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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

#112

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…

> the odds of the monitor detecting something in the intervening time and the intervention being correct are lower than the odds of the intervention causing some other unwanted side effect. 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…

It somewhat makes sense to me. Measuring all the time, you're susceptible to odd readings that are essentially false positives. If your device has a 1/1000 false positive rate, but you're usually only making one reading with it at a time, that's maybe acceptable. If you're making a million readings over a week because you're checking every second, than you're almost definitely going to have it show the same false positive enough that it looks real.

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

#113
post #92

Personal example: my primary care physician scheduled me for a physical, including picking the date, without even asking. It just showed up on my online chart. Okay, I hadn't had a physical for a while, so I just went with it. While stopped at an intersection on the way to his office, a woman plowed into me and 2 other cars because she wasn't paying attention, and was likely on her phone. That wreck generated $45K of…

Did you go back to working out and protein shakes? Because if you did, you still don't know why you are reacting that way which could be masking a problem elsewhere, and are exposing yourself to risk. There is a reason why metabolic values have "normal" ranges. Heck, if this were a JIRA ticket, I'd want a code review!

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

#114
post #92

Personal example: my primary care physician scheduled me for a physical, including picking the date, without even asking. It just showed up on my online chart. Okay, I hadn't had a physical for a while, so I just went with it. While stopped at an intersection on the way to his office, a woman plowed into me and 2 other cars because she wasn't paying attention, and was likely on her phone. That wreck generated $45K of…

> While stopped at an intersection on the way to his office, a woman plowed into me and 2 other cars because she wasn't paying attention, and was likely on her phone. That wreck generated $45K of medical bills for me and a 21-month settlement process.

Sorry to hear and I hope you recovered fully.

Fundamentally, our roads are unsafe and since the pandemic road deaths in the US have been on the rise. Locally where I live in, SF, the number of driving citations is significantly down over the last 10 years. I see incredibly risky maneuvers when I'm driving my car or on bike.

Many levels of gov are not addressing this serious risk to our health, road accidents. If our roads were declared a public health hazard and be avoided at all costs it might be draw some attention where we move towards finding solutions.

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

#115

You would think doctors would be able to collect data and then come up with statistical tables of “hey you may have xyz. The risk to look into this further has these possible complications with these success/failure rates. The risk of no intervention has these other set of outcomes with these likelihoods” All you get at a doctor is someone typically saying “eh you’re young don’t worry about it” until it’s too late. I…

I think the issue is that it becomes hard to estimate risk factors on an individual level with enough resolution to come up with such a table. Its easy to conclude that on average, walking a lot every day leads to better health outcomes, but probably hard to say whether you walking a lot would lead to better outcomes for you specifically. All this stuff has variance. On average, overweight people die sooner, but there are still overweight people who are long lived, and its hard to say whether you share those same latent variables that are actually influencing this result.

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

#116

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…

[deleted]

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

#117
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…

On the better handled side of this, my doctor pointed out that issue at my physical and instead of putting me on blood pressure meds he told me to get a blood pressure cuff and gave me a paper to fill out with daily readings before jumping to any conclusions.

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

#118

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…

The primary function of fetal heart monitoring is for pseudoscientific use by ambulance-chasing lawyers to generate $1M-$40M (!!) malpractice payouts from ignorant juries for children born with cerebral palsy.

The saying goes: "The only thing that can prevent a birth injury is a expert witness".

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

#119
post #8
post #5

That’s BS if I may. How would I know I have higher cholesterol if I didn’t do blood tests?

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…

But this thought process begs the question: what if this person is the one who STARTS the history of high cholesterol, and subsequent increased heart-related mortality. Or following it the other way, only people with a history of this are at risk? It is statistical: there could be a person with no history who is at risk, the probability is lower, but nonzero.

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

#120

You would think doctors would be able to collect data and then come up with statistical tables of “hey you may have xyz. The risk to look into this further has these possible complications with these success/failure rates. The risk of no intervention has these other set of outcomes with these likelihoods” All you get at a doctor is someone typically saying “eh you’re young don’t worry about it” until it’s too late. I…

> You would think doctors would be able to collect data and then come up with statistical tables of “hey you may have xyz.

There's a project that's attempting to collect such data on a large scale and long time span:

  The purpose of Project 10K is to develop methods that will predict
  diseases years before they break out.

https://www.project10k.org.il/en>
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