Comments on: 2009/12/15 http://healthblog.ncpa.org/20091215/ Health Care Policy and Reform Insights | NCPA Wed, 16 May 2012 20:29:55 +0000 hourly 1 http://wordpress.org/?v=3.3.2 By: Joe S. http://healthblog.ncpa.org/20091215/comment-page-1/#comment-50533 Joe S. Tue, 15 Dec 2009 23:10:43 +0000 http://www.john-goodman-blog.com/?p=7543#comment-50533 I am bowled over by the Jonathan Bush quote on health IT. We are using stimulus money to prop up outdated technology that no one should be using in the first place? How crazy is that? I am bowled over by the Jonathan Bush quote on health IT. We are using stimulus money to prop up outdated technology that no one should be using in the first place? How crazy is that?

]]> By: John R. Graham http://healthblog.ncpa.org/20091215/comment-page-1/#comment-50529 John R. Graham Tue, 15 Dec 2009 21:56:30 +0000 http://www.john-goodman-blog.com/?p=7543#comment-50529 Prof. Paulos is giving an specific illustration of a general truth: The smaller the actual incidence of X in a population, the bigger the problem of false positives. Furthermore, we generally define statistical significance with respect to the Type II (beta) error, which is 5% in Prof. Paulos' example. The false positive (Type I or alpha) error can only be reduced by increasing the specificity (alternatively, reducing the power or sensitivity) of the test, which increases the Type II error. Indeed, we could go to the other extreme than than suggested by Prof. Paulos: Outlaw all mammograms. That would eliminate false positives! Of course, the result is that 100% of the population would live in ignorance, which is surely stressful. We can go around all day like this. Far more important are the consequences of the errors. If the treatment has limited side effects, and failure to treat infected patients has catastrophic consequences, then why not accept a large number of false positives? It would seem to be a good policy to leave the individual to decide how to deal with the results of the tests. Prof. Paulos is giving an specific illustration of a general truth: The smaller the actual incidence of X in a population, the bigger the problem of false positives. Furthermore, we generally define statistical significance with respect to the Type II (beta) error, which is 5% in Prof. Paulos’ example. The false positive (Type I or alpha) error can only be reduced by increasing the specificity (alternatively, reducing the power or sensitivity) of the test, which increases the Type II error.

Indeed, we could go to the other extreme than than suggested by Prof. Paulos: Outlaw all mammograms. That would eliminate false positives! Of course, the result is that 100% of the population would live in ignorance, which is surely stressful.

We can go around all day like this. Far more important are the consequences of the errors. If the treatment has limited side effects, and failure to treat infected patients has catastrophic consequences, then why not accept a large number of false positives? It would seem to be a good policy to leave the individual to decide how to deal with the results of the tests.

]]> By: Larry C. http://healthblog.ncpa.org/20091215/comment-page-1/#comment-50522 Larry C. Tue, 15 Dec 2009 19:41:29 +0000 http://www.john-goodman-blog.com/?p=7543#comment-50522 The quote on mammograms is excellent. It ;should be obvious that there is no right number. The choice should be made based on individual preference -- including attitudes toward risk and the willingness to trade off money against risk reduction. The quote on mammograms is excellent. It ;should be obvious that there is no right number. The choice should be made based on individual preference — including attitudes toward risk and the willingness to trade off money against risk reduction.

]]> By: Ken http://healthblog.ncpa.org/20091215/comment-page-1/#comment-50520 Ken Tue, 15 Dec 2009 19:37:44 +0000 http://www.john-goodman-blog.com/?p=7543#comment-50520 The comment on health IT is really interesting. This is the first time I have seen this point of view. The comment on health IT is really interesting. This is the first time I have seen this point of view.

]]> By: Liz http://healthblog.ncpa.org/20091215/comment-page-1/#comment-50515 Liz Tue, 15 Dec 2009 17:25:47 +0000 http://www.john-goodman-blog.com/?p=7543#comment-50515 This is an interesting perspective on breast cancer. I have never thought about it that way. This is an interesting perspective on breast cancer. I have never thought about it that way.

]]> By: Devon Herrick http://healthblog.ncpa.org/20091215/comment-page-1/#comment-50513 Devon Herrick Tue, 15 Dec 2009 17:13:29 +0000 http://www.john-goodman-blog.com/?p=7543#comment-50513 Professor Paulos is correct that some women might be helped by greater screenings. However, the small benefit to a few women would be offset by the immense cost and inconvenience of increased screenings. That why the task force makes recommendations. Professor Paulos is correct that some women might be helped by greater screenings. However, the small benefit to a few women would be offset by the immense cost and inconvenience of increased screenings. That why the task force makes recommendations.

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