Because for forty years they’ve been arguing about what blood levels of TSH fine people have, and the latest answer is “such a narrow range that huge numbers of people who aren’t ill are outside of the range”.
Tests are Bayseian evidence. If people outside the range disproportionately have a condition, a test is evidence for that condition, even if not every person outside the range has the condition, and not every person with the condition is outside the range.
Absolutely agree, what I’m saying is that this test isn’t very strong evidence. And that they decided to use it without considering how strong it was. They did check specificity, by measuring TSH levels in some healthy people. As far as I can tell, they didn’t check sensitivity, and they never have.
I think you’ve just nicely summed up my argument for me. Thank you.
If you can find the bit where they checked sensitivity, and it’s sound, then I’m flat wrong and I’ll shut up!
They say:
(? (hypothyroid symptoms, gets better with T4) [in the Aristotelian sense]
I say they’ve shown:
(unambiguously healthy) ⇒ (0<TSH<2.5) [In the sense of plausible reasoning]
And that’s all they’ve shown. Ever.
I am avid for evidence that they’ve done more than that.
My counsellor tells me that he literally cannot believe that they would have forgotten, it must be buried in the literature somewhere, and that’s why we can’t find it. I am perfectly happy to believe that it was a careless mistake.
Tests are Bayseian evidence. If people outside the range disproportionately have a condition, a test is evidence for that condition, even if not every person outside the range has the condition, and not every person with the condition is outside the range.
Absolutely agree, what I’m saying is that this test isn’t very strong evidence. And that they decided to use it without considering how strong it was. They did check specificity, by measuring TSH levels in some healthy people. As far as I can tell, they didn’t check sensitivity, and they never have.
I think you’ve just nicely summed up my argument for me. Thank you.
If you can find the bit where they checked sensitivity, and it’s sound, then I’m flat wrong and I’ll shut up!
They say:
(? (hypothyroid symptoms, gets better with T4) [in the Aristotelian sense]
I say they’ve shown:
(unambiguously healthy) ⇒ (0<TSH<2.5) [In the sense of plausible reasoning]
And that’s all they’ve shown. Ever.
I am avid for evidence that they’ve done more than that.
My counsellor tells me that he literally cannot believe that they would have forgotten, it must be buried in the literature somewhere, and that’s why we can’t find it. I am perfectly happy to believe that it was a careless mistake.