Sure, but the same incentive applies to fire departments & hospitals. Many organizations get their funding exclusively from harmful events. And even if firefighters have a (weak) incentive against fire safety, they couldn’t stop us from practising it anyway.
Hospitals make money from treating people not from people being ill. Their problematic incentives get them to treat people that don’t really need hospital treatment more than they have an incentive to make people ill.
Given people a routine colonoscopy when there’s no evidence that routine colonoscopies increase lifespan and then treating what’s found, could be seen as creating disasters (positive test results) but thinking of the positive tests as a harmful event mistakes the dynamics.
There was no significant difference following mammography (0 days: 95% CI, −190 to 237 days), prostate cancer screening (37 days; 95% CI, −37 to 73 days), colonoscopy (37 days; 95% CI, −146 to 146 days), FOBT screening every year or every other year (0 days; 95% CI, −70.7 to 70.7 days), and lung cancer screening (107 days; 95% CI, −286 days to 430 days).
I don’t think that disagrees with me. Their 95% confidence interval contains both the possibility that it may cost you 146 days and gain you 146 days.
The examples brought forward are about cases where no studies have been run to find out the answer. We did run the studies for colonoscopy and the found no statistical significant effects on lifespan.
More specifically, I misread its endorsement of “colorectal cancer screening with sigmoidoscopy” as an endorsement of colonoscopy, which is explicitly separated later on.
The two procedures use the same equipment, but colonoscopy inspects the whole colon whereas sigmoidoscopy only inspects the last section of the colon.
Sure, but the same incentive applies to fire departments & hospitals. Many organizations get their funding exclusively from harmful events. And even if firefighters have a (weak) incentive against fire safety, they couldn’t stop us from practising it anyway.
Hospitals make money from treating people not from people being ill. Their problematic incentives get them to treat people that don’t really need hospital treatment more than they have an incentive to make people ill.
Given people a routine colonoscopy when there’s no evidence that routine colonoscopies increase lifespan and then treating what’s found, could be seen as creating disasters (positive test results) but thinking of the positive tests as a harmful event mistakes the dynamics.
This 2023 meta-analysis in JAMA Internal Medicine disagrees.
It’s been suggested that the phrase “no evidence” is quite often a bad sign.
From the meta-analysis you link:
I don’t think that disagrees with me. Their 95% confidence interval contains both the possibility that it may cost you 146 days and gain you 146 days.
The examples brought forward are about cases where no studies have been run to find out the answer. We did run the studies for colonoscopy and the found no statistical significant effects on lifespan.
You’re right! Retracting my comment.
More specifically, I misread its endorsement of “colorectal cancer screening with sigmoidoscopy” as an endorsement of colonoscopy, which is explicitly separated later on.
The two procedures use the same equipment, but colonoscopy inspects the whole colon whereas sigmoidoscopy only inspects the last section of the colon.