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Comment by jcims | Hacker News Reader

We found out about my daughter's type 1 diabetes purely by accident. I found a blood glucose test kit doing some spring cleaning and asked the family to gather around to check our sugar. It was really just a joke but I thought it would be fun. Queue three results around 100 and one at 270. We tested again the next day and it was 290.

Finding type 1 diabetes this way in a young teenager was so absolutely out of the norm that a major children's hospital had no idea what to do with her. They admitted her because it was protocol but it was completely unnecessary and we had to explain how it happened at least ten times while we were there.

It was an eye opening experience.

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Yeah that’s wild! I do think proactive medical screening is something most medical systems have mostly given up on, other than in very targeted ways, for very specific diseases in very specific high risk populations. But I don’t think this is because it’s a fundamentally bad idea, I think it’s more that it’s impractical right now. It does seem to me that AI has a chance to make it practical.

If you screen a lot of people for a lot of things, you will find a lot of things, but not all the findings will mean something or require action. The initial ramp up of huge "unwarranted" screenings will create a lot of pain until we/AI figures out when something warrants attention.

Can't we intelligently limit that to things with essentially no risk of false positive?

The problem with that is that even "essentially no risk of false positives" starts adding up when you do millions of tests every year.

If those tests are done on demographics where the chance of a true positive is also very low and the difference in risk profile between catching it during such screening vs. waiting until the patient discovers it is not very significant, it can take a very low rate of complications before it becomes a problem.

But, yes, we do limit that, and that is a major reason there are very few mass screening programs.

Then the selection of tests might get very small and we simply don't even know what all might be relevant if doing billions and billions of tests on a lot things - a lot of possible weird things to trip us up.

It is a fundamentally bad idea to do without very specific understanding of the risks. E.g. many programs intended to expand mass screening for breast cancer were reconsidered after it became clear that it was not a given that they would provide a net benefit, because it takes a very low level of risk from screenings and subsequent follow-ups before mass screening becomes harmful when applied to groups where it is likely to save many lives.

years ago doing similar thing found out my type2 diabetes when i was 24. It has been a life saver since i am able to manage it before any complication.

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