7 ms·

It's a controversial and complicated idea. The downside, and the reason why most doctors do not recommend full body scans, is that every human body is a bit we

• sroussey 4mo ago
  If the whole population had a full body scan every quarter, the “weird” things would feel more like the noise they are. But we would have great data over time, both individually (weird tends to only matter if they are changing) and as a population.
  • blensor 4mo ago
    How do you measure the body regularly without potentially introducing problems just by measuring it?
    • bialpio 4mo ago
      My understanding is that both MRIs and ultrasounds do not introduce problems.
      • ahtihn 4mo ago
        MRIs by themselves no, but depending on what you want to actually see you need to inject a contrast agent which is probably not something you want to do too frequently.
        • Levitz 4mo ago
          Nobody is proposing this though
        • bialpio 4mo ago
          Good point, I was not thinking about MRIs with contrast.
  • jibal 4mo ago
    The fundamental problem is that you generally can't diagnose simply from shapes. Scans show shapes, shapes cause concern, concern leads to invasive procedures, results are negative.
    • user43928 4mo ago
      Are people really going to perform invasive procedures over mere concern if there are no symptoms and the doctor recommends against it?
      • icantevenhold 4mo ago
        People take horse dewormer against COVID so yes they will do all kinds of irrational things
        • rlt 4mo ago
          Oh we're still doing the "horse dewormer" thing despite 250 million humans taking it each year?
          • multjoy 4mo ago
            Yes, because it's nonsense and those 250m humans need to get off Twitter.
            • rlt 4mo ago
              250M people take it as an anti-parasitic, as they should.
      • jibal 4mo ago
        There are numerous comments here from experienced people addressing this. Yes, that happens and a doctor who dismisses the concern can be sued for malpractice if something actually does show up, so they are put in a difficult position. For some reason you just assume that doctors will recommend against an invasive procedure when there is a positive tomography result. Review the numerous comments that address this as a statistical issue -- which it very much is when talking about the scale that Midjourney is claiming.
  • friendzis 4mo ago
    > If the whole population had a full body scan every quarter, the “weird” things would feel more like the noise they are. That's a tautology. We already have quite robust methods for detecting developed anomalies, treating every anomaly below standard human-to-human variation effectively raises the noise floor to already developed anomalies, defeating the purpose of population wide routine scans.
    • ramblerman 4mo ago
      If you think the premise and conclusion of Op's statement form a tautology then you agree with him strongly.
  • stymaar 4mo ago
    Maybe it would end up fine “in the long run” but you cannot ignore the significant issues arising at the beginning (and at each release of a more performant tool): what do you do if you find something that “shouldn't be there".
    • sroussey 4mo ago
      With enough data, it might change our idea of what shouldn’t be there. Like an appendix. But personalized!
      • stymaar 4mo ago
        That's exactly what I'm talking about when I say “in the long run” the problem comes in the meantime (and no, I don't think people in the present should endure bad things because it's going to make the future better).
  • aswegs8 4mo ago
    Without clear hypotheses you will have a lot of false positives. Which are quite costly in healthcare.
  • unholiness 4mo ago
    Overdiagnosis will be a major problem long after we have the data. It's just hard convince people with a general feeling something's wrong and a specific picture of something wrong that the two are almost certainly unconnected.
• jaggederest 4mo ago
  I think the anodyne to this is - and I admit the degree to which this is indicative of my biases! - more data, especially early on. Getting a good baseline before you have really any significant chance of most cancers to be able to do within-individual diffs, effectively, might be a big deal. It might also reveal that every MRI shows ghost artifacts a half a dozen times that make it longitudinally useless, of course. I'm not foolish enough to think that epidemiologists haven't thought of this.
• Beijinger 4mo ago
  "It's a controversial and complicated idea. " It is neither controversial nor complicated to detect some cancers by scent. Taking the "headspace" of something is also not really complicated. There are people who can reliably smell/detect Parkinson: https://www.npr.org/sections/health-shots/2020/03/23/820274501/her-incredible-sense-of-smell-is-helping-scientists-find-new-ways-to-diagnose-di https://www.npr.org/sections/health-shots/2020/03/23/8202745...
  • philistine 4mo ago
    You gloom on one aspect, the smell. OP focuses instead on full body scans themselves, and the irrelevant issues with everyone's bodies they would highlight.
    • emmelaich 4mo ago
      *glom
• david_shi 4mo ago
  I've heard this argument before and it's always seemed downstream of capacity constraints and the current incentives of the healthcare industry. There's a reason why billionaires like David Rockefeller, Larry Ellison, and Rupert Murdoch are able to live much longer lives than average, and having an oncall health team (that I'm sure does frequent testing and monitoring) is a big contributor to that. More testing and data collection doesn't mean that every single anomaly would need to be investigated or communicated with the patient, but would provide a better longitudinal view that can help with disease prevention and health optimization.
  • vasco 4mo ago
    It's obviously a lie to get us to accept no tests due to limited machines. The same as when COVID started masks "didn't help" because they didn't yet secure enough supply for everyone, then when they did, suddenly the masks helped. Every system that exists as a black box is more understandable with more sensing, not less. Our bodies are not special. It's also ridiculous that the proposition goes like: 1. Doctor knows some tests will flag tumors or variations that look weird and that we shouldn't then go investigate all of them 2. Doctor shuts off their brain and will then investigate all of them by doing invasive procedures Just knowing how many such variations there are and if they grow or not is useful information. But the doctors pretend like they are super smart before the test and super dumb right after.
    • deleted 4mo ago
      [deleted]
    • Paracompact 4mo ago
      It's not the same doctors saying they themselves are simultaneously smart and stupid. It's "smart" doctors saying that as a point of policy, it is not a good idea for biomedical companies to try to make a buck off of popularizing unnecessary diagnostics, because anxious patients will by chance or by intention find a "dumb" doctor who will agree to perform invasive procedures. (Have you ever heard a tech person say that the tech world has a lot of stupid ideas? It's the same thing.) Look up what happened with South Korea diagnosis vs. mortality rates when they instituted national thyroid screenings in the 90s. > Every system that exists as a black box is more understandable with more sensing, not less. With perfect humans in a perfect society, maybe. But such is ignoring the elephants in the room here, from the actual experts on the topic.
• wkoszek 4mo ago
  All doctors say this, and that sort of drove me away from healthtech. As if there were absolutely no way to take a step in a direction of fixing it. The faster and earlier we start to scan everyone regularly, as long as scanning methods aren't invasive, the more certainty we'll have what to warn people about and what not to tell them. Perhaps with the regular screening (imaging quarterly, if the scan is fast) you could see what is growing and what isn't.
  • poilcn 4mo ago
    Healthcare resources are very limited, you'd overwhelm it with lots of "yeah that's a defect, but 40% have it", things that would go away on its own, false positives, things that do not require urgent intervention, 10x increase of hypochondriacs and health deterioration caused by anxiety You'd have a system where every resource is allocated for diagnostics, but no medical staff to treat it Also a significant part of population avoids screening even if they are not required to paid anything from their pocket
    • rlt 4mo ago
      Maybe it's not a coincidence an AI company is building this thing...
    • mommys_little 4mo ago
      That's the real problem! That healthcare costs are a goldmine for Big Pharma instead of being a cheap and widely available service. And, as someone said before, the huge amount of data it produces, would decrease the rate of false positives to zero in no time! And your arguments about hypochondriacs are very similar to those that were once given against teaching reading to all people!
      • deleted 4mo ago
        [deleted]
      • nxobject 4mo ago
        > That's the real problem! That healthcare costs are a goldmine for Big Pharma instead of being a cheap and widely available service. I thought we were railing against Big Hospital/Big Insurance here? They'd love a cheap diagnostic.
• risyachka 4mo ago
  >> It's a controversial and complicated idea sure, and there will be downsides. But that data will be valuable nonetheless.
• rlt 4mo ago
  > every human body is a bit weird and there will almost always be something "wrong" that will be visible in a full body scan Would this be solved by routine scans, so you have a baseline you can compare against? Ignore anything slightly odd in the first scan but monitor for changes over time?
  • ufo 4mo ago
    Wouldn't help much. * Some kind of scans, like CT scans, use ionizing radiation and should not be done too often. * Looking at only imaging scans it is often impossible to tell apart a cancer and a benign growth. (More invasive tests would still be required, which was what the parent posters were warning about)
• seer 4mo ago
  Exactly - I had switched to a one meal per day setup and have been mostly following it for a few years. Then after a routine “heart health” check all my indicators were super out of whack - the doctors thought I was on my deathbed - but I am perfectly happy pain free, in shape, physically active person… Then _i myself_ had to dig into all these tests and figure out that they were measuring the wrong thing - since they try to time where your body is “just about to eat after a fast” - normally for most people in the morning before breakfast, but since my first meal of the day is usually around 20:00 - my body had adopted to have higher levels of various things just to stay on top of my lifestyle choices. Anyway I had to educate some doctors since they haven’t really had a case like mine, so they weren’t thinking critically of how to interpret the results… I imagine an automated test _could_ take these things into account with large enough dataset, but it would need to do a lot more reasoning than statistical correlation. I do believe current sota models should be good enough to come to the correct conclusions with the right harness though.
  • moffkalast 4mo ago
    If the current state is anything to go by, an automated test would not only flag your out of distribution results but try to gaslight everyone reading its output with additional false indicators to map you into an area that's in distribution. Statistical models cannot accept the existence of extremely rare edge cases.
    • ACCount37 4mo ago
      Modern LLMs routinely beat human doctors at diagnosing "extremely rare edge cases". They have unmatched breadth of knowledge by default, and can maintain attention across entire medical histories.
      • multjoy 4mo ago
        Citation very much needed.
        • fragmede 4mo ago
• vlfig 4mo ago
  You're absolutely right, and I share the frustration. I'm thinking a possible solution to this signal-to-noise problem is to embrace the longitudinal view: instead of comparing each scan with the normal across the population compare only against past self, unless there's a risk factor that warrants it. This way we could presumably make use of plentiful scan data and mostly look at the stuff that evolves in suspicious ways, not what looks suspicious.
• RobotToaster 4mo ago
  This always feels like a thinly veiled excuse to ration healthcare. Would these same doctors refuse a full body MRI to a billionaire paying out of pocket? Anything found can be monitored with focused follow up scans. It doesn't have to be immediately biopsied if it's in a location where that would pose a risk of iatrogenic harm.
  • disgruntledphd2 4mo ago
    At a population level, this would be both extremely time-consuming, and rather expensive. More generally, no test is perfectly accurate, and for low base rate conditions the vast majority of positive tests will be false positives. Like, again, as a data person I adore this idea in principle, but there would be a lot of details that we'd need to figure out to make it a reality.
• MagicMoonlight 4mo ago
  [dead]
• newsclues 4mo ago
  All the reasons you’ve listed are excuses why my government healthcare stopped having annual checkups. But to me it’s just worse quality care
• rzwitserloot 4mo ago
  One obvious alternative plan, presupposing that Full Body Scan is dirt cheap, is the following protocol: - At 25 years old or whatever you get a FBS. Pretty much no matter what, this FBS will not be used to do more checks, procedures, and so on. - ... and now we give you another FBS every so-many years, and only those things that are different from the previous scan are investigated. There's still an issue with needless procedures, but the amount of 'weirdness that are not going to cause an actual issue had the patient never been aware' is significantly reduced by looking only at changes. i.e. most 'weirdness' shows up early and is fairly stable. The difficulty is the moral issue. You cannot show that first scan to the patient. Even if every soul agrees beforehand that the rule is that nothing on that first scan, no matter how scary it looks, is further investigated... any medical issues raised by patients are used as a major information input for diagnosing issues. If I show a patient a scan that has this tumor looking thing on the left lung, then no doubt a few months later they'll be back complaining about shortness of breath and a pain on the left side of the torso. The mind is a powerful thing. At that point you can do a scan and see... the same nasty tumor looking thing we saw on that first FSB, and we're right back to the issue of these scans doing more harm than good. Is it morally acceptable to hide that first scan from the patient?
  • someothherguyy 4mo ago
    > - ... and now we give you another FBS every so-many years, and only those things that are different from the previous scan are investigated. The diff can be meaningless as well. All sorts of benign things develop with age. The resolution is the problem. You can't do the type of cytology and histology needed to understand all disease with just scans.
  • chickenman_98 4mo ago
    I think the issue with this and the proposed ‘spa’ scan model is that the diffs are usually meaningless. We all have cysts, masses, and weird shapes that shift around and show up on imaging. Many of these shapes require biopsy to determine what they are. Without symptoms the false positive rate is ridiculously high. Modern medicine sort of requires us to suspend the idea that we can know everything happening in our body at any given time. If we could develop a diagnostic technique to instantly determine if shapes in our bodies are malignant or benign something like frequent full body scans could be interesting, but they really just introduce noise right now.
• josefrichter 4mo ago
  Sorry, but that's a morally corrupt idea.
• davrosthedalek 4mo ago
  The question is: If you have enough full body scans of many healthy people, and the statistical tools to model it (beyond "this range is OK"), whether this would reduce these false alarms to an acceptable level. The real crux of it remains though: Let's say it finds something that increases your death risk by x=0.1%. Could you sleep? I'm not sure. Let's say the operation has 2x=0.2% risk. What do you do? What value of x makes this a problem for you?
• tgsovlerkhgsel 4mo ago
  That sounds like a problem with applying the wrong threshold for a positive finding, possibly due to liability concerns or wrong goals. To work, it would have to be incredibly accurate (specifically, have an incredibly low false positive rate).