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by Peradine
2006 days ago
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The problem with that anecdote is that its all with the benefit of hindsight. Certainly, in this instance, non-operative management was appropriate. But the more important question is what on average happens to the entire 'population' of people presenting with Hadfield's symptoms and signs if they're managed operatively and non-operatively. If we imagine a disease where non-operative management leads to a 50% mortality rate within a year. If we take 100 people with this disease and manage them non-operatively, at the end of a year we'll have 50 people saying how pleased they are to have avoided surgery and complaining about the aggressiveness of surgeons, and we'll have 50 dead people. That's why the diagnosis and management of disease must be informed by high quality clinical studies, rather than anecdotes. |
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https://www.usatoday.com/story/news/nation/2013/06/18/unnece...
key highlights:
"About 10% of all spinal fusions paid for by Medicare in 2011 were not necessary, either because there was no medical basis for them or because doctors did not follow standards of care by exploring non-surgical treatments"
"An estimated 7.5 million unnecessary medical and surgical procedures are performed annually with the number of unnecessary hospital stays around 8.9 million a year. One study determined that almost 29% were not necessary (Health In The 21st Century by Fransisco Contreras MD, page 212)"
"A 2011 study in the Journal of the American Medical Association reviewed records for 112,000 patients who had an implantable cardioverter-defibrillator (ICD), a pacemaker-like device that corrects heartbeat irregularities. In 22.5% of the cases, researchers found no medical evidence to support installing the devices"
Anecdotes are great for illustrating a point and making an emotional connection which is why I brought up the story from Astronaut's Guide. But there's absolutely no doubt that a significant and unacceptable number of surgeries are unnecessary.