> My real anger at airport screening is that we have found it possible to fund and implement this level of screening, at massive monetary, human and privacy cost, but I can't go to my doctor and for a few pennies (sorry, those don't exist now, how about for a few nickles?) get a body scan that does all the 3d segmentation, recognition, etc etc etc. We could actually save lives
This always strikes me as a weird thing tech people believe about medicine. Full body scans just aren’t medically useful for otherwise healthy people. You’ll inevitably see something and it’s almost certainly going to be benign but might send you down the path of a lot of expensive and dangerous treatments or exploratory procedures. This is why there’s always so much debate about prostrate exam and breast exam age recommendations. There’s a tipping point where the risk of iatrogenesis outward the risk of disease.
People should be able to do full 3d scans of their bodies, and then doctors should be able to tell them what they should ignore. If they spot something abnormal they could suggest coming back 6 months or a year later to check if it has changed, just like mole scans. The problems that you suggest only come from people overreacting to test results. We can do better.
Yep, it is working as intended then. My point was more that “preventative MRIs cause more problems than they solve” is an annoying statement because it does not have to be true if you get good medical advice. But saying “preventative MRIs are not worth the cost” is quite reasonable.
I read most of the research on this topic. And it's all basically "overdiagnosing".
We had the same story about prostate cancer screening: "overdiagnosing", "people die with prostate cancer but not of prostate cancer", blah blah blah. It turned out that simply adjusting the aggressiveness of follow-up was enough to make prostate cancer result in significantly fewer deaths.
From my point of view: MRI is the ONLY tool that can catch things like pancreatic cancer before it's lethal.
Sure but you have to scale that prostate intervention change across literally everything in every kind of internal medicine. There's just no way to justify the cost of doing this regularly for most people.
Just imagine the same argument, but for bloodwork. You're literally saying: "We didn't have to deal with these pesky MRIs before, so go away".
We will need some additional radiologist training, and the primary care doctors will need to learn when to escalate and/or require followup scans. But that's really about it.
MRIs are _cheap_ these days. The true cost of a scan is around $1000, including the radiologist's reading. They don't have to be reserved as a tool of the last resort.
I can make the same argument. Functional “medicine” quacks order loads of unnecessary blood tests with no diagnostic power to sell you supplements. I actually know someone who was was injured by one of those “supplements” after such a blood test.
No I’m saying for most people there’s more noise than signal and iatrogenesis is real. Pretending it’s not is foolish.
To put it in perspective, the real worry about MRIs is that people would want to do biopsies or a PET scan if they find something that looks like cancer.
That's really the main concern. And we can fix that by doing a follow-up scan several months later to look for any changes. It also has a nice side-effect of reassuring hypochondriacs that they _don't_ have cancer.
This always strikes me as a weird thing tech people believe about medicine. Full body scans just aren’t medically useful for otherwise healthy people. You’ll inevitably see something and it’s almost certainly going to be benign but might send you down the path of a lot of expensive and dangerous treatments or exploratory procedures. This is why there’s always so much debate about prostrate exam and breast exam age recommendations. There’s a tipping point where the risk of iatrogenesis outward the risk of disease.