Comments on: What’s bad for the goose…

By: Don Carlos

Don Carlos — Fri, 25 May 2012 17:42:08 +0000

“Do no harm” has its roots some 2000 years ago, and is today only applicable by therapeutic nihilists. For example, if an antibiotic is highly effective at curing a bacterial infection with a 20% (untreated) mortality rate but causes a fatal anaphylactic reaction once in 20,000 cases, does the “First, do no harm” doctrine apply?

Doom: you have not responded to my query of 23 May. Chicken?

By: Doom

Doom — Fri, 25 May 2012 17:13:36 +0000

Steve,

I agree with these last too comments from you. It is just that doctors have their own agenda, and to some unknown but significant degree that comes down to making money. Procedures, needed or not, make money. There are both sides to that coin and I think doctors are just as guilty of stretch as the government. Since many procedures are already government paid, one could argue that the debate is an internal government one, so no side is necessarily choosing for the patient, rightly, or on some moral high ground, but each speaks for their own interests.

And, your final post? Absolutely. But unless they make true positives accurate enough, and can filter out the unneeded (60%), then they really don’t know what they are doing, literally. What is the first rule of medicine? Do no harm, put very simply. They fail here.

By: SteveM

SteveM — Fri, 25 May 2012 14:52:45 +0000

Reminder: False positives suck, false negatives are heartbreaking, true positives are the worst, but also the best if a screening discovers a problem early enough for long-term remission or cure.

By: SteveM

SteveM — Fri, 25 May 2012 14:49:04 +0000

1. USPSTF is funded by the government.
2. The government is trying to cut costs for healthcare that they pay for.
3. Marching orders: Downgrade recommendations for screening tests, which might lead to expensive diagnostic studies.
4. Mission accomplished.

The reality? Many (most?) medical practitioners regard the Task Force recommendations as unrealistic, and have value only as the Weatherman for which way the government wind is driving healthcare.

By: Doom

Doom — Fri, 25 May 2012 02:07:31 +0000

Die unnecessarily, that is.

By: Doom

Doom — Fri, 25 May 2012 02:06:21 +0000

Don,

That 60% isn’t false positives, though that is rather high too. I can’t recall exactly, but I thought that had been in the 25% range. Now, you can’t just add 60% of cancers not becoming dangerous plus 25% of false positives that are wrongly treated in the first place, but it adds up to a LOT of unnecessary anguish. In my book, that means most treatment is bad. If they could get the percentages down into the 10%, or even 15%, then I’d bite.

Just add up how many women are being unnecessarily treated and what it does to their lives, their husband’s and children’s lives, their careers, their income, plus the costs, and as is, it’s not worth the screening. Heck, I would bet at those numbers more women die from the “cure” than die from the stinking disease!

By: KBK

KBK — Thu, 24 May 2012 02:19:37 +0000

Two words: watchful waiting.

By: Don Carlos

Don Carlos — Wed, 23 May 2012 22:08:30 +0000

Doom:
What is an acceptable rate of false positives for you?
Kindly remember that PSA is a screening test, not a diagnostic test.

By: Steve

Steve — Wed, 23 May 2012 19:11:58 +0000

The U.S. Preventive Services Task Force

What a name. Unbelievable really. Orwellian.

By: T

Wed, 23 May 2012 15:46:56 +0000

@2:41 Sergey wrote: “Early detection never reduce costs.”

My point above (@ 1:44 AM) is that we are contstantly TOLD that early detection reduces costs by the same people who work to limit or eliminate early detection techniques.

Susannamantha you restate my point succinctly. Thank you.