November 8th, 2014


Interesting Links for 08-11-2014

circular reasoning

Some doctors seem to think the answer is "More ignorance"

Over here is an article about thyroid cancer rates going up.

The article looks at why they've gone up, and sensibly uncovers that it's not because rates are increasing, but because it's now really easy to detect it.

It also points out that most thyroid cancers do people no harm, and that the treatment for it is much worse than the cancer itself unless you've got a severe case of it.

The money sentence is:
An epidemic of diagnosis is not good for anyone’s health. Resources are needlessly diverted; people are needlessly scared. But the biggest problem is that it begets an epidemic of treatment.
Which is fine in and of itself, except that the conclusion the author draws is "Therefore we should stop screening for it."

Which is the stupidest fucking thing I have heard in quite some time.

The answer is not to stop _knowing_ it's to break the automatic link between "We have discovered something" and "Therefore we must act!"

"Something Must Be Done!" is one of the curses of society, where everyone from politicians placating the media to doctor's placating demanding patients (and bosses nervous about litigation) feel they have to Do Something rather than making a sensible judgement.

It seems blindingly obvious to me that the answer here is to say to the patient "You have a problem. If we act then you will have these seventeen side effects. If we do not act then you will probably be fine for decades. We can take it out if you really want, or we can bring you back in once per year to check on it, and in the meantime you can watch out for symptoms X and Y."

But no, apparently once we know that there is even the slightest problem we must do something, even if that something is worse than the problem. And the answer is just not to find things out in the first place.

*insert incoherent noises of rage here*

Edit: The evidence, as pointed out in the discussions below, doesn't actually show a benefit from the screening. At least not on a broad level. I'm still intensely annoyed at the idea that because we find something it must be fixed. Particularly as patients, when presented with the information in the right way, will make sensible decisions:

Original post on Dreamwidth - there are comment count unavailable comments there.