The worried well are sure to find something “abnormal” to justify and amplify their anxiety doing thus, will not be easily talked down, and will be easy marks for snake oil, I mean vitamins and supplements, to address these problems their stupid doctors didn’t want to test for.
Part of the problem is that the more dimensions you measure across, the more extreme points you will find: only 32% of a single normal variable’s distribution is outside 1 sigma of the mean - but in two dimensions it’s 60% and three dimensions 80%. If you measure 100 variables, almost everyone will have one or two 3-sigma results.
That’s exactly what the billionaires want. Make actual healthcare unaffordable (because doing that right won’t make them money) so that the populace has to depend on their supplements and devices. All in the name of freedom - taking charge of your own life because you know what’s best for you. Do your own research!
I want all the data on my health I can obtain, and after discussing it with my doctor, I can conduct my own research and decide what, if anything, I want to do about it. I realize I am far from the norm, but there’s no reason for someone to buy snake oil if they know what they are doing.
I read the article. The “face” of Function is a friend of RFKjr.
Yeah. Don’t trust that as far as I can toss it.
I feel terrible for people who are suffering from undiagnosed disorders. And I understand the need to know what your numbers are and if something is laying in wait to knock you in a grave.
If these places are hawking supplements as a side business I’m suspect immediately.
I get every kind of offer you can think of from being a diabetic.
There’s a new thing I’m seeing that looks like a finger clip for patients that hospitals use, except for diabetics for home use. My immediate reaction was, cool, I want that. It’s a piece of unreliable junk I found out doing a bare minimum of research.
We as patients are prayed upon by unscrupulous snake oil sales pitches.
I laugh Everytime I see the supplement ads on TV. But I remember they are making a killing on the back of consumers.
Exactly right. There is little appreciation by most about statistical abnormalities vs disease or how Bayes Theorum and pretest probability makes abnormal results overwhelmingly likely to be false positives even with decent sensitivity and specificity when pretest probability is low. The average person will have multiple positives, almost always false positives for low probability items, and unneeded interventions will result at best, cascading more aggressive testing likely a fair fraction of the time. Real harms.
One hell of a red flag there. Hyman is the guy who claims he’s planning to live to be 120 (maybe 180) by addressing the “root causes” of disease - defined as not taking as many supplement pills daily as he wants to sell you. “Functional medicine” docs are notorious for ordering lots and lots of unnecesssary tests and finding reasons to put you…on more supplement pills and dubious treatments.
It’s been known for quite awhile that the false positive rate of a panel of common blood tests can be as high as 5% - meaning that of 20 tests, it’s quite likely that 1 will show results that are out of whack - but not really.
As an anecdote: years ago I had comprehensive blood work drawn and it came back showing liver function testing was abnormal - AST and maybe ALT markedly elevated. I was worried something was seriously wrong, maybe hepatitis B contracted through work, infecting not only myself but Mrs. J. Repeat testing showed - normal findings. Inexplicable error.
Test for 100 markers without good clinical justification, and several are bound to be out of range, panicking patients and offering great opportunities for functional medicine quacks and supplement sleazebags to exploit those worries.
Same for whole-body MRIs. They’re bound to turn up some incidentaloma that will get over tested and biopsied, causing many instances of unnecessary harm.*
*full disclosure: pathologists will make extra $$$ off biopsies resulting from routine whole-body MRIs. But it’s not income we want.
Jeez, like it’s not bad enough doctors have to field panicked Googles and AI bullshit. I’m sorry for you and any hapless patient taken in by this racket.
I get the patient perspective. It fucking sucks to have something wrong with you and not know what it is. I’ve been in that situation multiple times and I still am, thanks to what’s probably long COVID but who the hell knows?
In my not at all humble opinion no one who knows what they are doing would want to do one of these tests, so there is big selection bias going on.
What do you already understand about Bayes Theorem and pretest probabilities?
A test is 99% sensitive, and 94% specific. A pretty good set of numbers. The condition is present in one out of hundred of people with the vague complaints the person has. (A very high number for many of these things.) How likely do you think it is that the test is correctly identifying the presence of the condition?
My sister, who is also “planning” to live to 120, thinks that doctors are uninformed about nutrition (unless they take the time to research it outside of their regular studies, which most don’t have the time or inclination to do) and that she can instead rely on youtube videos about experimental proof (I would put that in scare quotes but why bother) that show which supplements will really help her avoid bad diseases and conditions that she doesn’t have yet. In the meantime, she spent a week woozy and disoriented (she lives alone) and did not seek help for it, and just waited for it to go away.
She has tried to push this supplement stuff on me but I ignored her, so she got huffy and said that she would stop trying to keep me informed. So something I did really did help.
I’m with you here, this seems like a terrible idea. All of those objections seem totally valid
Additionally I can see it being used as a way of avoiding going to the doctor for people who are averse to visiting the doctor. Which might be good thing if one of things being tested is at “go to ER right now” levels. But more likely if some things are just a little elevated a they’ll be “oh everything’s ok then” where as an actual doctor will be “we need to treat these, it’s a red flag”