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When they warn of rare disorders, these prenatal tests are usually wrong

nytimes.com

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Re: When they warn of rare disorders, these prenatal tests are usually wrong

#161

Post by OJFord »

thaumasiotes wrote: post #158
OJFord wrote: post #157

Earlier quoted context omitted.

Ok, fine, 'as you defined it'. It's hard to read your table on mobile. My only suggestion was that your definition might not be what the original commenter meant, because it's not my layman's understanding that they're different, but I don't know, maybe they also use your definition, no point arguing about it. (Though it does seem a little odd to me to object to the comment on the basis of a definition you introduce…

> Though it does seem a little odd to me to object to the comment on the basis of a definition you introduce yourself Notice that I always talk in terms of the question being asked. And your response to me was phrased in the same terms. You didn't say 10% was "the false negative rate", you said it was "the share of the time for which, when the test says 'no', the answer is 'yes'". You didn't say "the false negative r…

> > Though it does seem a little odd to me to object to the comment on the basis of a definition you introduce yourself

> Notice that I always talk in terms of the question being asked.

You were more specific, you replied to a commenter using 'false positive rate' as an undefined term; you introduced a definition. It's not the definition I'm familiar with; it's not the definition used on Wikipedia; I suggested it might (I don't know either!) be the definition intended by the commenter who used it.

Re: When they warn of rare disorders, these prenatal tests are usually wrong

#162

Post by BoorishBears »

OJFord wrote: post #150
BoorishBears wrote: post #111

Earlier quoted context omitted.

The reply is pretty tasteless. Especially: > Suggesting you should have aborted the 20-week fetus based on unusual skull appearance? Suggesting that the meningitis was a result of some malpractice? Don't ask people sarcastic questions on a subject like this. You wouldn't do it in real life would you? It's a real person who just shared a harrowing experience with a child, not talking about the latest "Rust framework f…

Woah, that wasn't my reading at all, I also didn't understand top-level commenter's implication, as in what went wrong and should have happened, or what's regretted; no judgement or disbelief or whatever - I just didn't understand (not denying there was one) the failing that meant the test manufacturers should join the commenter in hell.

So you read:

> Anyone trying to shickle a few dollars from the medical system to provide "pre-natal diagnosis" without sound science - they can come burn in the same hell I live in every day.

And didn't understand the failing? Really?

> Anyone trying to shickle a few dollars from the medical system to provide "pre-natal diagnosis" without sound science

I mean how much more obvious could they have made it? Do you just not understand why pedaling unsound prenatal tests is a failing?

Re: When they warn of rare disorders, these prenatal tests are usually wrong

#163

Post by OJFord »

BoorishBears wrote: post #162
OJFord wrote: post #150

Earlier quoted context omitted.

Woah, that wasn't my reading at all, I also didn't understand top-level commenter's implication, as in what went wrong and should have happened, or what's regretted; no judgement or disbelief or whatever - I just didn't understand (not denying there was one) the failing that meant the test manufacturers should join the commenter in hell.

So you read: > Anyone trying to shickle a few dollars from the medical system to provide "pre-natal diagnosis" without sound science - they can come burn in the same hell I live in every day. And didn't understand the failing? Really? > Anyone trying to shickle a few dollars from the medical system to provide "pre-natal diagnosis" without sound science I mean how much more obvious could they have made it? Do you just…

Maybe it's because I'm not American and am pretty unfamiliar with that system, but yeah.

To be clear I'm not disagreeing with OP or saying nobody else is to blame, I just didn't fully understand. I was glad someone else had asked and hoped to scroll down and understand, not find an argument, I think everyone had good intentions here.

Re: When they warn of rare disorders, these prenatal tests are usually wrong

#164

Post by rayiner »

honkycat wrote: post #159
rayiner wrote: post #155

Earlier quoted context omitted.

> The mother, exclusively, can decide whether or not she wants to proceed with the pregnancy through to birth, and she doesn't need a reason other than "I don't feel like it". The morality of that is quite vigorously contested. And even in places that have elective abortion, it’s often only available in the first trimester, while many of these tests are performed after that. But even if we accept the notion of electi…

Moral and legal are two different classifications. I think it should be LEGAL to have an abortion no matter your reasoning. The reason for this is we need to preserve the bodily autonomy of people who can become pregnant. Weather or not it is MORAL is another question. It is LEGAL to protest outside of a veteran's funeral. However, I would argue it is not a MORAL thing to do.

We’re talking about morality in the context of this article, since abortions based on this testing are legal in the United States and most other developed countries.

Re: When they warn of rare disorders, these prenatal tests are usually wrong

#165

Post by rayiner »

watwut wrote: post #131
lelanthran wrote: post #123

Earlier quoted context omitted.

> Why stop there? It can be a challenge to have a kid who is ADHD, or is susceptible to depression or mental illness, or a different sexual orientation, etc. It’s not wrong to abort those children either, right? But we don't stop there. The bar is considerably lower than "the kid might have problems". The mother, exclusively, can decide whether or not she wants to proceed with the pregnancy through to birth, and she…

This is not true in every state. Abortion is in the process of being outlawed in United States. Texas outlawed it. Supreme court is hostile to it for religious reasons.

Abortion isn’t primarily a religious debate in the US. There is a broad consensus view that elective abortion should be illegal after the first trimester: https://apnews.com/article/only-on-ap-us-supreme-court-abort.... Even highly secular countries like France draw the line at the end of the first trimester, because after that point the fetus looks a lot like a baby (has a face, fingers, toes, etc): https://www.babycenter.com/pregnancy/week-by-week/13-weeks-p...

Roe continues to be controversial because it prohibits states from adopting abortion laws that reflect the consensus view. Roe mandates elective abortions until viability, which is toward the end of the second trimester. Roe is thus opposed by many people who don’t believe that life begins at conception for religious reasons. Those people oppose Roe for whatever moral reasons that drive highly secular countries like France to prohibit abortions in the second trimester.

Re: When they warn of rare disorders, these prenatal tests are usually wrong

#166

Post by BoorishBears »

OJFord wrote: post #163
BoorishBears wrote: post #162

Earlier quoted context omitted.

So you read: > Anyone trying to shickle a few dollars from the medical system to provide "pre-natal diagnosis" without sound science - they can come burn in the same hell I live in every day. And didn't understand the failing? Really? > Anyone trying to shickle a few dollars from the medical system to provide "pre-natal diagnosis" without sound science I mean how much more obvious could they have made it? Do you just…

Maybe it's because I'm not American and am pretty unfamiliar with that system, but yeah. To be clear I'm not disagreeing with OP or saying nobody else is to blame, I just didn't fully understand. I was glad someone else had asked and hoped to scroll down and understand, not find an argument, I think everyone had good intentions here.

It's not an American concept. Pre-natal diagnoses based on unsound science is a bad thing regardless of if money is involved.

And bilking a medical system has nothing to do with if it's free or privatized.

Even with free healthcare the suppliers are still getting paid somehow... so them providing an unsound test is still making unjust profit.

Re: When they warn of rare disorders, these prenatal tests are usually wrong

#167

Post by jacobolus »

BoorishBears wrote: post #166
OJFord wrote: post #163

Earlier quoted context omitted.

Maybe it's because I'm not American and am pretty unfamiliar with that system, but yeah. To be clear I'm not disagreeing with OP or saying nobody else is to blame, I just didn't fully understand. I was glad someone else had asked and hoped to scroll down and understand, not find an argument, I think everyone had good intentions here.

It's not an American concept. Pre-natal diagnoses based on unsound science is a bad thing regardless of if money is involved. And bilking a medical system has nothing to do with if it's free or privatized. Even with free healthcare the suppliers are still getting paid somehow... so them providing an unsound test is still making unjust profit.

From what was described in the NYT article, the tests are not “unsound”. Nor are those making the tests inherently corrupt or malicious (some medical testing companies are, e.g. Theranos, but the same could be said of any other occupation or industry). My impression is that people who design these tests go into the field to help give parents the best possible information, and do their best to make tests which are as accurate as possible. (Disclaimer: I don’t know anyone in medical technology, pharmaceutical, etc. industries.)

The tests are extremely good, but they are not perfect, with a specificity in the 99.9%–99.99% range, which is low enough that there are more false positives than true positives for extremely rare conditions. Making tests with specificity in the 99.999% range or beyond is an inherently extremely hard problem.

The current quality would be fine if the posterior probabilities were properly explained to patients and if physicians had enough basic intro-level statistics background to interpret the test results. Unfortunately patients often aren’t given the results directly or told accurately how to interpret them and apparently many physicians lack basic statistical competence. It isn’t too promising that this NYT article expressly aimed at clearing up laypeople’s misconceptions does such a poor job explaining the subject, and spends its first half on misleading clickbait about how “wrong” the tests are.

Re: When they warn of rare disorders, these prenatal tests are usually wrong

#168

Post by tagoregrtst »

Apes wrote: post #118
tagoregrtst wrote: post #96

Earlier quoted context omitted.

The alternative is loving a human being and playing the cards you’re dealt

It's fine for you to live in whatever fantasy world that allows you to never have to make any hard life choices, but you shouldn't go out of your way to try to make others feel guilty for having the unfortunate fate of having to live in the real world.

You literally know nothing about me past my 24 karma point earning comments.

Re: When they warn of rare disorders, these prenatal tests are usually wrong

#169

Post by tagoregrtst »

oneoff786 wrote: post #101
tagoregrtst wrote: post #96

Earlier quoted context omitted.

The alternative is loving a human being and playing the cards you’re dealt

with one of those cards being a lifetime of medical debt

Thats a political and social problem, not an ethical consideration.

Re: When they warn of rare disorders, these prenatal tests are usually wrong

#170

Post by tagoregrtst »

zarzavat wrote: post #128
tagoregrtst wrote: post #96

Earlier quoted context omitted.

The alternative is loving a human being and playing the cards you’re dealt

Many of these conditions would in the past have been fatal in infancy, and it is only through modern medicine that children can survive them at all. It's fair to expect medicine to provide the solution to the problem it has created. There's nothing natural about children having to live their lives in and out of a hospital.

So… let’s have HIV positive people die since they can’t naturally live without modern medicine?

Why do adults get to be rescued by modern medicine and not children ?

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