OT: Doctors are NOT gods; fire those that act that way

Sounds like they didn't teach them the important bits in medschool. Hope they know than cancer isn't a single disease, though!

It is not a "trick question", but it IS an imaginary situation that a doctor would not encounter in practice. "a test to detect a disease" with those parameters will of course not be used.

It is just like a DMM manufacturer that offers a 4-digit DMM with an accuracy of .01% +/- 50 counts. You can ask the users what it means for the accuracy of the indicated values, and it can be answered, but it is not a device you will find on the market.

a

It is a real situation that doctors will encounter quite frequently in prac tice.

There are quite a few rare diseases about, and tests for these diseases whi ch are set up to give a low - but non-zero - rate of false positives. You c an you set the criterion to give fewer false positives but this then raises the false negative rate - and false negatives have even nastier consequenc es than false positives.

The prostate specific antigen test isn't a perfect example of this kind of test, since it detects several benign conditions as well as prostate cancer , but it is a widely used test which requires doctors to explain the - limi ted - significance of a positive result rather carefully. Not all of them c an manage it.

--
Bill Sloman, Sydney

They are used all the time. You think it won't be used because it has a high false positive rate? It will when that is all there is.

Out of all of Roberts cut-and-paste spam dumps on s.e.d, this is the first one I recall that is not just some recylced urban myth he has fallen for.

Look at prostate cancer screening as an example

The same is true for many other types of cancer screening, the more rare the disease the more harm screening can do. The benefit of detection of real disease, that will result in death, needs to be weighed against the harm of unneccessary surgery and complications.

It is not that all screening is useless, but needs to be used in conjuction with the false positive rate and te prevalance as Robert describes. I would have hoped that actual doctors know this.

The difference is that in some cases medical tests are simply not that definitive.

--

John Devereux

** Looks very much like a contrived and trick question, I bet the Harvard Medical School story is a fabrication too.

The "False Positive Paradox" is well known and so has a Wiki:

... Phil

.... Phil

It's not reality because a doctor would not request or rely on such a test knowing "nothing about a person's symptoms or signs".

Does your doctor start cutting immediately if your PSA is positive? I agree, you need to find a new doctor!

That's the point. It's not reality.

But they're not used in a vacuum, either.

The actual practice is much more than doing simple arithmetic. In this case , you're looking for the positive predictive value or PPV. In the case of a disease of such low prevalence coupled with potentially harmful confirmato ry diagnosis, other more practical techniques are used.

It's another dumb and mythical post, the right-wing moron who wrote the blu rb he cut and pasted doesn't have a clue about how medicine is practiced. T he practice always follow guidelines prescribed by their national health au thority, and those guidelines originate with a working group or committee w ho base their decisions on the best science available at the time.

lurb he cut and pasted doesn't have a clue about how medicine is practiced. The practice always follow guidelines prescribed by their national health authority, and those guidelines originate with a working group or committee who base their decisions on the best science available at the time.

I agreed until you said best science.

NT

So far your pink utopian theory.

In reality the field of medicine is one big mess of extremely huge corporate financial interests and people in those working groups and committees you mention are standing neck deep in a pool of mixed and conflicting interests, and there is no fair equilibrium in that.

Example: The WHO, not without reason called the highest medical authority on this world, changed the definition of pandemic prior to the outbreaks of the bird-, pig-, asian- and whatever flues with the result that governments were contractually obliged to purchase loads of vaccines from the pharmaceutical companies, just 'in case', of which the majority hasn't been used. This highly fraudulent joke has transferred billions from the general population to the stockholders of the companies involved. And the mess doesn't stop there.

So yes, the practice follows the guidelines, even when the practitioner thinks it's not in the interest of his patient, because if he doesn't, he will lose his career, or even his license.

I don't see what's so good in that.

joe

And yet, you can't seem to come up with anything better.

All aspects of our institutions are motivated by the personal interests of those making each decision. All human systems are like that, including engineering. The problem with medicine is that the patients have been unwilling to have a voice thinking the doctors know best. So far that has allowed the medical industry to control the motivations for doctors. There is one solution that will solve many of the problems, but most don't want to hear about it. So we keep the antiquated system we have had for so long... and all of it's problems except for one. At least now anyone can get insurance so they can at least be part of the system rather than not getting the care they need.

When patients decide to do some thinking for themselves maybe things will change.

--

Rick

Some do. We are a pain in the ass for some doctors and a breath of fresh ai r for others. The difference is their competence and ours. Like my Father : "I am not taking that, it is a calcium blocker". Then there were the whate ver MAO inhibitors they used to prescribe for a bunch of things, WHAT ?

They are taught that this set of symptoms and readings means X disease, thr eat with X, if that does not work try Y, and if that doesn't work try Z. Th at is why they could not diagnose my black mold. There is no set of symptom s. We found it in the environment. Once removed I started to recover.

So basically, they are not even as competent as a TV tech 2ho has to go wit h NO information sometimes, and if the patient dies, does not get paid. The y have alot of knowledge, but critical thinking is not paramount as it shou ld be.

Some people do interact with their doctor and are active their treatment ap proach. And some doctors do not like that. Fukum. They should go flip burge rs. Can't have them making steaks because of rare, medium rare and all that . No taking orders, all must be the same. You will take the drugs from the company that bought me these dandy golf clubs and I don't want any lip. DOC TOR'S ORDERS !

Well I don't take orders from people I pay.

So the gods are good at algebra?

I just thought they had a funny sense of humour.

RL