symptoms from this whatsoever. I never have. It's unlikely that I ever will. If it weren't for the MRI, I'd never have known. Doctors use to think that the degree of it that I have meant I'd have problems with it. After all, people who came in with the symptoms and then had an MRI or CT scan tended to show that level of herniation. Thus, it was assumed, that level of herniation was considered a diagnostic indicator. And then MRIs became cheaper and more accessible, and patients had them for all sorts of other reasons — like I did. Doctors discovered that the degree of "malformation" I have is very common among asymptomatic adults. In fact, you're many times more likely to be perfect fine with it than to experience symptoms. Well, huh. That doesn't sound like much of a malformation anymore. Or at least, by itself it doesn't mean anything, other than that perhaps you're more likely to have problems than otherwise. On its own? It's more of a normal variation. [0] https://en.wikipedia.org/wiki/Chiari_malformation https://en.wikipedia.org/wiki/Chiari_malformation
- oarfish 8mo agoThis is well known for spine issues in general: MRI is super unspecific, and the older you get, the more interesting things you can find on the scans. Even if you're fully asymptomatic. So such findings are now better reframed as age-related changed rather than pathologies. The fact that every radiologist will highlight different things also doesn't help. This is in fact one reason why you don't want an MRI if the outcome does not change what you do (i.e. sports related injuries or non specific low back pain). You will just nocebo yourself into thinking you have problems that are not real, because the belief in the answer donut is so strong.
- kstrauser 8mo agoThat makes perfect sense to me. One nit: this happened to me maybe 20 years ago. It wasn’t even an age-related change. I think it was more like a changing idea of the range of normal human anatomy.
- nonameiguess 8mo agoIt's a poor term but it's talking about a healthy baseline for any human as far as I'm aware. It's not adjusted for expected deterioration due to age. 100% of organs eventually fail if given enough time, but it's still fine to call the resulting failed organ a defect. Presumably, some of this is just it's pretty damn inevitable you're going to accumulate at least some level of detectable injury that doesn't completely heal over the course of 40 years. I needed shoulder reconstruction because I fell off a skateboard trying to bomb a hill a year and a half ago and it's healed to the point there isn't any functional impairment, but given there's metal in there now, it's obviously going to look abnormal on an image. There's just an impedance mismatch here between what imaging finds and what people actually care about. Any detectable deviation from expected tissue configuration is going to show up and get reported, but there is no reason for a patient to give a shit. Functional impairment and/or pain is what they care about, though those are both also universal if you live long enough. No 90 year-old walks without a limp but it's still completely fair to call a limp an "abnormal" gait.
- pengaru 8mo agoIf you ignore the time dimension, sure. But if 99% of adults today have an abnormality that 99% of adults historically didn't, it's abnormal.
- NedF 8mo ago[dead]
- keeganpoppen 8mo agono it doesn’t. not at all. “abnormality” is a measure vs. the median… what else could “abnormal” possibly even mean? how could anyone ever be abnormal in any way otherwise, given the number of possible avenues of abnormality in the universe? this logic can only even “play ball” with a singular “is this person abnormal or not?” boolean… if there existed even two axes of abnormality then by your folksy definition it cannot actually exist. QED.
- deleted 8mo ago[deleted]
- hnkgnn 8mo agoaverage ≠ normal
- ahartmetz 8mo ago1% are suffering from a normality ;)
- pibaker 8mo agoA majority of humans will eventually contract the herpes virus sooner or later and they will stay infected until they die. Does this make herpes normal? Maybe. Does this make herpes something we should stop worrying about? Probably not.
- Braxton1980 8mo agoIf a town existed where 80% of the population had their arm become infected and fall off would you consider it normal ? You're treating it like a behavior where normal is defined by the majority. Human anatomy and function is what you should compare to