3 ms·

false positives are a real problem

by kilbuz 4mo ago

adastra22 4mo ago
Only if you let them. The false positive thing is a nonissue that only arises from assuming you would respond to information a certain way.
- deleted 4mo ago
  [deleted]
- Forgeties79 4mo ago
  I don't really get what this means. A false positive causes issues inherently - you don't know if it's right or wrong. It's noise which is bad for care, and it's anxiety-inducing for patients which is also bad. It produces worse outcomes for everyone. There isn't a "choice" or assumption here, you respond to a positive as if it's accurate until you know it isn't. This is a known issue. Hell Scrubs did an episode about the negative impact of full, generalized body scans on a patient's wellbeing decades ago.
  - adastra22 4mo ago
    The medical industry should NOT be paternalistic towards patients. People have a right to decide for themselves and be treated as adults capable of informed consent. Thankfully that model is starting to change, although there is much inertia. Any test that is approved for use would have a better-than-random outcome distribution. Preconditioned on that, a test result is still useful no matter how uncertain. It is never the case that more information leaves you in a worse position. I have personal experience here: Every year I have elected to have ultrasounds done of my major internal organs. In the past two visits, the technicians spotted multiple developing growths in my liver and now kidneys. These are very likely to be benign cysts, but one piece of blood work that could be a marker for cancer is inconclusive. The odds are still high that this is totally benign and will either clear up on its own, or at least stop growing and cause no further issue. Still: 1. I'm getting my blood work done now far more frequently (twice per year instead of every other year), with specialized/not typically ordered screening tests; 2. I am redoing the ultrasound every year to track progress; and 3. I am actually taking advice about losing weight and exercise far more seriously than I otherwise would, as these issues often resolve with weight loss. I am actually healthier now than I was two years ago, and feel better about my physical and mental well-being. All while staying on top of what could have be a life threatening issue if left untreated and ignored. I look forward to the day when I can go get a monthly MRI-like scan. That would be wonderful.
    - Forgeties79 4mo ago
      Well now we’re going down a different path. Telling people to go burn through mountains of cash to get tests they don’t need is not ethical.
      - adastra22 4mo ago
        Costs me less than $1000 so far…
        Forgeties79 4mo ago
        Almost half of the US population doesn’t even have $1000 saved away nor do they have insurance that covers these tests. It’ll be far more expensive unless insurance deems it necessary, which none of what you’re suggesting would be by definition.
  - simianwords 4mo ago
    > I don't really get what this means. A false positive causes issues inherently - you don't know if it's right or wrong. It's noise which is bad for care, and it's anxiety-inducing for patients which is also bad. No its not. This is extremely paternalistic. Humans know how to understand noise and statistics. You don't get to decide that for me. I want more lives saved with more information.
    - Forgeties79 4mo ago
      It’s not paternalistic. It’s reality. Most people are not equipped to vet all the medical information that comes their way. That’s why we should talk to our doctors about results. I don’t think my mechanic is being paternalistic when he talks through my car and what is/isn’t important. I like that helps me prioritize things. Why is this any different? In the end a person can tell a doctor “I don’t care run the test” or whatever so what’s the big deal? You can still do what you want. Get that biopsy if you need the peace of mind.
      - simianwords 4mo ago
        I agree but do you want your mechanic to hide information from you for any reason? For instance, that information can have false positives. Like, your mechanic hides the fact that your engine may be broken but he's just 70% sure of it. Since he's not 99% sure, he hides it from you. Do you think its a good thing to do?
- jibal 4mo ago
  That makes no sense at all, unless you're saying that people should respond to all such information by ignoring it.
  - reverius42 4mo ago
    In which case, why bother getting the information in the first place?
  - Sankozi 4mo ago
    There is a lot of space between ignoring and doing invasive dangerous operation after some blot was spotted on some imaging diagnosis.
  - adastra22 4mo ago
    You could repeat the test, perhaps on a more frequent interval to keep an eye on it. You could follow up with a more specific test, or do confirming blood work. In the meantime you can adjust your diet as a precaution, or get motivated to get in shape just in case. There's plenty of room between "go under the knife" and "ignore altogether."
    - tgsovlerkhgsel 4mo ago
      Or only consider it a positive once the confidence is high enough that false positives are not a problem anymore. Getting a test good enough to still make it useful (detect enough of the true positives) would of course be a challenge, but the more data is available, the more feasible that might be.
  - simianwords 4mo ago
    yeah? give adequate accurate information to people and let them decide what to do with the information. if someone told you, you had a .01% chance of getting a disease for example, aren't you better off with that information? even if it is noisy?
  - jibal 4mo ago
    P.S. The responses ignore what I actually responded to, which was a claim that "The false positive thing is a nonissue" -- where the "thing" is 99% false positives. The only way to respond to information such that "the false positive thing" becomes "a nonissue" is to never respond to it at all. The responses to my comment all address some strawman.
simianwords 4mo ago
??? how is more information worse than less? if you know the extent of false positives -- use it! its better than having no information. the question should be: does cost of obtaining extra information pay off in lives saved. i would say yeah obviously.

false positives are a real problem

by kilbuz 4mo ago

false positives are a real problem

Only if you let them. The false positive thing is a nonissue that only arises from assuming you would respond to information a certain way.

deleted 4mo ago
[deleted]
Forgeties79 4mo ago
I don't really get what this means. A false positive causes issues inherently - you don't know if it's right or wrong. It's noise which is bad for care, and it's anxiety-inducing for patients which is also bad. It produces worse outcomes for everyone. There isn't a "choice" or assumption here, you respond to a positive as if it's accurate until you know it isn't. This is a known issue. Hell Scrubs did an episode about the negative impact of full, generalized body scans on a patient's wellbeing decades ago.
- adastra22 4mo ago
  The medical industry should NOT be paternalistic towards patients. People have a right to decide for themselves and be treated as adults capable of informed consent. Thankfully that model is starting to change, although there is much inertia. Any test that is approved for use would have a better-than-random outcome distribution. Preconditioned on that, a test result is still useful no matter how uncertain. It is never the case that more information leaves you in a worse position. I have personal experience here: Every year I have elected to have ultrasounds done of my major internal organs. In the past two visits, the technicians spotted multiple developing growths in my liver and now kidneys. These are very likely to be benign cysts, but one piece of blood work that could be a marker for cancer is inconclusive. The odds are still high that this is totally benign and will either clear up on its own, or at least stop growing and cause no further issue. Still: 1. I'm getting my blood work done now far more frequently (twice per year instead of every other year), with specialized/not typically ordered screening tests; 2. I am redoing the ultrasound every year to track progress; and 3. I am actually taking advice about losing weight and exercise far more seriously than I otherwise would, as these issues often resolve with weight loss. I am actually healthier now than I was two years ago, and feel better about my physical and mental well-being. All while staying on top of what could have be a life threatening issue if left untreated and ignored. I look forward to the day when I can go get a monthly MRI-like scan. That would be wonderful.
  - Forgeties79 4mo ago
    Well now we’re going down a different path. Telling people to go burn through mountains of cash to get tests they don’t need is not ethical.
    - adastra22 4mo ago
      Costs me less than $1000 so far…
      - Forgeties79 4mo ago
        Almost half of the US population doesn’t even have $1000 saved away nor do they have insurance that covers these tests. It’ll be far more expensive unless insurance deems it necessary, which none of what you’re suggesting would be by definition.
- simianwords 4mo ago
  > I don't really get what this means. A false positive causes issues inherently - you don't know if it's right or wrong. It's noise which is bad for care, and it's anxiety-inducing for patients which is also bad. No its not. This is extremely paternalistic. Humans know how to understand noise and statistics. You don't get to decide that for me. I want more lives saved with more information.
  - Forgeties79 4mo ago
    It’s not paternalistic. It’s reality. Most people are not equipped to vet all the medical information that comes their way. That’s why we should talk to our doctors about results. I don’t think my mechanic is being paternalistic when he talks through my car and what is/isn’t important. I like that helps me prioritize things. Why is this any different? In the end a person can tell a doctor “I don’t care run the test” or whatever so what’s the big deal? You can still do what you want. Get that biopsy if you need the peace of mind.
    - simianwords 4mo ago
      I agree but do you want your mechanic to hide information from you for any reason? For instance, that information can have false positives. Like, your mechanic hides the fact that your engine may be broken but he's just 70% sure of it. Since he's not 99% sure, he hides it from you. Do you think its a good thing to do?
jibal 4mo ago
That makes no sense at all, unless you're saying that people should respond to all such information by ignoring it.
- reverius42 4mo ago
  In which case, why bother getting the information in the first place?
- Sankozi 4mo ago
  There is a lot of space between ignoring and doing invasive dangerous operation after some blot was spotted on some imaging diagnosis.
- adastra22 4mo ago
  You could repeat the test, perhaps on a more frequent interval to keep an eye on it. You could follow up with a more specific test, or do confirming blood work. In the meantime you can adjust your diet as a precaution, or get motivated to get in shape just in case. There's plenty of room between "go under the knife" and "ignore altogether."
  - tgsovlerkhgsel 4mo ago
    Or only consider it a positive once the confidence is high enough that false positives are not a problem anymore. Getting a test good enough to still make it useful (detect enough of the true positives) would of course be a challenge, but the more data is available, the more feasible that might be.
- simianwords 4mo ago
  yeah? give adequate accurate information to people and let them decide what to do with the information. if someone told you, you had a .01% chance of getting a disease for example, aren't you better off with that information? even if it is noisy?
- jibal 4mo ago
  P.S. The responses ignore what I actually responded to, which was a claim that "The false positive thing is a nonissue" -- where the "thing" is 99% false positives. The only way to respond to information such that "the false positive thing" becomes "a nonissue" is to never respond to it at all. The responses to my comment all address some strawman.

simianwords 4mo ago

??? how is more information worse than less? if you know the extent of false positives -- use it! its better than having no information. the question should be: does cost of obtaining extra information pay off in lives saved. i would say yeah obviously.