It was asserted recently that common sense needs to be used in medical decisions. There is a long list of common sense leading to major problems
Bypass surgery, lobotomies hormone replacement therapies knee surgery, Prostate cancer screening etc etc
all of which were popular but no are longer done on a regular basis as in the past
I don't think that what you have listed is common sense . The treatments and preventative measures became mass policy treatment to deal with disease and risk. Since then technology and evidence have improved.
ReplyDeleteBefore stents, there were few alternatives for treating heart attacks (infarctments). PSA tests Vs actual prostate biopsies. Today a good doctor would wish to avoid unnecessary biopsies.
But in 30/40 years from now, there will be further developments, and new gold standards.
you are wrong about psa
DeleteWhile PSA testing may help 1 in 1,000 avoid death due to prostate cancer, 4 to 5 in 1,000 would die from prostate cancer after 10 years even with screening. This means that PSA screening may reduce mortality from prostate cancer by up to 25%. Expected harms include anxiety for 100–120 receiving false positives, biopsy pain, and other complications from biopsy for false positive tests.[medical citation needed]
In short it is now believed that the benefits do no outweigh harm
Your stats may well be right. All I said was that a biopsy might be unnecessary as it can be harmful. The PSA in itself is hardly harmful. It's a simple blood test. We are not J's witnesses.
DeleteThe problem is that 85% of prostate cancers grow so slowly that one will die of old age before the cancer has a chance to cause harm. Meanwhile, by having found it we now sujbect the man to surgery, chemo and radiotherapy and the label of "cancer patients", all for nothing.
DeletePSA free/total ratios didn't really pan out. Some specialists will do PSA velocity, but it looks like the next level of screening will be MRI.
And how did we get this knowledge? Because PSA test was used for years until analysis showed that there are slow growing cancers and aggressive ones, and PSA alone cannot sift between these.
DeleteSo new types of tests are being developed, eg the Stockholm 3, saliva test etc.
It takes a bit of applied common sense to understand that tests are not given to us from heaven, we have to find a biomarker, then see the level of association with disease.
Getting a diagnosis with non invasive tests is very difficult. And that requires data from invasive tests ie biopsies.
That we should all be healthy!
What is common sense?
ReplyDeletehttps://knowledge.wharton.upenn.edu/article/what-is-common-sense/
Connonsense is the common understanding based on experience or cultural or society norms - education especially in science goes against common sense
DeleteCorrect, and common sense often relies on a person's database. That's why science seems to contradict it. However, a stronger knowledge of science often reinvents what common sense determines.
DeleteMedicine is both an art and a science.
ReplyDeleteThe evidence base is out there but knowing how to use it, how to interpret studies and bring the findings to bedside is the art.
So it will always be a combination of common sense and evidence.
Try using common sense or logic to answer this one:
DeleteIn bamidbar 9 it says
13 But the man
that is clean, and is not on a journey, and forbeareth to keep the passover, that soul shall be cut off from his people; because he brought not the offering of the LORD in its appointed season, that man shall bear his sin.
So are we all under kareis now?
Why not do it somewhere near the temple mount to at least avoid kares?
Smoking 🚬
ReplyDeleteEach one takes 20 minutes off lifespan.
https://www.independent.co.uk/news/health/smoking-minutes-life-expectancy-cost-b2671401.html