[bamboozled]

The other day I had to get a CT scan, I was kind of annoyed I wasn't offered and MRI, and here we are.

I hold a different opinion to you though, I'm glad doctors are always learning more while generally operating with good /extremely good intentions.

[Aurornis]

> I was kind of annoyed I wasn't offered and MRI, and here we are.

This paper isn’t saying that MRI contrast agent is high risk in general.

There’s a risk in misinterpreting these niche papers to overstate their relative risk. This is a common mistake when people start reading medical papers and begin overweighting the things they’ve read about as the most significant risks.

[byryan]

Really wish more people had that mind set. Practicing medicine isn't easy, especially in the US when you have to battle the insane insurance industry.

[dreamcompiler]

CT is cheaper than MRI, and it's harder to get insurance to pay for the latter. There are some legitimate diagnostic reasons to prefer CT imagery, but I think cost may be a more common deciding factor.

[raverbashing]

The most common factor is that they see different things. There may be some overlap but you want one or the other depending

But yes cts are cheaper.

[margalabargala]

> I hold a different opinion to you though, I'm glad doctors are always learning more while generally operating with good /extremely good intentions.

I agree. Expecting perfection from humans, even experts, is not reasonable and is frankly counterproductive.

Willful ignorance is one thing, but people who genuinely attempt to do the right thing at worst just need to be steered slightly differently.

[pazimzadeh]

expecting humbleness and willingness to be wrong from medical personnel is reasonably though

[bdzr]

> I agree. Expecting perfection from humans, even experts, is not reasonable and is frankly counterproductive.

There's a big difference between perfection and "Statistical Literacy Among Doctors Now Lower Than Chance"[1]. I don't think their intentions are bad, but they are woefully incompetent at many basic things.

[1] https://slatestarcodex.com/2013/12/17/statistical-literacy-a...

[bonsai_spool]

> There's a big difference between perfection and "Statistical Literacy Among Doctors Now Lower Than Chance"[1]. I don't think their intentions are bad, but they are woefully incompetent at many basic things.

As it happens, the daily practice of medicine does not require interpretation of p-values. Indeed, medicine existed before the p-value.

The people who create studies that ultimately guide policy decisions are specialized (much like people who write GPU drivers are different from those who run inference)

[bdzr]

> As it happens, the daily practice of medicine does not require interpretation of p-values. Indeed, medicine existed before the p-value.

What are you talking about? Doctors refer people based on test results every single day. From what I've seen, hardly any of them understand the precision/recall of the tests that they then use to refer you (or not) to screening procedures (which are not all harmless).

[bonsai_spool]

> What are you talking about?

What are you talking about? How is a single lab value going to generate a p-value? Why are you presuming that your family med doc should be calculating an ROC for each of her 1,500 patients?

The selection of lab critical values is performed by experts in clinical pathology. Exactly the people who were not included in the paper you cited.

You can find links to support any argument you want on the internet.

To place this in clearer HN terms, you're saying that a front end dev is trash because he didn't write his own web browser in assembly.

[stalfie]

To be fair, being knowledgeable about the pre-test probability of a patient having a certain disease vs the sensitivity/specificity of a test IS part of the ideal practice of medicine, although how important it is in practice varies somewhat between specialities. In rheumatology for instance, it is front and center to how you make diagnoses. I was in primary care for a short while myself, and on more than one occasion regretted deeply ordering certain rheumatological screening panels (which you get without asking for it when looking for certain antibodies).

Explaining to a parent the fact that their child did in fact not have a rare, deadly and incurable multi-system disorder even though an antibody which is 98% specific for it showed up on the antibody assay, that we took for an entirely different reason, is the kind of thing thats hard to explain without understanding it yourself.

[torstenvl]

Except that a disturbing number of doctors insist that they are always right and you are always wrong.

A year ago, one insisted vehemently—to the point of yelling—that I shouldn't be supplementing Vitamin K because my potassium levels were fine.

[dreamcompiler]

OMG! This doctor shouldn't be practicing medicine if he thinks Vitamin K is potassium.

OTOH Vitamin K can cause blood clots.* I assume you know this and are being appropriately attentive to the issue.

* The K comes from Koagulationsvitamin which it was called in Danish when first discovered.

[lsniddy]

vit k does not cause blood clots

[gf000]

As opposed to what group of humans?

[aspenmayer]

I can only presume that they got the atomic symbol for potassium (K) mixed up with vitamin K. That’s so wrong it crosses over into being “not even wrong” but entirely wrong and beside the point. I hope they aren’t your doctor anymore, or anyone’s. Please tell me you reported this incident to the state medical board.

https://en.wikipedia.org/wiki/Not_even_wrong

> "What you said was so confused that one could not tell whether it was nonsense or not."