[Veedrac]

I have libertarian enough tendencies to think that if a person wants to self-operate, or pay for an operation that doctors are telling them is not justified given the evidence, then they should have right to do it. But I don't think that's what people normally mean when they say that eager screening causes harmful overdiagnosis.

> So your suggestion for indeterminate scans is more scans?

The solution to imperfect evidence is consistent and calibrated risk estimation of both disease and intervention.

[bonsai_spool]

The risk estimation is why people aren’t recommended to get scans! There are studies on ‘VIPs’ who get ‘executive MRIs’ and wind up getting treated for things that would never have justified intervention.

[mhb]

Isn't the way we decide what justifies intervention by comparing observational data, action and outcomes? Currently our observations are limited by many things including the cost and side effects. More frequent or better observations will improve the assessment of what justifies interventions.

[goda90]

That sounds more like a capitalism issue, to be honest. Treatment = revenue, so of course there will be unscrupulous individuals who will bend their oath and let patient anxiety drive care.

The trick seems like it would be to strongly incentivize waiting and watching any symptomless anomalies if further investigation is invasive. If you're getting 60 second scans every month then something growing will be catchable and something static or that disappears can be ignored until the next scan.