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Comment by vasco | Hacker News Reader

It's obviously a lie to get us to accept no tests due to limited machines. The same as when COVID started masks "didn't help" because they didn't yet secure enough supply for everyone, then when they did, suddenly the masks helped.

Every system that exists as a black box is more understandable with more sensing, not less. Our bodies are not special.

It's also ridiculous that the proposition goes like:

1. Doctor knows some tests will flag tumors or variations that look weird and that we shouldn't then go investigate all of them

2. Doctor shuts off their brain and will then investigate all of them by doing invasive procedures

Just knowing how many such variations there are and if they grow or not is useful information. But the doctors pretend like they are super smart before the test and super dumb right after.

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This kind of thinking (that it’s an obvious lie, perpetrated by a cabal) is the sort of superstitious bullshit that is going to jet us all killed. Look up Bayes theorem. As yourself how good a test would have to be if the base rate is low. Wonder what the probability of harm might be if the next advised test was invasive and the patients was anxious because a lump had been detected.

You should read til the end! No cabal, just stupidity and believing other people are stupid instead of telling them the truth and expecting them to act smart based on the information.

Ask yourself, do you think billionnaires have yearly MRIs or that they wait for later because the doctor and themselves will be anxious? It's an argument that treats regular people as stupid.

First, many regular people are “stupid” in the sense that they do get anxious about things that ar slow probability and are not anxious about things that are high probability.

If you are a billionaire you also have a doctor with the time and expertise to properly evaluate the evidence in a Bayesian framework, and you have time to talk to them and understand and implications. That isn’t scalable.

Also, it’s quite likely that billionaires are having lots of unnecessary procedures and that harm is being caused. The mri scans are not the reason they live longer!

Ok but now the argument shifted from "More MRI = bad" to "More MRI = okay as long as doctors do a good job and have enough time". I agree with that. My point was just that it's possible to get to a point where everyone having yearly MRIs is doable because the issue isn't with more information in itself, it's with doctors not having enough time for the patient.

But now your argument also depends on no opportunity costs for doing unneeded mri, or infinite medical resources.

As I said … we really don’t known how much harm billionaires are suffering (sob) and there are much simpler explanations for their longevity.

It's not the same doctors saying they themselves are simultaneously smart and stupid. It's "smart" doctors saying that as a point of policy, it is not a good idea for biomedical companies to try to make a buck off of popularizing unnecessary diagnostics, because anxious patients will by chance or by intention find a "dumb" doctor who will agree to perform invasive procedures. (Have you ever heard a tech person say that the tech world has a lot of stupid ideas? It's the same thing.) Look up what happened with South Korea diagnosis vs. mortality rates when they instituted national thyroid screenings in the 90s.

> Every system that exists as a black box is more understandable with more sensing, not less.

With perfect humans in a perfect society, maybe. But such is ignoring the elephants in the room here, from the actual experts on the topic.

So do you think the doctors should hide the data from you so you don’t know anything looks weird, or tell you it looks weird but they don’t think it’s worth investigating it? And do you think the average patient will say “ok that’s fine, I’m not getting a second opinion and if I die my family will sue you into the grave too”?

I believe doctors should tell you the truth and not assume you will do things later that are detrimental with the information as that has a lot of bad consequences.

Case in point, doing that during COVID I think amplified the wave of antivaxxers and medical denialists. Which itself had in my opinion a way worse effect on global health than almost anything else recently because now you have to convince a number of people to trust the medical system again.

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