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astrea

So what's the alternative? Just wait until something bad happens to come in? Seems a lot more unproductive.

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I think this isn’t about specific screenings rather than the most basic physicals people get.

Screenings for specific diseases like cancer and regular blood checkups do definitively catch things early.

So if this article is not against regular blood checkups then what...?

"“From a health perspective, the annual physical exam is basically worthless,” Zeke Emanuel, an oncologist at the University of Pennsylvania, has written after reviewing the research.

"Almost nothing in the complete annual physical examination is based on evidence," Michael Rothberg, who directs the Cleveland Clinic Medicine Institute Center for Value-Based Care Research, wrote in the esteemed Journal of the American Medical Association in 2014. "Why, then, do we continue to examine healthy patients?""

At the turn of the century in the early 1900s we were nuking babies' thyroids cause the only corpses they could find had diseased thyroids and the healthy babies had them. So obviously something must be wrong.

There's always value in the counter example to see where our processes breakdown and fail.

What we learn tomorrow in how abnormal our bodies are from another?

So bloodwork yes but no touch...?

But I would never get screened or do blood work if it weren't for my annual checkup.

Your annual physical is where those things happen, or get scheduled.

That's what baffles me about this article. My annual checkup is pretty much the only time I ever see my doctor at all.

In most cases, you’re far more likely to get a false positive than a real positive with those tests - unless you feel or notice something wrong already.

That is what is being pointed out.

If it ain't broke, don't fix it. Most diagnostic tests have good sensitivity (they pick up most cases of real disease) but relatively poor specificity (they pick up lots of false positives). Actively looking for asymptomatic disease does identify some diseases earlier and improve outcomes for those patients, but it also subjects a large number of patients to expensive, inconvenient, painful and risky tests and treatment. The benefits to the former group are matched almost exactly by the harms to the latter group, so (with very few exceptions) just waiting for symptoms to emerge gives you the same net benefits at significantly lower cost.

> So what's the alternative? Just wait until something bad happens to come in? Seems a lot more unproductive.

Maybe it does seem less productive, but really it’s just a reminder that surprising results that contradict are intuition need not be wrong.

Make a list of which screening do appear to be beneficial, and setup doctor visits based on the recommended schedules for those screenings instead of annually.

Does this list exist anywhere? I would have assumed so, but I'm struggling to find it.

Or maybe it's exactly the same?

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