[nihonde]

"What possible use could there be for doing this?"

I've encountered this attitude before, and I always find it perplexing that there are people who are annoyed by, even hostile to, the idea of frequent health telemetry.

What possible use? How about giving people greater visibility inside their own bodies without having to navigate the labyrinth of the healthcare machine and without having to justify themselves to actuaries?

[lonely_wanderer]

A counter point: a fixation on medical diagnoses can be counterproductive to living a good, happy, and healthy life. My implication is that data will lead to self-diagnosis, when maybe it’s not necessary.

There’s a reason most people don’t get medical scans every checkup, they’re simply not necessary for the majority of (healthy) people.

[nihonde]

In Japan, the government gives everyone a battery of full body tests at least once per year. I guess you know better than Japan, right?

The whole argument that "you'll worry yourself sick" is such patronizing trash. It's obviously programming that came from the insurance industry, and you lapped it right up.

[klausa]

There's a world of difference between the health checkups we get in Japan, and something like a full-body MRI/CT.

You're not arguing in good faith when you equate those.

[nihonde]

Are you joking? 人間ドック is absolutely more than a "health checkup". Maybe do some reading: https://medical.kameda.com/general/en/ningendock/what/

> The Ningen Dock is a comprehensive health checkup system that includes a battery of tests, including blood tests, chest X-rays, and ultrasound scans, among others as well as advanced diagnostic tests as Magnetic Resonance Imaging (MRI), Computerized Tomography (CT) or Endoscopy. These tests can help detect potential health problems early before they become more serious or difficult to treat.

[klausa]

That is not the same as the annual mandatory health check.

Maybe your employer pays for you to get a more comprehensive checkup by default and you're unaware of this?

But the ones vast majority of population here gets do not include MRI or CT or Endoscopy.

And, _even then_; specific checkups when you're looking for _specific things_ are still very different things than a full-body MRIs.

[lonely_wanderer]

I think there’s actually a difference between getting a battery of tests from a set of doctors (overseen by the government) tailored to your risk factors and a company trying to sell a fully body scan which they think you should casually get all the time.

[nihonde]

I don't think there's much difference? The technicians that perform the tests are not doctors. You usually see a doc for 5 mins at the end, to discuss any anomalies. Even then, they're just going to refer you to see your GP or a specialist. At the end of the day, the ningendoku is just information that your doctors can access. I'd much prefer a high-resolution full body scan.

Either way, the patient should make the choice about whether they want that info, not an insurance company or a know-it-all armed with a dubious study concluding that asymptomatic conditions are better left undiscovered.

[lonely_wanderer]

I have thought about your position more and I realize I basically agree. More data isn’t strictly good, but in the right hands it is useful, and that choice should be left to individuals.

Also, it makes sense to me that, as technology improves and becomes cheaper, we should utilize it more. It may take time to come up with the proper process to maximize usefulness and reduce false positives, but it’s the path of progress.

I hope that in the future, humans consider it barbaric that we weren’t aware of things like cancer and tumors at the earliest stages, even if in many cases there’s no treatment necessary.

[Barrin92]

because it has negative effects. Over scanning leads to, in particular with the economic incentives of the healthcare system at large not to mention a company like this, over-treatment. It's one of the reasons countries have scaled back mammograms because women have been forced into surgery and treatment with no meaningful improvement in outcomes. Prostate cancer being another one.

My wife's a cardiologist and hypochondriacs with smartwatches have become a frequent occurrence because healthy young people despite regular check ups have convinced themselves their watch telling them their pulse got high that one time must mean they're dying and they'll show up not one but five times.

The same is happening with so called "sleep optimizations" which themselves can produce insomnia as people start to self-monitor and enact sleep efforts.

[nihonde]

Rather than dealing with the issue—hypochondriacs or whatever—you prefer to remove the option for the non-hypochondriacs?

The fact that doctors like your wife think that people who are concerned about their health and want more information is a problem tells me everything I need to know about your (and her) worldview. You've dressed it up as being pragmatic, but the reality is that you're arguing for censorship and against freedom of information.

[Barrin92]

>that people who are concerned about their health and want more information is a problem

It is a problem because there's evidence based standards for when examinations are indicated and prolong or improve a person's life. You being extremely concerned doesn't move that needle and subjecting you to tests simply because you're anxious is blatantly unethical and harmful to your psychological wellbeing.

And nope this isn't censorship, it's being mathematically literate and understanding how data production works. Here's an actual real world example. There are aids tests that are 99% accurate. About 30 in 1000 people in the US have AIDS. 99/1 is great odds, let's test everyone, data doesn't hurt right? Except as it turns out if you test a thousand people randomly you'll have 10 false positives and 3 people with AIDS, Bayes in action.

So if you sent every American through body scanners, which are less reliable than that test btw, you'd have quite literally millions of people in follow up procedures for diseases they do not have with their mental health ruined and the system ground to a halt, because producing information is not always the right thing to do.

[davidivadavid]

That's definitely an important point to consider, in fact something I think everyone in these conversations should be cognizant of, and also why it makes me believe the actual conversation should move to whether the device improves false positives/negatives rates or not (or at least has a chance to), which then might warrant wider access/use.

[runako]

A better question is if people are going high-res, why not go high-res with tests whose accuracy is known, and for which there are useful, data-driven treatments?

Instead of casting a net of unknown quality every month, comparing against a null dataset (there does not exist a large dataset of these scans with outcomes for given markers).

Why not advocate cheap, easy blood/urine tests with higher frequency? Those tests do have large reference datasets with outcomes. And they have prescriptive value: there is likely more benefit to catching hypertension or diabetes earlier in more people.

[davidivadavid]

True, though those things don't have to be mutually exclusive.

[nihonde]

Something doesn't add up. The entire Japanese healthcare system is built around the idea that preventative testing for asymptomatic conditions is effective. You can read all about it, if you want.

Personally, I think you've swallowed some kind of health insurance industry black pill, whether you know it or not.

[Barrin92]

>You can read all about it, if you want.

I don't need to, I've lived in Japan and done the Ippan Kenshin which is the once a year health checkup. It consists of getting your weight, height blood pressure measured, an eye test, urine tests for diabetes and a blood test for cholesterol. That's very reasonable.

The one thing some doctors still tend to do is a chest-xray, which is not reasonable. They do it because tuberculosis was widespread in post-war Japan and they just kept doing it, but it has no positive impact on mortality rates.

[ngruhn]

I don't read the parent comment to take issue with the use case per se but the billion scans per month figure.

Surely, whatever this is giving you, getting a scan once a month must be plenty. They need a billion people to get a scan every month.

[klausa]

Because false positives have a tremendous emotional (and, depending on your healthcare system, also monetary) cost to patients.