False positives in medicine can cause unnecessary interventions that carry their own risks. Believe it or not, there is an optimum level of ignorance for maximum health.
If having more information leads to worse outcomes, that's fundamentally a problem with how you're responding to the information, not with having the information.
I can learn almost anything. So, I have to put values on what it is I'm learning, so I don't waste my time. My estimation is that learning how to interpret my health data so that I can spend a lot of time gathering and then continually interpreting that health data is not going to evince any additional value in my life.
> If having more information leads to worse outcomes, that's fundamentally a problem with how you're responding to the information, not with having the information.
Not necessarily.
Rohin Francis (Medlife crisis) has I think a video on overtesting, but for example, if you have a new technology that tests and suspects a tumor, which results in CT scans for patients, if millions of users use this tech there's a likely non-zero number of people who may get cancer from the CT exposure.
"What about those who actually had the tumor?"
Well it's possible that 99% of these cases would've been symptomatic anyway in a few more months.
By explanation isn't the best, but over-medication is not a non-issue.
That's still the response though. You can simply say "Well, we expect an error rate of X with this new test, so in the absence of other risks factors we predict the actual odds of the condition are Y".
Then you can decide whether a test makes sense or doesn't make sense, given the tradeoffs of radiation and cost vs. the risks of harm.
In the real world, information absolutely can lead to harm, but it's still all in the response and how medicine and patients use information.
But as information gets cheaper and more common we can develop ways of dealing with it. If it was difficult and expensive to test for fever you'd see people in the medical profession warning against it because it could lead to overreaction.
I get your point, however I think there are a few confounding things. For a lot of people, if you get a positive result from a test that a doctor brushes off that's not going to go well. I'm very much in favor of more testing personally, there are almost certainly folks who're on SSRIs who'd benefit more from Vit D/Mg supplementation for example.
Another thing I seem to remember in his video was that a tumor is not necessarily dangerous. Out of a hundred (say) tumors in a person's life, only maybe 5 are risky. But I'm paraphrasing this badly.
>For a lot of people, if you get a positive result from a test that a doctor brushes off that's not going to go well.
This is precisely because of the rarity of testing. Suppose the cost of testing dropped 1000x and we could get tests for things each day or each month. We'd start to have systems that put these things on context.
When you have a single isolated result there really isn't that much to go on.
You don't know if it's a false positive or not until you do further interventions. Realizing it's unnecessary is only evident in hindsight.
E.g. CT scan shows an incidental, tiny lung nodule. You do a biopsy. Unfortunately, during the process of getting a biopsy, you develop a pneumothorax (an uncommon but well-known complication of a lung biopsy) and need a chest tube, hospitalization, etc. You get discharged and you're fine, but man, that wasn't fun. Biopsy comes back negative for cancer. Nodule goes away on its own with time.
Edit: that being said, I'm excited about OTC CGMs! But the "data" we have in medicine is not as accurate as other fields and always subject to false positives/negatives.
Agreed. Thanks for the perspective. Never considered downsides of such interventions (as I have been mostly a lab rat for doctors but never experienced things like that, but it's understandable).
the gap between cgm and a biopsy from a CT scan is vast. CGM is not enough to trigger any such intervention. Unnecessary interventions are absolutely a concern. A CGM is about as controversial as someone taking their own heart rate to help them calm down from panic attacks. Minimally invasive and nobody would base a dramatic intervention on this data alone.
Sure. As I stated in my original comment, I'm excited about CGMs being widely available. The example in my comment was very specifically answering "why do doctors perform unnecessary interventions?".
Doctors make mistakes. Procedures carry inherent risks, such as infection, allergies, blood clots, etc. Even driving to the doctor to discuss your blood glucose carries a risk of car accident. All of these are low probability events, but non-zero.