51–60 of 236 posts
> The average cost of a WB-MRI scan for NSCLC patients was £317 Wow! $3000+ here in the US. Ever get the feeling you've been cheated?
Not all MRI machines are equal, though, so it's hard to tell without specifics. A low field 0.2T machine might be $150k. A full bells+whistles 3T machine might be $3M.
Many doctors hate full body scans. Every individual has a handful of anomalies which are almost always benign. They show up on full body scans and chasing them down comes with cost and patient risk. I have a hard time with reporting like this that doesn't quantify cost of biopsy on false-positives as well as cost of complications from examining false-positives. Source: worked in clinical research for 2 years.
There are many ways to deal with incidentalomas. If full body scans were more widespread, maybe doctors would have confidence to deal with them properly. For example, watching them over time.
Earlier quoted context omitted.
State of the art MRI machine costs $3 million up front. Would take 20 scans a week, every week, for 10 years to break even on that investment at $300 per scan. Not counting physician & staff time or cost of capital.
Well if you are not including external costs, you can get a MRI machine at around $100k to $500 depending on your needs[0]. [0]: https://www.alibaba.com/product-detail/IN-16CT-Hospital-Medi...
In all seriousness the product linked is a CT scanner, which are way less expensive in general.
Many doctors hate full body scans. Every individual has a handful of anomalies which are almost always benign. They show up on full body scans and chasing them down comes with cost and patient risk. I have a hard time with reporting like this that doesn't quantify cost of biopsy on false-positives as well as cost of complications from examining false-positives. Source: worked in clinical research for 2 years.
Do tumors from various cancers typically share any discernable features?
Many doctors hate full body scans. Every individual has a handful of anomalies which are almost always benign. They show up on full body scans and chasing them down comes with cost and patient risk. I have a hard time with reporting like this that doesn't quantify cost of biopsy on false-positives as well as cost of complications from examining false-positives. Source: worked in clinical research for 2 years.
This sounds to me like doing a full workup on blood chemistry. Individuals vary so much that you can get false positives. Wouldn't it be more useful as a baseline? Scan once and store it, then scan every few years and compare. If any of the "anomalies" has grown or new ones have appeared between scans, then they might be worth a second look?
In the case of blood chemistry that is caused by fluctuations due to time of day, time of month, season, what you recently ate and so one.
In the case of MRI the problem is that internal organs shift to the point that it is impossible to automatically compare. And a experienced doctor comparing the scan millimeter for millimeter takes hours and would be very expensive. Even just tracking the volume of a known tumor in the brain (that shifts very little) to track the effect of radiation is tedious, time consuming and error prone.
Earlier quoted context omitted.
Why do doctors advocate less frequent scans when they see that frequent scans creates false positives? Can a metric be invented such that a doctor can make a solid decision "I'm 99% sure this wont kill you in two years" and leave the tumour alone?
We don’t advocate less frequent scans, we advocate targeted scans. Because the probability of a positive result being a false positive depends heavily on the population. In a population with a high baseline frequency, the probability of a positive being false is relatively low; in a population with a low baseline frequency, the likelihood of a positive being false is relatively high. So, you don’t mammogram every per…
I’m sitting bedside wading through pull requests for software installation scripts. How is it the opinions of folks on my team for a bullshit process get more scrutiny than a potentially life-altering assessment that requires expertise, a keen eye and sharp mind every time?
Earlier quoted context omitted.
Why do doctors advocate less frequent scans when they see that frequent scans creates false positives? Can a metric be invented such that a doctor can make a solid decision "I'm 99% sure this wont kill you in two years" and leave the tumour alone?
We don’t advocate less frequent scans, we advocate targeted scans. Because the probability of a positive result being a false positive depends heavily on the population. In a population with a high baseline frequency, the probability of a positive being false is relatively low; in a population with a low baseline frequency, the likelihood of a positive being false is relatively high. So, you don’t mammogram every per…
I am not a doctor, but I cannot fathom why a doctor would ever advocate against more data. Even if that doctor chooses to ignore it, at least let the patient utilize it as he sees fit. As someone who has regularly had to argue with doctors to get a test done, it is incredibly frustrating.
Many doctors hate full body scans. Every individual has a handful of anomalies which are almost always benign. They show up on full body scans and chasing them down comes with cost and patient risk. I have a hard time with reporting like this that doesn't quantify cost of biopsy on false-positives as well as cost of complications from examining false-positives. Source: worked in clinical research for 2 years.
Many doctors hate full body scans. Every individual has a handful of anomalies which are almost always benign. They show up on full body scans and chasing them down comes with cost and patient risk. I have a hard time with reporting like this that doesn't quantify cost of biopsy on false-positives as well as cost of complications from examining false-positives. Source: worked in clinical research for 2 years.
Earlier quoted context omitted.
Why can't a doctor see an anomaly and decide not to chase it down based on the same reasoning that they use to not scan for it? Is there some pointless legal trap related to malpractice where the only allowable "don't operate" decision happens when the doctor decides what to test for?
(1) Because we do not have the body of knowledge that tells us how to predict an anomaly is not worth pursuing. It would require a lot of major, expensive, long-term studies involving non- negligible chemical exposures in$ asymptomatic people in order to get a good idea of what the “healthy” anomaly looks like. $ many of these MRIs require contrast material. (2) Malpractice for a missed cancer in most states has an e…
but factually incorrect call is apparently OK, because they are treating "median person", and not the actual patient.
This has to do with money - and nothing else.