Most people are quite skeptical when I tell them the standard estimate is near zero for the marginal effect of medicine on health. While they grant that much of medicine may be useless, they point to particular cases where medicine was helpful, and can’t imagine much of it being harmful. But as I posted in November:
In at least 0.4% of hospital stays, a medical mistake “caused or contributed to a patient’s death.” (more)
Also, even standard diagnostic tests can be quite harmful:
CT scans of the heart cause one cancer for every 270 [=0.37%] 40-year-old women who undergo the test, researchers estimate. Yet in a study of CT scans investigating abdominal, hip or pelvic pain, only 9 percent of emergency-room doctors knew that the scans increased cancer risk. (more)
29,000 future cancers could be related to CT scans received in 2007, with the greatest number of cancers projected in the abdomen and pelvis. The cancer risk was greatest for young patients. (more)
A medical treatment really has to be quite clearly and strongly beneficial to overcome such harms. Just sort of maybe hoping that it might be useful, cause, heh, you haven’t heard anything specifically bad about it, just isn’t good enough.
Added 8p: Reasonable doubts have been raised about both the 1/270 and the 9% figures.
"The studies of colonoscopies DO include the costs, in that they have looked at total cancer rates for people who do and do not get the procedures. They have observed that people who recieve colonoscopies have a lower overall risk of dying from colon cancer."
The only results from comparing screened versus unscreened patients show MARGINAL (or even ZERO) decreased risk of colorectal cancer. What's more, the SCREENED groups had a higher ALL-CAUSE mortality rate. Read that last part again.
Colonoscopies are a sham. Period.
To clarify: I don't mean to say the goal is maximizing bad cuts to spending and minimizing good cuts to spending; I mean maximizing cuts to bad spending and minimizing cuts to good spending. This should be obvious from context, but I apologize for the ambiguous grammar.