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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

#211

Post by hayst4ck »

yesbut wrote: post #207
hayst4ck wrote: post #170

Earlier quoted context omitted.

What you are arguing is that we should be a low trust society: https://en.wikipedia.org/wiki/High_trust_and_low_trust_socie... No. The government should provide consequences for those who violate trust promoting the idea that I can trust someone else who is from the same society I am. Here is a game that shows what happens at a societal level when doctors lie or mechanics over charge: https://ncase.me/trust/ In the g…

The government is us. Not some aliens. We should be democratically deciding what is correct and what is a violation and what the consequences for violating trust are. We should not hand that decision over to a few elected representatives. This should be a collective democratic process. * legalize abortion? yes or no * go to war? yes or no * arm teachers? yes or no * corporate news outlet allowed to sell ad time to co…

How do "we" decide something? It sounds like you are advocating for mob rule but calling it democracy. Help me understand how that is not what you are saying.

What is the "collective democratic process" you are advocating for? How does a law get made and how does a law get enforced?

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

#212

Post by elevatedastalt »

throwaway292939 wrote: post #205
prirun wrote: 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…

What type of workouts were you doing, were they unusually strenuous? This reads as if the general population doesn't work out — if they did, your workouts wouldn't be that out of the norm.

I think OPs summary is a bit inaccurate. Regular working out is not the issue in my understand. When you start working out after a long break, some of the AST ALT stored in your skeletal muscles gets released as the muscles undergo some breakdown, and this is most common with weight training, not cardio. This is what elevates the bloodstream levels. Once you have worked out for a few weeks it stabilizes to regular levels.

So don't get your liver enzymes tested just a week after starting to do weight training.

> This reads as if the general population doesn't work out

Regardless of the liver enzyme detail, this isn't too far from the truth. And even those who work out usually do cardio, not weight training.

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

#213

Post by motohagiography »

Nassim Taleb wrote at length about his beliefs about "iatrogenic" harm, which is that caused by the doctor themselves. His ideas about it are mercifully summarized in the FS blog: https://fs.blog/iatrogenics/ and how it expands as a pattern to be aware of.

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

#214

Post by Barrin92 »

Here's a small quiz regarding the false positives mentioned in the article.

If 3 in 1000 people in the general population are HIV positive, and a HIV test has a 1% false positive rate, (assuming no false negatives for simplicity) how likely is it, that if you run routine tests on a random group of people, for an individual to be healty despite the test coming out positive?

Despite the fact that false positives only occur 1% of the time, the answer is about 70% that they are healthy. This question has actually been put in front of practicing physicians, an overwhelming amount could not answer this question correctly, many were off by a magnitude.

Worth keeping that in mind when your doctor uncriticially tries to prescribe you something for a relatively rare disease because a measurement was positive.

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

#215

Post by jawon »

eloff wrote: post #175

There seems to be some solid data that mammograms, colonoscopies, and treating prostate cancer (with many caveats on that last one) is actually mostly not beneficial in reducing overall mortality. The reasons are likely complex and nuanced, but do your research carefully if your doctor is trying to talk you into one of those. You probably will only benefit their next car payment, not your health. For a mammogram, it…

Doesn't reasoning like this fall under the ecological fallacy? You can't use statistics to predict the outcome for the individual.

If I get a colonoscopy tomorrow there is not a 1/1000 chance I'll die of a perforated bowel. Except perhaps by pure coincidence. My odds will be different. Maybe 1/10. Maybe 1/10,000.

A government can use statistics like these to direct spending, but as an individual you need to take your own personal history into account, and your trust in your medical professionals, and roll the dice.

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

#216

Post by lz400 »

eloff wrote: post #175

There seems to be some solid data that mammograms, colonoscopies, and treating prostate cancer (with many caveats on that last one) is actually mostly not beneficial in reducing overall mortality. The reasons are likely complex and nuanced, but do your research carefully if your doctor is trying to talk you into one of those. You probably will only benefit their next car payment, not your health. For a mammogram, it…

>one in 1000 chances of perforating a bowel and dying here and now

that sounded impossible and googling a bit I think it's off by a couple of orders of magnitude: closer to 1 in 10000 chances of perforation, which has a single digit % of death

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2811793/

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

#217

Post by ifyoubuildit »

aj7 wrote: post #182
holbrad wrote: post #173

Earlier quoted context omitted.

"yeah doctors have no idea what they are doing" isn't really that far off the mark for a lot of things. The health of the average person in the west (And globally) is in decline. Obesity, diabetes, heart disease and cancer are all massively massively increased from where they were 100 years ago. If the standard advice given isn't working for people (And it most obviously is not) then looking for alternatives really i…

The above is all nonsense, especially for Hacker News readers. Someone here in their early 30’s has a mean life expectancy of almost 90. Many people opt to commit slow suicide. That’s what you’re seeing.

Possibly dumb question: can an early 30 something trust that number to apply to them?

I'd imagine the calculation is more sophisticated than I can imagine, but can it take into account things that haven't necessarily had their full impact yet? Like potential world war, deep recession/depression, massive unrest, things like microplastics, forever chemicals, dropping testosterone, the after effects of covid itself as well as everything around it.

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

#218

Post by froh »

Barrin92 wrote: post #214

Here's a small quiz regarding the false positives mentioned in the article. If 3 in 1000 people in the general population are HIV positive, and a HIV test has a 1% false positive rate, (assuming no false negatives for simplicity) how likely is it, that if you run routine tests on a random group of people, for an individual to be healty despite the test coming out positive? Despite the fact that false positives only o…

> _Worth keeping that in mind when your doctor uncriticially tries to prescribe you something for a relatively rare disease because a measurement was positive._

yes and yet this is slightly overgeneralizing

what you have to keep in mind specifically is that these two things, prevalence in to he population and false positives (and negatives!) do _exist_ and that you should inform yourself about them and factor that into your decision making

a PCR COVID test for example is something you don't argue with. and the quick tests on the other hand came in widely different qualities.

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

#219

Post by eloff »

jawon wrote: post #215
eloff wrote: post #175

There seems to be some solid data that mammograms, colonoscopies, and treating prostate cancer (with many caveats on that last one) is actually mostly not beneficial in reducing overall mortality. The reasons are likely complex and nuanced, but do your research carefully if your doctor is trying to talk you into one of those. You probably will only benefit their next car payment, not your health. For a mammogram, it…

Doesn't reasoning like this fall under the ecological fallacy? You can't use statistics to predict the outcome for the individual. If I get a colonoscopy tomorrow there is not a 1/1000 chance I'll die of a perforated bowel. Except perhaps by pure coincidence. My odds will be different. Maybe 1/10. Maybe 1/10,000. A government can use statistics like these to direct spending, but as an individual you need to take your…

Your should assume your odds are 1 in 1000, without reason to believe otherwise. Your actual odds are obviously going to be different, but that is unknown to you and shouldn’t affect your reasoning about the risks.

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

#220

Post by eloff »

lz400 wrote: post #216
eloff wrote: post #175

There seems to be some solid data that mammograms, colonoscopies, and treating prostate cancer (with many caveats on that last one) is actually mostly not beneficial in reducing overall mortality. The reasons are likely complex and nuanced, but do your research carefully if your doctor is trying to talk you into one of those. You probably will only benefit their next car payment, not your health. For a mammogram, it…

>one in 1000 chances of perforating a bowel and dying here and now that sounded impossible and googling a bit I think it's off by a couple of orders of magnitude: closer to 1 in 10000 chances of perforation, which has a single digit % of death https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2811793/

Thank you, my source was probably wrong, or my memory.

However, I wouldn’t be quick to say it invalidates the conclusion, without more careful analysis.

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