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Diagnostic tests 'just to be on the safe side' not recommended (We are better off ignorant)
Medical Xpress / Norwegian University of Science and Tech / Journal of General Internal Medicine ^ | Jan. 16, 2023 | Bjørn Hofmann

Posted on 01/21/2023 3:18:57 PM PST by ConservativeMind

Paradoxical maybe, but it's what often happens in the health services: When you ask for an MRI to be on the safe side, your uncertainty increases, says Bjørn Hoffman, a professor at the Department of Health Sciences at the Norwegian University of Science and Technology, Gjøvik.

Imagine that you contact your GP because you have back pain. You want to have your back examined and so you request an MRI. The GP knows that if the pain has lasted less than four to six weeks and you are not experiencing certain warning symptoms, then sending you for an MRI will be of little help.

But you think it has to be better to know than not to know and push to have the MRI. The GP wants to be helpful and agrees to an MRI referral. You go in for your appointment a few weeks later, and after a few days you hear back.

The MRI results show that you have several herniated discs in your back. It is unclear whether they have anything to do with your current pain or are old prolapses.

Yet you still think that this finding might be a possible cause of the pain, and you read up on prolapses. Could surgery help? You ask your GP whether you should be referred to an orthopedist for assessment. The GP says there's no good reason to do that, but you're not sure what the best option is—your back really hurts and you're even more unsure than you were before you had the MRI.

Should you have surgery? Would an operation be successful—and what are the risks?

This is just one example of how we can become more uncertain by trying to reduce uncertainty. In the case above, the MRI generated a (random) finding of ambiguous significance.

(Excerpt) Read more at medicalxpress.com ...


TOPICS: Health/Medicine
KEYWORDS: diagnostictests; imaging
I didn't edit this one down.

The lengths some in the medical establishment go to to keep you ignorant, yet, they hope, happy, are innumerable.

He mentions doctors assisting patients in these cases is a bad thing. He later mentions the threat of a false positive.

I personally encourage people to get their own preventative tests done. These will generally be at your expense, unless it’s an annual physical. I had a full body CT scan done a few years ago, and and full body MRI done last year. I get some testing done through online providers like Direct Labs, for some things I know my doctor would not order, but are helpful.

There’s more at the link.

1 posted on 01/21/2023 3:18:57 PM PST by ConservativeMind
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To: Mazey; ckilmer; goodnesswins; Jane Long; BusterDog; jy8z; ProtectOurFreedom; matthew fuller; ...

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2 posted on 01/21/2023 3:19:32 PM PST by ConservativeMind (Trump: Befuddling Democrats, Republicans, and the Media for the benefit of the US and all mankind.)
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To: ConservativeMind
I endured years of low back pain before I could get them to do an MRI. By the time they did one, my stenosis had me using a walker and begging for stronger opioids. Meanwhile the Establishment had collected tens of thousands of $$ for worthless PT treatments and even epidurals, while what I needed all along was a laminectomy. Not that that was a great experience, but I'll spare y'all the nasty details.
3 posted on 01/21/2023 3:53:25 PM PST by Chad C. Mulligan (eleutheromaniac)
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I wear a knee bracel or a back brace when either acts up.


4 posted on 01/21/2023 3:56:38 PM PST by Does so (What distinguishes today's Russian aggression from that of the USSR?)
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To: ConservativeMind

Here’s the false positive problem.

Take a test that’s 99.5% accurate (HIV testing, for example).

Test 1000 Kinshasa prostitutes. 500 test positive. 496 have HIV, 3 don’t. 500 test negative, 498 don’t have HIV, 2 do.
5 wrong/1000 = 99.5% accurate.

Now test 1000 nuns. 995 test negative, 5 test positive, none have HIV. 99.5% accurate.

So, it’s not just how “accurate” a test is, but what is the anterior probability (probability before the test) that you have the disease in question.

A lot of expensive “screening” tests that people buy have very low anterior probabilities - so that half, or more than half, of positive tests will be false positives. And after the biopsy and the surgery, or whatever happens because of the false positive test, it’s no longer just your money, but it’s also the harm and even occasionally the deaths that result from unnecessary testing.


5 posted on 01/21/2023 7:28:16 PM PST by Jim Noble (You have sat too long for any good you have been doing)
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To: Jim Noble
If one is worried about false positives, try the test again or a different test.

Additionally, MRIs and CT scans can't “false positive.” What is there, is there. For instance, I have never heard of someone getting an MRI and having a picture of the Himalayan mountains or the moon showing up. You get exactly what is on that image. If something looks out of the ordinary, it is. You just don't know what sort of tumor or issue it is.

Blood and urine tests can help with further locking what it might be, down, but exploratory surgery may be needed.

A lot of latent cancers and other issues are now being detected by such voluntary scans. As we pay for such voluntary scans ourselves, no insurance resources are used until a likely problem is found, and then it's found early.

6 posted on 01/21/2023 8:01:52 PM PST by ConservativeMind (Trump: Befuddling Democrats, Republicans, and the Media for the benefit of the US and all mankind.)
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To: ConservativeMind

This is a perfect example of how Socialized Medicine works....there is a natural tendency to NOT stay ahead of health concerns but restrict diagnosis on the basis of scarce resources and too little finding in the free public health system.Plus the quality of care varies substantially if you are a relative of physician or higher up in government.

Thank goodness we do not have that problem in the USA compared to the Scandinavian countries, the UK and Canada.

Note also that a soft form of euthanasia is permissible in Canada and the Scandinavian countries.Their health systems will inform you when its OK to kill yourself and they offer you an assisted death option.

I lived in Canada and the USA. The US has a much better health system when it comes to this issue.


7 posted on 01/22/2023 5:02:30 AM PST by Candor7 ( ( Ask not for whom THE Trump trolls...He trolls for thee!))
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