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The Epidemic of Fake Disease

Medlife Crisis

580K subscribers • 5 videos on Rounds

YouTube
  • Recommended by 7 people, in Hacker News, across 7 different months.
  • The description links 4 papers.
  • Debated among experts. Its central claim is contested, so look for the other side.

For anyone, no background needed. Education, not medical advice.

2.4M views6 years ago7 recommendations

Clinical medicineCancerScreening and early detectionDiagnosis and clinical reasoningPublic health and policy

Medlife Crisis explains the concept of overdiagnosis and how aggressive medical screening can sometimes lead to unnecessary treatments and patient harm.

@medlife2 nebula.tv/medlifecrisis twitter.com/medcrisis instagram.com/medcrisis (sh*tposting only) Myocardial mug by Hana Ayoob curiousoctopus.co.uk/ Suggested reading: The Patient Paradox by Margaret McCartney - amazon.co.uk/Patient-Paradox-Sexed-Medicine-Health/dp/178066… Overdiagnosed by H Gilbert Welch - amazon.co.uk/Overdiagnosed-Making-People-Pursuit-Health/dp/0… References: Overdiagnosis in cancer - academic.oup.com/jnci/article/102/9/605/894608 How 5 year survival can mislead - bmj.com/content/346/bmj.f548 Are increasing 5-year survival rates evidence of success against cancer? - ncbi.nlm.nih.gov/pubmed/10865276?dopt=Abstract Why cancer screening has never been shown to “save lives”—and what we can do about it - bmj.com/content/352/bmj.h6080 Incidentalomas - ncbi.nlm.nih.gov/pubmed/29914908 Thyroid cancer - ncbi.nlm.nih.gov/pubmed/27627550 The NELSON lung cancer screening trial - nejm.org/doi/pdf/10.1056/NEJMoa1911793?articleTools=true

Why it's here

7 people recommend this

What people say. Highly recommended for its clear explanation of the counterintuitive dangers and negative consequences of medical overtesting and overdiagnosis.

WillDaSilvain Hacker News • Recommends

On “Walmart Gets Into Health Care”

>Are there legitimate safety reasons these mundane diagnostics are so locked down? Healthcare is not my area of expertise either, but my understanding is that the short answer to your question is yes. For a longer introduction to the issues surrounding letting anyone get whatever diagnostics they want to pay for, this Medlife Crisis video that came out today seems appropriate: link to this video
View on Hacker News

capn_cabbagein Hacker News • Recommends

On “I lost my boyfriend to cancer 'conspiracy theories’”

The opposite can be just as dangerous * . "Medlife Crisis" has an informative video1 that explains some of what can happen. * Edit: I shouldn't have equated the dangers here. This was a bad take. I still believe there are good bits of info provided in the video, but the relevance to this thread is less than I considered and I should have thought more about what I was sharing. Edit 2: I didn't mean to link to a specific timestamp of the video in the original link. That has been removed. 1: link to this video
View on Hacker News

ejoltoin Hacker News • Recommends

On “Are we screening too much for skin cancer? It's complicated”

This one is even more relevant as he talks about dangers of over screening for beast cancer, and side effects of mastectomy+chemo: link to this video
View on Hacker News

Someone1234in Hacker News • Recommends

On “The paradox of the Prostate-Specific Antigen (PSA) test”

This video does a good job also of covering the topic of over-testing/over-treating potential cancer (or creating "Fake Disease" as it terms it): link to this video
View on Hacker News

eruin Hacker News • Recommends

On “The FDA's Restrictive Regulation of Home-Testing Devices (2017)”

Compare and contrast this video from 'Medlife Crisis': link to this video > Trying to detect disease early seems like an obviously good thing to do. But reality isn't always quite so straightforward, especially in medicine. If It Ducks Like A Quack is a series where I try to go beyond the hype and explore how complicated the apparently simple phenomena in medicine are. One point from the video: five year survival rates of prostate cancer in the US are massively better than in the UK. However, roughly the same proportion of people die of prostate cancer in both countries. The US just screens a lot more.
View on Hacker News

fooblasterin Hacker News • Recommends

On “Shocking hospital mistakes led to our daughter’s death”

I'd encourage you to think about the consequences of over testing. Although it is somewhat counter intuitive, there are many negative consequences to patient outcomes from overtesting. A deeper overview: link to this video
View on Hacker News

jamesbelchamberin Hacker News • Recommends

On “How often do full-body MRIs find cancer?”

It does, doesn't it! This is basically the reason scepticism in screening has risen (amongst scientists and medics, not the general population) - research seems to show that screening catches much more cancer but doesn't save many more people. Rohin Francis does a good video on it, which you don't have to watch because it has references underneath you can click straight through to (the video is good though): link to this video I am frustrated by this because it seems obvious to me that "more data == better" but I guess it makes sense if you think of the scans as having high amounts of noise, and us having a poor understanding of the system we're monitoring (this never happens in tech, of course :)).
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i_cannot_hackin Hacker News • Mentions

On “Vets today are like doctors yesterday”

Are you implying that more active screening would cause more good than harm, and that the scientific evidence that shows otherwise is mistaken? What makes you think the evidence is wrong? Screening is a very complicated topic and being overly aggressive with screening can really hurt patients. link to this video Or do you simply not support using scientific evidence and/or harm reduction to guide medical policy? What do you propose should be used instead in that case?
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rdedevin Hacker News • Mentions

On “Most cancer screenings don’t extend life, study finds”

I think the consensus on cancer screening is stil not fully there? Came across this video by a cardiologist a long time ago link to this video I guess the main gist is that screening is not completely benign and a positive screen might lead to more interventions for what in the end could just be a benign tumor. Then there's the other point of detecting it late in life. Like treatment for cancer might not make much sense if you are already 89 years old
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