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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

#261

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…

My best friend is diagnosed with a disease nobody has a cure, his wife, Krohns disease, his son on the spectrum. They visit the doctor every 3 months (each) since 2015. And each time they go it's more decay and more confusion.

I'm not anti science but there are echos from nntaleb Antifragile in this.

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

#262
post #257

Earlier quoted context omitted.

> That wreck generated $45K of medical bills for me and a 21-month settlement process. Someone hit you with their car and you got $45k of medical bills? What sort of a backwards place do you live in?

USA, about a mile from several major hospital complexes. Not at all in the sticks. The ER bills for the day of the accident were around $22K for X-rays and CT scans. The ambulance was $650. I had 2 broken ribs, a broken nose, and a fractured vertebrae. Bruises on every body part. A back brace was $1500. An elbow MRI was $3500. Had to have nose surgery to fix my smashed nose, for breathing, not for looks: $11K. The re…

Wow, that sounds intense. Hope you're ok now!

Was that a wake up call for you to migrate somewhere else? Someone elses actions costing you a life changing (for most people) amount of money?

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

#264
post #224

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…

I think this is unnecessarily conspiratorial. Medical tests often have much more uncertainty than most expect, and many interventions are net negative on average. This particular research was new to me but I have seen a number of studies of cancer screenings and treatment showing the same or even worse effects. The recommended standards for some cancer screenings have been updated in recent years to be more restraine…

> I think this is unnecessarily conspiratorial. Medical tests often have much more uncertainty than most expect, and many interventions are net negative on average.

If a crucial test is giving false positives, rather than dismissing the test altogether, it would be more beneficial to adjust the response protocols, invest in improving the test's accuracy, or focus on better informing patients about the potential risks and benefits. Discarding a test entirely could lead to missed opportunities for early detection and intervention, which can be crucial for certain conditions. There has to be some balance between skepticism and the potential value of medical tests and screenings.

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

#265
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 li…

Around once a week in the Bay I'm exposed to severely reckless driving (going 60+ mph downhill through residential stop signs around blind curves, not swerving into any of the 3 empty passing lanes when going 120+ till within spitting distance, actively swerving in front of me to throw trash into my windshield and slam on the brakes while zig-zagging to prevent passing, ...).

Police are sometimes helpful but usually won't bother to even make a report. I take less psychotic roads nowadays even if they're slower. I'm not sure what to do other than stop driving or leave. Do you have any advice for surviving SF roads?

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

#266
post #265

Earlier quoted context omitted.

> 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 li…

Around once a week in the Bay I'm exposed to severely reckless driving (going 60+ mph downhill through residential stop signs around blind curves, not swerving into any of the 3 empty passing lanes when going 120+ till within spitting distance, actively swerving in front of me to throw trash into my windshield and slam on the brakes while zig-zagging to prevent passing, ...). Police are sometimes helpful but usually…

On bike I only ride routes that I have either been before, walked, or driven through. I have some sense of safety.

Otherwise, I stay calm on roads and never try to overreact to the overly aggressive people driving around me. I also never take too aggressive lane change because I worry someone might have road rage.

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

#267

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…

I just went and checked and I was slightly wrong about the methodology. The comparison was actually between continuous electronic monitoring and manual listening with a stethoscope. I would hope/expect that a nurse is coming to visually inspect a laboring woman at least once per hour regardless.

This [0] is one of the studies cited by the book where I learned about this phenomenon. Continous monitoring was found to have a higher incidence of c-section and forceps deliveries. The only condition where continuous monitoring came out ahead was in detecting seizures.

[0] https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD...

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

#268

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…

Any references for this? I would like to read further.

Posted it above but I read about it in the book Expecting Better by Emily Oster. She cites this study https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD...

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

#269

Earlier quoted context omitted.

I agree we live in a relatively oligarchic society - that is an inescapable outcome for democracies. We would probably disagree as to the causes and alternatives to this oligarchic structure, but I don't want to go down that rabbit hole at the moment. What I am saying is that when you look at the problems with the medical profession, there is more at play here than the self-interest of billionaires. You talk at high…

Snyder would say you are practicing the politics of inevitability: https://hac.bard.edu/amor-mundi/the-politics-of-inevitabilit... What the politics of inevitability does is that it teaches you to narrate in such a way that the facts which seem to trouble the story of progress are disregarded. So in the politics of inevitability, if there is huge wealth inequality as a result of unbridled capitalism, we teach ourselv…

> Here is a relatively quick video of him pretty directly critiquing what you just stated...

None of that big wall of text seems to directly address anything I actually said.

> It is not positive government policy that is the problem but government failure to act because the government operates on behalf of money (oligarchy), not on behalf of us (democracy).

The only thing worse than pedantry is wrong pedantry. Your attempt at correcting me here is wrong because The absence of the kinds of policies you would like to see is still policy.

In other words, not everything that goes wrong with an industry is the result of the government not doing what you wish it would do.

And to be more specific, even those things that go wrong because of government policy are not necessarily caused by oligarchic influence.

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