| | Big brother is watching you.
Or maybe I should say big government is now using medicine and science to instruct you how to live your life.
Or maybe I am just reading too much into these NYTimes articles.
Item One:
Thinking twice about Health Checkups.
yes, those "remember your yearly health checkup" propaganda we have listened to for years is now being questioned. Why? Maybe to save the government money.
In an analysis of studies including more than 180,000 subjects, researchers have found that general health checkups — like annual physicals or other visits to the doctor by asymptomatic people — are ineffective and possibly harmful. The investigators found no evidence that an annual physical will prevent death by cancer, cardiovascular disease or any other cause. Nor did they find any effect on hospital admissions, disability, additional visits to the doctor or absences from work. The researchers, writing in the October issue of The Cochrane Library, found that health checkups have no effect on clinical events or other measures of morbidity.
The first red flag is that this is a Chochrane Library study. These studies take articles on the subject and put their data into their computers, and voila, instant results if the treatment works. The problem? Garbage in, garbage out.
Are these studies of young people? Old people? High risk people? Targeted physicals? routine screening?
One item that really raises a red flag is that these were "old" studies. How old? Who knows. Yet "one trial" did find things we can treat and stop the diseases:
But one trial found an increased rate of diagnoses of hypertension and high cholesterol, the scientists noted, and another found a 20 percent increase in the number of new diagnoses per patient. One possible harm, the authors point out, is that the checkups can lead to unnecessary treatment of conditions that would not cause symptoms or death. The authors acknowledge that most of the studies are old, which may make the findings less applicable to modern health settings.
The idea of health studies is to find early disease. Most diseases don't matter if they are caught early and some diseases could be screened for but are so rare that we don't regularly check for them.
So what studies do you want?
That changes every year. for example, the new HPV vaccine and HPV test suggests we don't have to screen with pap tests quite as often. Yet that means we will end up missing a lot of STD's in women, especially chlamydia, that can lead to infertility and chronic pelvic pain.
Mammograms and PSA tests for men often "overdiagnose" and lead to expensive testing and even surgery that may not be necessary, yet it also leads to saved lives.
For example, the PSA test may find five cancers, two of which will kill the patient even if you find it early, because the cancer is aggressive. Two of the cases would live anyway, since the person will die of something else before the cancer ever gets around to spreading, especially when you screen older men. So these men will suffer from the unnecessary treatment. Ah, but one case will be found early and you will save his life. (These statistics are old, and newer tests and less extensive treatments are available, so don't quote me here).
Me? No, I don't get yearly checkups.
But then I am a doctor, and know my cholesterol is okay and can do my own BP and diabetes checks. As for paps: nothing there to check. The mammogram is every two years, no problem. But the only valuable test I "need" and I can't get done here is a screening colonoscopy, which in the future (when there are enough docs in the US to do it) will be done once at age 60.
What is not mentioned in the "scientific" study are things we do routinely: Flu shots, pneumonia shots, chicken pox shots, tetanus shots, etc. And of course that non scientific part of the visit: Getting to know your health care provider personally, so when all hell breaks lose, you aren't being treated by a stranger.
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Here is another garbage study in the NYTimes: If Intelligence is the norm, stupidity gets more interesting.
this is talking about finding the genome for intelligence, but says instead we should be looking for the genome for stupidity.
Other genetic factors may be at work: A report last year concluded that several hundred gene variants taken together seemed to account for 40 to 50 percent of the differences in intelligence among the 3,500 subjects in the study. But the authors couldn’t tell which of these genes created any significant effect. And when they tried to use the genes to predict differences in intelligence, they could account for only 1 percent of the differences in I.Q. But is the genetic cup really empty, or are we just looking for the wrong stuff? Kevin Mitchell, a developmental neurogeneticist at Trinity College Dublin, thinks the latter. In an essay he published in July on his blog, Wiring the Brain, Dr. Mitchell proposed that instead of thinking about the genetics of intelligence, we should be trying to parse “the genetics of stupidity,” as his title put it. We should look not for genetic dynamics that build intelligence but for those that erode it.
The rest of the argument is merely filler with statements like if you have a more symmetrical face you are probably smarter, but since you are also more beautiful, it means you will reproduce more. I d on't think this is especially true, but never mind.
Reality check: Most of our intelligence is based on things like nutrition, prenatal influences, and good upbringing. Put a kid with a potential IQ of 150 in an urban third world city, feed him diluted baby formula which results in kwashiorkor, and don't expose him to learning, and bring him up in an area of crime without a good family to support him emotionally, and you will have a low IQ kid, and maybe even a sociopath.
Feed him breast milk (or a protein rich diet) for 2 years, wean him carefully, and let him be taught and nourished emotionally (either by family in traditional skills or in a school) and you have a well adjusted child. Whether he has a high iQ depends on his school, but he has the ability to learn and function.
At the turn of the 20th century, the eugenics movement complained about all those stupid Irish who needed to stop breeding, and one study in 1911 said the average IQ of Jews in NYCity ghetto was lower than normal. And then there was the meme of the stupid white (or black) southerner, which had more to do with chronic malnutrition and hookworms than with genes.
and the doctors in the article don't even define "intelligence", which makes things even more silly.
The entire article assumes that "intelligence" is better, meaning that people out there are trying to figure out how to screen for it with a test: the next step presumably is to stop you from being born if you flunk the test.
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The final article says that we need the government to "help us chose" a good diet, or we'll all be fat.
In the Fight against obesity, drink size matters.
Yes, more intrusive government.
Well after all, if you are fat, your health care will cost the government more money, so they have the right to stop you from eating/smoking etc. if it causes health problems.
Yes, but where is that in the US constitution?
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| | Posted 10/23/2012 7:02 AM - 188 Views - 6 eProps - 3 comments
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