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byInvicta{HOG} ( 38763 ) writes:
He makes a lot of good points in his article. Obviously the length of the article limits how much detail he can go into and how much of data he can reference, but there is definitely a lot of tests and procedures which are likely causing more harm than good. He makes note of one good example (prostate cancer screening) that we know causes more harm than good in certain populations. In older men, detection of prostate cancer is far more common but the chances of symptoms from the prostate cancer is low. We actually know that in these men we cause more harm than good due to morbidity from biopsies and from unnecessary surgeries/procedures.
It is unfortunate that he mentions the lower cut-off for diabetes - even if he thinks that 130 is too low, we actually know that even people with fasting sugars of 100 are at increased risk for diabetes and, thus, for death. If the intervention is more intensive couseling of lifestyle changes, then there's not a lot of downside to increasing the diagnosis of diabetes and prediabetes.
But his central point still stands - if the US is going to tame its healthcare costs then it needs to look at overdiagnosis and its causes. In some cases, expert committees and professional societies (with their own biases) are to blame. In other cases, malpractice lawyers, the pharmaceutical industry, greedy doctors, and patients who cannot live with uncertainty are to blame. Luckily, there are entire journals devoted to this aspect of healthcare policy and it has not been ignored by mainstream medicine and those who wish to improve it.
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byInvicta{HOG} ( 38763 ) writes:
Haha you can read my prior posts you so funny
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