Comments on: "A CT scan in hand is far better then no CT scan or biopsy at all" http://www.kevinmd.com/blog/2007/03/ct-scan-in-hand-is-far-better-then-no.html Tue, 14 Feb 2012 23:00:00 +0000 hourly 1 By: Happymanhttp://www.kevinmd.com/blog/2007/03/ct-scan-in-hand-is-far-better-then-no.html#comment-72947 Happyman Fri, 16 Mar 2007 23:33:00 +0000 http://clients.emmense.com/kevinmd/2007/03/a-ct-scan-in-hand-is-far-better-then-no-ct-scan-or-biopsy-at-all.html#comment-72947 I wonder if Dr.Siegel has a stake in the Princeton Longevity Centers and their pan-ct-scans. And I wonder if they add to longevity as their name suggests, or if anyone cares whether they do or not, as long as "my patients know as early as possible, because they want to know".<br/><br/>Ridiculous.<br/><br/>If doctors (internists, no less, those who are drilled with EBM from early in residency) don't understand the math or translating it into clinical practice, those who DO understand it will NEVER be able to convince our patients of the right course, even when epidemiologic studies enter mainstream media in almost original unadulterated & unaltered format. I wonder if Dr.Siegel has a stake in the Princeton Longevity Centers and their pan-ct-scans. And I wonder if they add to longevity as their name suggests, or if anyone cares whether they do or not, as long as “my patients know as early as possible, because they want to know”.

Ridiculous.

If doctors (internists, no less, those who are drilled with EBM from early in residency) don’t understand the math or translating it into clinical practice, those who DO understand it will NEVER be able to convince our patients of the right course, even when epidemiologic studies enter mainstream media in almost original unadulterated & unaltered format.

]]> By: Gasmanhttp://www.kevinmd.com/blog/2007/03/ct-scan-in-hand-is-far-better-then-no.html#comment-72899 Gasman Thu, 15 Mar 2007 18:06:00 +0000 http://clients.emmense.com/kevinmd/2007/03/a-ct-scan-in-hand-is-far-better-then-no-ct-scan-or-biopsy-at-all.html#comment-72899 Innumeracy bias again, this time from the doc. Sadly Diora, few humans, regardless of educational background can accept statistics that provide answers they don't like.<br/><br/>The numbers don't lie. Indeed they reveal that which we are unable to see when medicine is practiced anecdotally, that is, one patient at a time.<br/><br/>The randomized trial with biases eliminated and unequivocal outcomes (a body count) revealed no health benefit from the CT scans. Indeed, the patient's with the CT scans didn't live quite as long. Knowing one's potential fate possibly had some consequences, like following a positive CT with invasive and sometimes deadly confirmatory tests. Further, if the patient's time spent obtaining the CT scanning and followup tests, treatment ect. is counted as days of life lost (lost in the sense that they were not available to the patient to expend in a completely voluntary and utilitarian way) then the CT group would look even less favorable. <br/>There is nothing abstract or impersonal about the results of this study as many anecdotalists would like to believe. Instead of smokers and former smokers hand-wringing over whether a CT scan can save their lives, the real lesson here is to just stop the damn smoking! Innumeracy bias again, this time from the doc. Sadly Diora, few humans, regardless of educational background can accept statistics that provide answers they don’t like.

The numbers don’t lie. Indeed they reveal that which we are unable to see when medicine is practiced anecdotally, that is, one patient at a time.

The randomized trial with biases eliminated and unequivocal outcomes (a body count) revealed no health benefit from the CT scans. Indeed, the patient’s with the CT scans didn’t live quite as long. Knowing one’s potential fate possibly had some consequences, like following a positive CT with invasive and sometimes deadly confirmatory tests. Further, if the patient’s time spent obtaining the CT scanning and followup tests, treatment ect. is counted as days of life lost (lost in the sense that they were not available to the patient to expend in a completely voluntary and utilitarian way) then the CT group would look even less favorable.
There is nothing abstract or impersonal about the results of this study as many anecdotalists would like to believe. Instead of smokers and former smokers hand-wringing over whether a CT scan can save their lives, the real lesson here is to just stop the damn smoking!

]]> By: Diorahttp://www.kevinmd.com/blog/2007/03/ct-scan-in-hand-is-far-better-then-no.html#comment-72897 Diora Thu, 15 Mar 2007 17:09:00 +0000 http://clients.emmense.com/kevinmd/2007/03/a-ct-scan-in-hand-is-far-better-then-no-ct-scan-or-biopsy-at-all.html#comment-72897 A question. Do you guys learn basic epidemiology in med school? The guy doesn't seem to understand the basics. <br/>So much for the EBM. Evidence doesn't matter, if it seems intuitively work than it must be so; if I believe in a test, then it must be useful. How is this better than any altie woo? <br/><br/>If doctors have problems understanding why early detection doesn't always make a difference, how can you guys complain that patients don't. They listen to the doctors like this guy. A question. Do you guys learn basic epidemiology in med school? The guy doesn’t seem to understand the basics.
So much for the EBM. Evidence doesn’t matter, if it seems intuitively work than it must be so; if I believe in a test, then it must be useful. How is this better than any altie woo?

If doctors have problems understanding why early detection doesn’t always make a difference, how can you guys complain that patients don’t. They listen to the doctors like this guy.

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