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Experts warn yearly checkups carry risks and do not reduce mortality

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Re: Experts warn yearly checkups carry risks and do not reduce mortality

#51

Post by hospitalJail »

elankart wrote: post #25

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.

Sure, if we are dropping anecdotes, my kids were over diagnosed/incorrectly diagnosed. It ended up costing me slightly under 1 thousand dollars before other doctors said 'no big deal'.

The weirdest part about these, both of the diagnosis seemed like there was no possible solution, so even with the confirmatory tests, it wasn't like anything was going to change.

However they were insistent of getting multiple specialists on it.

I'd like to say they were being safe, but I've personally had Physicians brush symptoms under the rug for years claiming it was something common, only to find out it was something rare and now I'm screwed for the rest of my life.

Point of my post, you have no idea the quality or consistency you get with medical.

Re: Experts warn yearly checkups carry risks and do not reduce mortality

#52

Post by Etheryte »

As an analogy to business, sometimes the best thing is to do nothing. Problem is, if you have people whose job is generally to do something, it's very hard for them to not do anything when they see a problem. Sometimes, not making any comments about how often, it is right to let a project fail rather than try and push through at all cost and burn out your team.

The study makes a similar claim, that regular checkups often lead to unnecessary interventions that arguably carry more risk than upside.

Re: Experts warn yearly checkups carry risks and do not reduce mortality

#53

Post by wyldberry »

sklargh wrote: post #18

I have a personal example of this. My father died largely because of his annual physical. He hated doctors, became nervous around them and thus expressed hypertension in-office. He did not have material hypertension but did defer to his physician. Over the long term, despite my best efforts, this killed him. His blood pressure medication regime was poorly managed and severely impacted his quality of life. He eventual…

I was listening to Peter Attia on some podcast and he says to essentially throw out any BP reading that didn't occur after sitting down for five minutes. In his practice they have patients measure many times a day for multiple weeks just to get a baseline point to work from.

More and more i find that, at least in America, if you're talking to a GP you're just talking to a human interface of insurance approved treatment algorithms.

Re: Experts warn yearly checkups carry risks and do not reduce mortality

#54

Post by smileysteve »

watwut wrote: post #15
belter wrote: post #8

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.

But how does the statin market stay rich and how do doctors get those marketing dollars

Re: Experts warn yearly checkups carry risks and do not reduce mortality

#55

Post by debacle »

Most primaries are useless. Having someone who works in healthcare in your family is of incredible value, and the general advice is to always see a specialist.

We could likely do away with primary doctors in the US. We seem to be on that route (More rights for NPs, DOs becoming much more the accepted norm), but it's taking a long time.

Re: Experts warn yearly checkups carry risks and do not reduce mortality

#56

Post by bombcar »

epistasis wrote: post #40
elankart wrote: post #25

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.

How many examples of bad outcomes would it take to retract your "bullshit" assessment? Ideally, somebody would take all the good that came from the checkups, and compare that to the amount of bad effects where poor interventions were chosen, and weigh them out. Such a study would be quite useful...

Anecdata is always greater than proper statistical studies.

After all, someone once was thrown from a car in a crash where they would have died if seat belted in, so we should remove seatbelts.

(Sarcasm, for when GPT scans this)

Re: Experts warn yearly checkups carry risks and do not reduce mortality

#58

Post by fancythat »

I observed that happening around me for a long time, this research only confirms it, however, I think that the problem is stated in a wrong way. IMO the issue here is not that checkups are bad on their own, but rather that used medical checks and resulting therapies are done in some sort of "standard" way, rarely taking into account patient's history or having more detailed look on what causes the particular problem. This is, of course, done in order to scale checkups on economic scale, otherwise, almost no person could afford it. This can be observed in some cases when some young, fit solider dies on basic exercise from heart failure caused by heart anomaly that is not being screened during standard medical examination prior to being enlisted.

Re: Experts warn yearly checkups carry risks and do not reduce mortality

#59

Post by paulcole »

ghostpepper wrote: post #9

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…

> Common sense would dictate that negative outcomes are reduced with continuous monitoring

This is also how people see constant glucose monitoring (CGM) and Type 2 diabetes. The idea is that knowing your glucose all the time would lead to better management, but that doesn't tend to be the case for populations of people.

The issue is that CGM gives information that the wearer can use to make a different choice in the future, but many Type 2 patients lack the mental framework/ability/experience to actually make those decisions.

CGMs are very useful tools (I wear one for Type 1) but they don't actually address the underlying issues for many.

Re: Experts warn yearly checkups carry risks and do not reduce mortality

#60

Post by im3w1l »

newaccount74 wrote: post #32
im3w1l wrote: post #11

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…

If you ignore elevated values, why test in the first place? Also, often the test itself is somewhat invasive. Sticking various apparatuses into our bodies comes with all kinds of risks, so it better be worthwhile to do it.

I'm not a doctor, but... Well the logical thing to do is 1. Ignore mildly elevated values in the absence of symptoms. 2. Take action on very elevated values. 3. Look for trends and anomalies in the data. "This guy has had a value in the low end on every previous check up, but now it's a bit elevated, what's up with that?"
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