False positives trigger more diagnostics some of which can be harmful, not just psychologically but physiologically as well.
If false positives are ok, why not build a down time detector that rolls a die every 5 mins and alert on hitting a 6.
If false positives are ok, why not build a down time detector that rolls a die every 5 mins and alert on hitting a 6.
It's perceived as much less (medico-legally) risky to "do something" (or more often "refer the patient to someone else to do something") than not do something.
I would argue that getting "predatory capitalism" out of the way has sharply curtailed MRI availability where that's been tried. Maybe we should loosen the leash on capitalism a bit to get better care...
Like what?
I've seen instances where this is used as an excuse for what is, ostensibly, a trick to dimiss people using something that sounds vaguely professional. Like when doctors say they don't want to do additional x-rays because of the risk of radiation exposure, nvm that if it comes out slightly blurry they'll ask to redo it, or if you're cautious about it initially they'll tell you how it's not big deal and there's more radiation in a cluster of bananas.
A lot of potential harms are at a societal level as well—from a public health perspective, if everyone starts having regular MRIs that produce incidental findings which require followup, you’re suddenly tying up lots of resources that would otherwise be available to actually-sick people. A person with symptomatic problems whose treatment is delayed because they can’t get an appointment because the specialists are booked full with incidental findings, that person is indirectly harmed by this.
The radiation from CT scans is not especially concerning at an individual level when there is a compelling reason for it, but, if we’re suddenly doing tons more to investigate incidental MRI findings, there may well be a point where those scans are causing a significant amount of cancer overall—a recent study suggested, I believe, that CT scans may be responsible for 5% of cancers already.
Well, from the original article: "And if someone is over-diagnosed, gets a biopsy and develops an infection, that's a direct harm."
Contrast-induced nephropathy?
Gadolinium accumulation in the brain doesn't sound good for you...
Although I think this argument is usually talking about the risks of the resulting procedures (eg an injury or complication related to a biopsy done for a finding on imaging).
It takes a lot to clear the dye.
Personally I’d rather have cancer checked out rather than have a “wait and die” approach
And the person that's making the recommendation on whether or not to check it out may get sued for $10M if they tell you it's probably nothing and they're wrong, but have no harm come to them if they tell you it's worth having some other doctor do a biopsy.
And they might make an extra couple hundred bucks every time you have to come back and see them to follow up on this spot.
And the radiologist interpreting the MRIs... the same perverse incentives regarding how they interpret a "spot."