Emre

fındık ezmesini o kadar çok beğendi ki üstündeki numarayı arayıp teşekkür etti

I usually agree with Dr. Locasale. But not on this. A $100 full-body ultrasound on asymptomatic people, sold as a wellness service, will open a massive can of financial worms for individuals. You’ll pay around $100 for the scan, there’s a 90% chance they find something you’ll worry about, your insurance won’t cover the expensive follow-up they recommend, so you’ll be deciding whether to spend thousands to relieve anxiety about something with a 98% chance of being nothing. How’d I get there? Enough screening full body MRIs have been done to give us a good idea of the size of the can and what’ll be in it. Roughly 90% of asymptomatic people who get a screening full body MRI have an abnormality. We have decades of diagnostic imaging with millions and millions of followed-up findings that allow 2/3 of those to be classified as incidental findings that definitely don’t need further work up. Of the roughly 1/3 they can’t be sure about, after work up, 10% of them (4% of people who got a scan) end up with something important, and about 1.5% of people have a cancer detected. And the existing evidence says finding those lesions doesn’t improve overall mortality. I know that’s hard to believe, but it’s true. Look up Korean thyroid ultrasounds or German melanoma screening. Now extend it to a modality we have no baseline data on follow-up of lesions. Midjourney has been explicit that the early scans train the model and diagnostic accuracy comes later. For the first year or two, it’s reasonable to say 90% of people who get a scan will have an abnormality they can’t rule out as concerning, and it’ll be up to the individual to pay to train Midjourney’s model. Insurance probably won’t cover the follow-up scan or biopsy with an established modality, because there’s no evidence saying it needs follow-up. So 90% of people who get scanned will be worried and facing the decision of whether to pay out of pocket for the expensive follow-up. A small percentage of those will have side effects and complications from the follow-up testing. And remember, 98% of the findings are nothing. You can argue affluent people could get one, chase down all the abnormals, then repeat a scam (sorry, meant scan) every 3 months to look for changes. But that just leads to over-diagnosis with no mortality benefit. So, rich people get scanned every 3 months with subsequent overtesting and overdiagnosis, normal people get anxious over things that are 98% likely to be fine, nobody has a survival benefit and Midjourney gets their model trained for free. I wonder who’s coming out ahead here?

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