41–50 of 269 posts
I call bullshit on this. I had a very rare heart condition that was discovered during one of my yearly check ups. Chasing the root cause led us to even more scarier findings.
I find this sentiment almost offensive. Like it goes against everything I believe to say that less data is better. But the root of it is pretty clear "even basic blood tests can lead to unnecessary interventions or treatments". It's the belief that a test leads to interventions. But it doesn't have to of course. An intervention is a decision, and if an intervention is likely to be unnecessary, then they shouldn't int…
Agreed 100%. It's absurd. The results get distilled as "more data leads to worse outcomes" and that's ridiculous -- it should be: "more data leads to bad decisions which lead to worse outcomes". We should ALWAYS strive to have more and better data. What needs to change is how we (and our doctors) respond to that data.
There's a similar phenomenon when you look at fetal heart monitoring for otherwise healthy pregnant women going into labour. The two options are continuous monitoring, where the monitor is left in place for the entire hospital stay, and periodic monitoring, where a nurse installs it, takes a reading, and removes it about once an hour. Common sense would dictate that negative outcomes are reduced with continuous monit…
All you get at a doctor is someone typically saying “eh you’re young don’t worry about it” until it’s too late. It would be nice if the medical world was more data driven but it’s more handy wavy “ehhh I went to med school and I think you are ok”
That’s BS if I may. How would I know I have higher cholesterol if I didn’t do blood tests?
And where dietary cholesterol has been proven to not be directly related, you're fighting your liver and genetics.
Edit: apparently not a joke! See below for study link.
Earlier quoted context omitted.
Interestingly, the scenario is somewhat discussed in the article: "...Rivero used as an example a request he receives frequently: to check the cholesterol of young people with no risk factors. “Checking a 32-year-old man with no history of sudden death or hypercholesterolemia in the family is pointless,” and can result in prescriptions for medication of questionable usefulness and that is not without risk in the even…
I think that in that case, the issue is not that patient had checkup, but that standard reaction to high cholesterol is wrong. Having it checked up less often may help the patient, but real fix for healthcare system would be to not prescribe this medication in this situation.
I find this to be dubious and honestly a little insulting. Here in the UK there is a not insignificant number of people that die from cancers because their local health practice ignored or even refused to listen to a patient. The idea of a yearly checkup is totally foreign here unless you are going private.
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There's a similar phenomenon when you look at fetal heart monitoring for otherwise healthy pregnant women going into labour. The two options are continuous monitoring, where the monitor is left in place for the entire hospital stay, and periodic monitoring, where a nurse installs it, takes a reading, and removes it about once an hour. Common sense would dictate that negative outcomes are reduced with continuous monit…
Huh. So that means, when the doctor decides to intervene based on what the continuous monitor comes up with, the interventions have negative expected value? Which means the doctors are making bad decisions about what interventions to make based on the data they have? I'll believe this is possible, but I want to ask to be sure.
I also would wonder about other explanations. You say "a nurse installs it, takes a reading, and removes it about once an hour"; presumably the nurse also glances at the patient and, if anything seems off, might ask the patient questions or take other appropriate actions. Could that be a significant effect? (In other words, to eliminate this potential difference, the better comparison for "continuous monitoring" would be for a nurse to come by once per hour and give the patient the same level of attention, perhaps going through the same motions that are involved in the monitor process.) Incidentally, as I read your comment, I expected it to conclude that the monitor itself or the process of repeatedly installing it and removing it was harmful (although that would point in the opposite direction).