Experts warn yearly checkups carry risks and do not reduce mortality • Hacker News Board

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

#241

Post by ggforpp » Tue, Apr 04, 2023, 10:58 AM UTC

yesbut wrote: post #233

KronisLV wrote: post #231

Earlier quoted context omitted.

> What that requires is a well informed, well educated population. Isn't this very uncommon, in addition to the need to be at least somewhat compassionate (e.g. in regards to issues that might not affect individuals personally, but that affect minorities, or simply those who are different)? A certain social cooling might be needed in many societies, less extremism, less identity politics, less hate. I don't think we…

It is the world we should create instead of waiting for others to improve things for us. The status quo is the problem.

Yes, but where are we if we are considering arming teachers?

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

#242

Post by astura » Tue, Apr 04, 2023, 11:11 AM UTC

lloydatkinson wrote: post #7

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.

>their local health practice ignored or even refused to listen to a patient.

This is not at all what this article is talking about.

This article is about people with no symptoms, experiencing no medical problems, going to the doctor to get medical tests.

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

#243

Post by yesbut » Tue, Apr 04, 2023, 11:40 AM UTC

ggforpp wrote: post #241

yesbut wrote: post #233

Earlier quoted context omitted.

It is the world we should create instead of waiting for others to improve things for us. The status quo is the problem.

Yes, but where are we if we are considering arming teachers?

We are already arming teachers as a result of representative democracy. Their corporate arms manufacturer donors need to keep selling guns.

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

#244

Post by geye1234 » Tue, Apr 04, 2023, 12:24 PM UTC

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…

It seems very many people have this problem - skim through the hundreds of comments on this page [0].

I remember when I first panicked about having my BP taken: I had an irrational thought that the cuff would completely cut off my circulation and kill me. (I since discovered I have OCD.) So of course my BP shot up. And a second time, I was running like crazy to get to the appointment, and very stressed from a new job I'd just started and had just finished for the day, so again the BP was crazy high.

Since then, I always panic about taking my BP, even at home, though it's worse in the office. To my previous worries, I've added fears about heart attack/stroke from high BP, irony of ironies but a common one.

My solution is to buy a machine with a memory, take several readings per day over a period of at least a week (2-3 weeks is better), and cover up the screen on the monitor with a piece of card when taking the readings. At the end of the 2 weeks, remove the card, discard the first two days' readings, and take the average of the remaining readings. When I do this, my BP is almost normal (low 120s over low 80s).

I don't waste my time trying to relax, since it tends to make things worse, although I do make sure I've been still for a couple of mins. I have a supportive doctor who understands statistics, which helps.

(Standard disclaimer: this isn't medical advice. IANAD. Real hypertension is dangerous.)

[0] https://www.innerhealthstudio.com/phobia-taking-blood-pressu...

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

#245

Post by nradov » Tue, Apr 04, 2023, 2:20 PM UTC

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…

Your estimate of colonoscopy risk versus reward is completely wrong.

https://peterattiamd.com/peter-on-the-importance-of-regular-...

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

#246

Post by Ntrails » Tue, Apr 04, 2023, 2:36 PM UTC

stu2b50 wrote: post #210

hayst4ck wrote: post #151

Half the posts in this thread bring back the old SlashDot adage: The plural of anecdote is not data. I am not sure what the point this article is trying to make is. I do not feel more informed for having read it. It seems a populist appeal to the idea that the medical institution has no idea what it is doing. Is it good, is it bad? It doesn't matter. The end result is damaged institutional trust. How many people woul…

The point I got from the article is to bias against medical interventions. That doesn't mean never consider them, but they really need to have a serious reason to occur. It doesn't have to that doctors are bad at their jobs, but rather that they're humans, and humans are hardwired to try to make other humans happy, and patients like being actively given treatment as opposed to "have you considered sleeping well, eati…

> The point I got from the article is to bias against medical interventions.

I will always regret not asking what the difference in outcome was from a surgery on a ligament in my ankle. I feel like the surgeon saw a thing they could fix and said they should do so. I don't think they had an internal monologue of does it matter and I never checked.

Not a major mistake, but not one i would make again

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

#247

Post by taylodl » Tue, Apr 04, 2023, 2:51 PM UTC

nradov wrote: post #86

mhaberl wrote: post #66

This is just clickbait and people comment the title without reading the article. It doesn't say "don't do checkups" > “The conclusions do not imply that physicians should stop clinically motivated testing and preventive activities,” The article is saying that some tests give false positives, some tests even if positive don't point to illness without symptoms, but people get treated for illness. I believe you should d…

That depends what you mean by "checkups". For healthy adults there is no proven net benefit to an annual physical exam. https://www.nejm.org/doi/full/10.1056/NEJMp1507485?af=R&rss=... However, there are certain preventative care and screening services that everyone should get periodically. https://www.healthcare.gov/coverage/preventive-care-benefits...

> That depends what you mean by "checkups"

Exactly. There's no set definition for "annual physical exam." This article notes you shouldn't be regularly checking for uncommon health events, but instead check for common events, especially if the patient's family history warrants. That's why blood pressure, weight, A1C, triglycerides, and cholesterol are good things to regularly check for in Americans as the typical American diet tends to cause problems in these areas.

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

#248

Post by nradov » Tue, Apr 04, 2023, 3:18 PM UTC

taylodl wrote: post #247

nradov wrote: post #86

Earlier quoted context omitted.

That depends what you mean by "checkups". For healthy adults there is no proven net benefit to an annual physical exam. https://www.nejm.org/doi/full/10.1056/NEJMp1507485?af=R&rss=... However, there are certain preventative care and screening services that everyone should get periodically. https://www.healthcare.gov/coverage/preventive-care-benefits...

> That depends what you mean by "checkups" Exactly. There's no set definition for "annual physical exam." This article notes you shouldn't be regularly checking for uncommon health events, but instead check for common events, especially if the patient's family history warrants. That's why blood pressure, weight, A1C, triglycerides, and cholesterol are good things to regularly check for in Americans as the typical Ame…

The usual blood tests for triglycerides and cholesterol are mostly useless. They continue to be performed out of inertia rather than any clinical efficacy.

https://peterattiamd.com/ama34/

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

#249

Post by eloff » Tue, Apr 04, 2023, 3:57 PM UTC

nradov wrote: post #245

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…

Your estimate of colonoscopy risk versus reward is completely wrong. https://peterattiamd.com/peter-on-the-importance-of-regular-...

He doesn’t give any numbers there. I may well be completely out to lunch, but that source doesn’t modify my opinion.

Here's the results of the first large randomized clinical trial - the gold standard in medicine. The study involved over 80,000 participants in Nordic countries.

"colonoscopy reduced cancer incidence but not death"

https://www.statnews.com/2022/10/09/in-gold-standard-trial-c...

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

#250

Post by kornhole » Tue, Apr 04, 2023, 4:58 PM UTC

cuteboy19 wrote: post #167

kornhole wrote: post #162

Earlier quoted context omitted.

This article gives people things to consider and does not dare give specific advice. Everybody is different. Some people are in touch with their bodies and can detect if something is going wrong, and others are not. Institutions and pharmaceutical companies can adversely affect our health if they are able to influence doctors to advise us wrongly in a for profit health care industry. If you look at the health of the…

>Some people are in touch with their bodies and can detect if something is going wrong and how does one come to know this? > If you look at the health of the US population with a declining life expectancy, rising obesity, immunological diseases, and cancer, some self learning seems like a good thing rather than to leave your health up to institutions, companies, and doctors Could you show your work? Some steps are cl…

>Could you show your work? Some steps are clearly missing between the premise and the conclusion

Life expectancy is dropping in the US according to official studies you can easily find. It is now lower than China. Obesity, immunological diseases, and cancer have also been rising over the decades. I am not going to pin anything to specific causes as that will spur a debate too long for my attention. IMO the system is generally failing us. Without your health, you have nothing. It is too important for me to completely trust to others especially with how our system is currently incentivized.