Reminds me that a few years ago my wifes grandfather (80+) was wondering if he should cut back on the amount of exercise he was doing. He would regularly be knocking on our door at 6am to see if one of us would want to got for a quick 10k run or to hit the gym.

He was a firefighter in NY in his youth and had never stopped exercising even after retirement.

He went to his GP explained his workout routine and was basically told there is no precedent for it as people his age tend to not be running 10km a day. In short he was told if you're not in pain or fatigued keep at it.

I think he's nearly 90 now and has cut back the running to only a day or so a week, but last time we went to visit he was in his garage bench pressing 50kg

Sorry to branch out: How does this one meal per day work for you? There is recommended calories for a person, do you have to follow it somehow to make sure you have enough energy and exercise?

If the current state is anything to go by, an automated test would not only flag your out of distribution results but try to gaslight everyone reading its output with additional false indicators to map you into an area that's in distribution. Statistical models cannot accept the existence of extremely rare edge cases.

Maybe it would end up fine “in the long run” but you cannot ignore the significant issues arising at the beginning (and at each release of a more performant tool): what do you do if you find something that “shouldn't be there".

Without clear hypotheses you will have a lot of false positives. Which are quite costly in healthcare.

The fundamental problem is that you generally can't diagnose simply from shapes. Scans show shapes, shapes cause concern, concern leads to invasive procedures, results are negative.

How do you measure the body regularly without potentially introducing problems just by measuring it?

> If the whole population had a full body scan every quarter, the “weird” things would feel more like the noise they are.

That's a tautology. We already have quite robust methods for detecting developed anomalies, treating every anomaly below standard human-to-human variation effectively raises the noise floor to already developed anomalies, defeating the purpose of population wide routine scans.

Healthcare resources are very limited, you'd overwhelm it with lots of "yeah that's a defect, but 40% have it", things that would go away on its own, false positives, things that do not require urgent intervention, 10x increase of hypochondriacs and health deterioration caused by anxiety

You'd have a system where every resource is allocated for diagnostics, but no medical staff to treat it

Also a significant part of population avoids screening even if they are not required to paid anything from their pocket

The targeted scans and tests that we already do offer surprising little benefit.

Mammogram screening based on randomized-trial all-cause mortality, has not shown a measurable reduction in total deaths.

Randomized colonoscopy screening has not shown a statistically significant all-cause mortality reduction.

It's more statisticians saying this, and not doctors per se. You run into issues of signal detection theory, false positives, and the lay confusion that Bayesian P(A|B) !== P(B|A).

You're right that we could take steps to fix it, but unfortunately, those steps involve mass education that every human body has anomalies, and many of those should just be ignored.

We'd get a wave of anxiety, lawsuits, and unnecessary interventions, until humanity collectively internalized this.

This Silicon Valley mentality applied to a mechanistic view of the body is a fucking disgrace. This will fail, and luckily we won’t have to endure more of Silicon Valley’s dunning krueger on steroids about medical solutions. The Silicon Valley has NO CLUE of the complexity of clinical science, yet they hold this populistic view that everything can be foxed with tech and nothing stops the hybris. We all can see where that leads

Wouldn't help much.

* Some kind of scans, like CT scans, use ionizing radiation and should not be done too often. * Looking at only imaging scans it is often impossible to tell apart a cancer and a benign growth. (More invasive tests would still be required, which was what the parent posters were warning about)

I think the issue with this and the proposed ‘spa’ scan model is that the diffs are usually meaningless. We all have cysts, masses, and weird shapes that shift around and show up on imaging. Many of these shapes require biopsy to determine what they are. Without symptoms the false positive rate is ridiculously high.

Modern medicine sort of requires us to suspend the idea that we can know everything happening in our body at any given time. If we could develop a diagnostic technique to instantly determine if shapes in our bodies are malignant or benign something like frequent full body scans could be interesting, but they really just introduce noise right now.

> - ... and now we give you another FBS every so-many years, and only those things that are different from the previous scan are investigated.

The diff can be meaningless as well. All sorts of benign things develop with age.

The resolution is the problem. You can't do the type of cytology and histology needed to understand all disease with just scans.

You gloom on one aspect, the smell. OP focuses instead on full body scans themselves, and the irrelevant issues with everyone's bodies they would highlight.

At a population level, this would be both extremely time-consuming, and rather expensive.

More generally, no test is perfectly accurate, and for low base rate conditions the vast majority of positive tests will be false positives.

Like, again, as a data person I adore this idea in principle, but there would be a lot of details that we'd need to figure out to make it a reality.

A sample size of 3 is hardly statistically significant.

From what I could found, billionaires die on average at ~83 years old. ( https://strygin.substack.com/p/how-billionaires-die )

It's not far off what a decent health care system is able to provide in most wealthy countries. It's even somewhat lower actually.

It's difficult to assess the risk factors, but in the end, I have the feeling their additional medical staff and their ability to "cut the queue" (S. Jobs-style) just barely offsets the additional common risk factors (stress, long hours, segregated life), specially if we compare to the upper-middle class.

In the end, there is no magic $100M pill giving you 10 more years. And in truth, access to food, drinking water, a non-toxic environment and really basic healthcare & medicine (vaccines, antibiotics) probably already brings you at a fairly high life expectancy.

It's obviously a lie to get us to accept no tests due to limited machines. The same as when COVID started masks "didn't help" because they didn't yet secure enough supply for everyone, then when they did, suddenly the masks helped.

Every system that exists as a black box is more understandable with more sensing, not less. Our bodies are not special.

It's also ridiculous that the proposition goes like:

1. Doctor knows some tests will flag tumors or variations that look weird and that we shouldn't then go investigate all of them

2. Doctor shuts off their brain and will then investigate all of them by doing invasive procedures

Just knowing how many such variations there are and if they grow or not is useful information. But the doctors pretend like they are super smart before the test and super dumb right after.

This. All diagnoses are "given this set of symptoms and test results, which is the most likely issue".

By having a whole slew of test results already, you will have much better priors.

Sure collecting more data makes sense. We agree there. If that gets you to the required degree of statistical confidence my argument is moot.

Positive for what, exactly? Quoting convnet, above:

> The downside, and the reason why most doctors do not recommend full body scans, is that every human body is a bit weird and there will almost always be something "wrong" that will be visible in a full body scan. This can lead to unnecessary testing, anxiety, and even unnecessary procedures. Many of these oddities flagged by the scan would never have caused any actual issues had the patient never been aware.

The fundamental problem is that you generally can't diagnose simply from shapes. Scans show shapes, shapes cause concern, concern leads to invasive procedures, results are negative.

Also, overdependency on "spas" for health information could lead to an atrophy of other sorts of medical information gathering and diagnosis. e.g., there's no mention in the dreamy description of this spa experience of getting a blood draw or a patellar reflex test.

You’re dealing with populations here. Literally the odds of a positive being false would be over 90%. Much higher in the more rare conditions. I’m not exaggerating. That means every almost every follow up you do is a waste of time, money and limited resources, denying care to those who need it. Including you when you actually do need it. It also exposes you to the risks of unnecessary follow-ups like infection. Your expected outcome is worse this way.

The chance a positive is real is so low you may as well just point to a body part and get it biopsied.

A positive from this kind of test is statistically meaningless.

They kind of are. Spain doesn't have yearly physicals, and during a GP visit, they don't even take your blood pressure. Blood tests are extremely uncommon, unlike in British medicine, where they take your blood pressure every time and blood tests are so prevalent people usually request one from time to time despite having no symptoms. Spain's example showed the above (or the lack of) doesn't increase all-cause mortality and even excelling in longevity statistics.

https://www.rieti.go.jp/en/columns/a01_0455.html This japanese article found "No clear-cut evidence exists to determine whether undergoing health checks leads to greater longevity and/or lower medical expenditures."

Math does indeed make for solid arguments. If you want to make a counterargument then you have to address their math, which you didn't.

No you can't. Statistical tests assume independent data points. Testing the same individual repeatedly would be pseudoreplication, leading to wrong conclusions.

If you mean run different tests, where you collect different kinds of data from the same individual, sure but that's not something you can "just do" in the general case.

Yes, don’t do tests on asymptomatic low-risk people until you can demonstrate that a positive result has any meaning whatsoever.

In the UK I see a medical practitioner before any tests, always.

> Perhaps we need more R&D in here to accelerate progress.

In general yes, just that "more" is monstrously massive to the point of it being closer to science fiction than reality, IMO.

To reiterate, various assays fluctuate rather wildly over the course of various body cycles. The reason(-s) your doctor should remind to get a blood drawn in the morning after a period of fasting is that the sample is taken at a somewhat steady state and the result is comparable to reference values without too much of a margin.

Anyone with a requirement to manage blood glucose levels will tell you that CGMs are vastly superior to finger pricks first and foremost due to the sample rate available and comfort reasons secondarily. With a finger prick test the patient is only somewhat aware where in the curve they are, which makes the test only a rough estimate due to this temporal error margin. A lot of people do not zero in their readings with finger pricks as they are mostly interested in the deltas.

Suppose you manage to make urine sampling relatively accurate and super cheap (e.g. tens of eurodollars per analyzer or cents per test strip) so you can have poorly-supervised, long-term studies with huge cohorts. However, unless you somehow control for sample collection conditions, all this baseline variability suddenly infects your whole dataset and effectively raises noise floor. It's not unreasonable to expect that whatever was found to be a useful signal under controlled conditions to fall below noise floor under uncontrolled conditions.

That's basically THE problem with the hypothetical test-it-all machine. Again, maybe in some cases that could be extremely useful, but in a lot of cases that would be counter productive. However, what CGMs hint us at is that various kinds of Continuous X Monitors could provide insights into body reactions to things, which is, currently, effectively not a signal in general medicine. Once the test-it-all machine is reframed as an array of continuous monitors and the useful signal is reframed from long-term drifts to short-term deltas it may unlock some additional diagnostic pathways.

That makes no sense at all, unless you're saying that people should respond to all such information by ignoring it.

I don't really get what this means. A false positive causes issues inherently - you don't know if it's right or wrong. It's noise which is bad for care, and it's anxiety-inducing for patients which is also bad. It produces worse outcomes for everyone. There isn't a "choice" or assumption here, you respond to a positive as if it's accurate until you know it isn't. This is a known issue. Hell Scrubs did an episode about the negative impact of full, generalized body scans on a patient's wellbeing decades ago.