Earlier quoted context omitted.
I've heard this argument before and it's always seemed downstream of capacity constraints and the current incentives of the healthcare industry. There's a reason why billionaires like David Rockefeller, Larry Ellison, and Rupert Murdoch are able to live much longer lives than average, and having an oncall health team (that I'm sure does frequent testing and monitoring) is a big contributor to that. More testing and d…
It's obviously a lie to get us to accept no tests due to limited machines. The same as when COVID started masks "didn't help" because they didn't yet secure enough supply for everyone, then when they did, suddenly the masks helped. Every system that exists as a black box is more understandable with more sensing, not less. Our bodies are not special. It's also ridiculous that the proposition goes like: 1. Doctor knows…
Midjourney Medical
351–360 of 927 posts
Re: Midjourney Medical
#352Earlier quoted context omitted.
Yes, don’t do tests on asymptomatic low-risk people until you can demonstrate that a positive result has any meaning whatsoever.
Hypertension is asymptomatic for years and is prevalent in every demographic. Leaving it unattended it can cause stroke, heart attack, or organ damage through long-term vessel strain, by which time damage may be irreversible; detecting it on time can prevent this with lifestyle changes and medication. Diabetes is asymptomatic for years and is prevalent in every demographic. Leaving it unattended it can cause damage t…
On the other end of the spectrum, what doesn’t make sense is testing a random person off the street for Ebola. The prevalence approaches zero and symptoms are fairly noticeable, so any positive test is definitely wrong.
Most diseases are in between and have to be evaluated case by case, not buckshot.
You may be particularly interested to hear that there’s little evidence to support regular checkups in most adults beyond blood pressure testing and cervical cytology.
> Given the lack of favorable evidence and the potential adverse effect, primary care providers should consider the fact that general health checks, beyond the screening interventions shown to have benefit, likely have little or no effect on important health outcomes. Some of the interventions with demonstrated benefit have sufficiently large effects that a uniform application is warranted (blood pressure measurement and cervical cytology screening). In others, the trade‑off between benefits and harms is so close that patients should be involved in fully shared decision making regarding their participation (breast and colon cancer screening).
https://pubmed.ncbi.nlm.nih.gov/31642821/
I suspect your doctor would agree with me. See if they’ll test you for Ebola, for instance. Not because you have symptoms but just cuz.
Re: Midjourney Medical
#353Earlier quoted context omitted.
> it's _git gud_ There are physical limits to detection and technical parameters that make some situations indeterminate even for the best of the 'gud'. It is frustrating that, hearing an argument from many different individuals over a long time, you assume that each speaker is missing the critical insight that you possess. > but the tools to make scalable, calibrated risk estimates based on large data dumps is getti…
I go to the doctor every year for a checkup without symptoms. Why a year? Why not every six months? Two weeks? Day? If the false positive rate is demonstrably low, I can't see the risk. People who think they need a doctor will go to a doctor with or without a fancy scan. People who want to play armchair physician will play armchair physician with or without a fancy scan.
Many countries with far better outcomes don’t do this, is it necessary, or is it just the product of an insurance-driven health industry which prioritises interventions over health?
Re: Midjourney Medical
#354Earlier quoted context omitted.
If the whole population had a full body scan every quarter, the “weird” things would feel more like the noise they are. But we would have great data over time, both individually (weird tends to only matter if they are changing) and as a population.
> If the whole population had a full body scan every quarter, the “weird” things would feel more like the noise they are. That's a tautology. We already have quite robust methods for detecting developed anomalies, treating every anomaly below standard human-to-human variation effectively raises the noise floor to already developed anomalies, defeating the purpose of population wide routine scans.
Re: Midjourney Medical
#355Inventing new, affordable early detection devices is incredible, but being so misleading in their positioning is going to kill long-term trust in this and other new scanning tech.
Re: Midjourney Medical
#356Clearly something like this would need to be approved by the FDA, it is literally irresponsible to promote something like this as being more powerful than a MRI.
Are you implying soundwaves are dangerous?
Re: Midjourney Medical
#357Re: Midjourney Medical
#358> But suddenly, you have a huge library of data about your health. With "you" being a VC backed startup aiming for the next $1T IPO. What could possibly go wrong?
> As a reminder, Midjourney has no investors. We are a totally new kind of research lab. We've seen academic, corporate, and government labs - but we are a distinct (and curious) new thing: we are a community-backed research lab.
Re: Midjourney Medical
#359Re: Midjourney Medical
#360At the end of the post mortum with the CMO, as I was getting ready to leave I decided to bring this to his attention. I’ll never forget the change of mood preceding the dressing down I received: “do not ever put yourself in a position to make clinical decisions.”
3 months later, the charting anomalies were so egregious that the CMO’s spot-checks led him to sit the medical director of that physicians clinic down for a chat. They were good doctors, but they were over-billing. A year and a half later their practice goes under pre-payment review, and four years after I wrote a script that noticed an anomaly - the head MD of the practice was sent to prison for 4 years after collecting millions of dollars in over-billed house calls.
I loved working in healthcare, and I still miss it to this day. I don’t know where I am going with this, but right now I believe there is a diagnostic technology out there that is being used in veterinary science or piloted in some other country that could save a statistic level of lives …. However, due to the fact that doctors practice medicine and we don’t, as a group they act as defacto gate-keepers (which they are entitled to be as clinicians), the best thing you can do is to incentivize them with money (like Obama did) with Medicare bonuses for using an EMR that logged CCRs and alerted the doc if the patient didn’t have certain vaccine information in the elderly.
If the first guy to wash his hands was seen as a lunatic, the first geriatric practitioner to give over an iota of their clinical practice to automate Rx dispersal while navigating poly pharmacology concerns will go to jail for a narcotics crimes or will be labeled to heretic until Medicare pays them all for it.