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Elo comments on Open Thread, Jun. 22 - Jun. 28, 2015 - Less Wrong Discussion
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I went to the dermatologist and today and I have some sort of cyst on my ear. He said it was nothing. He said the options are to remove it surgically, to use some sort of cream to remove it over time, or to do nothing.
I asked about the benefits of removing it. He said that they'd be able to biopsy it and be 100% sure that it's nothing. I asked "as opposed to... how confident are you now?" He said 99.5 or 99.95% sure.
It seems clear to me that the costs of money, time and pain are easily worth the 5/1000(0) chance that I detect something dangerous earlier and correspondingly reduce the chances that I die. Like, really really really really really clear to me. Death is really bad. I'm horrified that doctors (and others) don't see this. He was very ready to just send me home with his diagnosis of "it's nothing". I'm trying to argue against myself and account for biases and all that, but given the badness of death, I still feel extremely strongly that the surgery+biopsy is the clear choice. Is there something I'm missing?
Also, the idea of Prediction Book for Doctors occurred to me. There could be a nice UI with graphs and stuff to help doctors keep track of the predictions they've made. Maybe it could evolve into a resource that helps doctors make predictions by providing medical info and perhaps sprinkling in a little bit of AI or something. I don't really know though, the idea is extremely raw at this point. Thoughts?
A perspective on the nature of medical advice: There exist people who are so concerned about not dying that they would do anything in their power to survive medically, and organise for themselves regular irrelevant medical tests. They are probably over-medicated and wasting a lot of time. i.e. a brain scan for tumours (where no reason to think they exist is present). There exist people who get yearly mammograms. there exist people who probably get around to their (reccomended yearly) mammogram every few years. There exist people who have heart attacks from long term lifestyle choices. There exist people who are so not concerned about dying that they smoke.
This is the range of patients that exist. You sound like you are closer to the top in terms of medical concern. The dermatologist has to consider where on the spectrum you are when devising a treatment as well as where the condition is on the spectrum of risk.
For a rough estimate (not a doctor) I would say the chance of a cyst on your ear killing you in the next 50 years would be less than the chance of getting an entirely different kind of cancer and having it threaten your life. (do you eat burnt food? bowel cancer risk. Do you go in the sun? skin cancer risk)
If it can be removed by cream; it will still be gone. The specialist should suggest a biopsy to cover their ass, but really; it could be 99 different types of skin growths or few type of cancerous growth. With no other symptoms there is no reason to suspect any danger exists.
the numbers you suggested sound like they were fabricated when given to you. Which is a reason to not mathematically attack them; but take them on the feeling value of 99.99% thumbs up. (and its really hard and almost impossible to find 0.01% so medically we don't usually bother)