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Comment by arama471 | Hacker News Reader

if they've already got the fever then it's a bit late for that

Seems like it'd make sense to go into your doctor at some point when you're perfectly healthy and let them measure a bunch of baseline values to put in your medical file.

It's like my bird's vet said once: If you start measuring, you're gonna find stuff. The more you dig, the more you find. Does it mean your bird is sick? Eh look at him, does he look like a sick bird?

My girlfriend can be very ... concerned. We spent $1000 in vet bills before a real avian expert was like "Guys, he's fine. Look how happy he is. He just loves the attention."

Apparently one of his tests for vet interns is to tell them "This bird is sick. Figure it out". Then he gives them a perfectly healthy bird. Their bias always makes them find something. Caused by their tests half the time because they're stressing the bird.

> Apparently one of his tests for vet interns is to tell them "This bird is sick. Figure it out". Then he gives them a perfectly healthy bird. Their bias always makes them find something.

Seems like the "bias" in that case is likely due to an authority figure intentionally misleading them in the context of a "test", where one naturally assumes they're not being deceived by the very premise of said test? If an actual bird owner came in as a client and said the same (or if the test explicitly told them to assume this is the situation), the interns might very well still realize the client is wrong.

I think the lesson he’s teaching is that examination should be hollistic, not just focus on specific tests. Different tests are appropriate in different situations and they often give conflicting results.

I’m no vet but if you have to dig hard for signs of illness, the patient likely isn’t sick. Our bird had increased uric acid. Could be anything. It was a little high.

If he was actua sick we wouldn’t be guessing whether the number is high. It’s be 10x. Waaay out of bounds. A clear signal.

It’s like in product design. Your conversion rate inproved 0.05% after you ran an experiment for 2 days. Is that a signal or noise? Eh probably just noise. Observe longer.

The problem with comfortably saying the client is wrong is tht they’re the authority figure. They have years of data, you have 30 minutes with the patient.

And yes I have had vets casually chat with me for 2 hours when they did spot something suspicious in the bird’s behavior and wanted to observe longer to see if it’s a pattern.

I'm not a vet, but if I were and someone said "This bird is sick." I hope the first question I'd ask is "Why do you think so?" Not to doubt the person but to figure out what the presenting symptoms were.

It is not abstract general someone. It is very concretely more experience professional and teacher whose judgement you trust more then your own. And no, if you dont go much out of way to be approachable or have reason to be afraid of him, no matter how small, they will not ask more. Because most interns know they are beginners and don't know yet.

"Diagnostic stewardship" is currently a hot topic in infection control and antimicrobial resistance work for exactly this reason. If we look hard enough, we'll find something to give you antibiotics for, even if you don't need them.

I've heard similar sentiments around looking at API monitoring graphs when you're not investigating a specific problem. Weird stuff happens all the time, and most of the time it's no big deal.

I have similar sentiments towards the health of humans.

Body temperature for an individual patient can vary significantly based on time of day, activity level, diet, menstrual cycle, etc. A single point measurement taken once every two years doesn't really give a useful baseline and might even be misleading.

Within the parent comment and beyond, it seems people are putting emphasis on a change in temperature but do not state a deviation from the average 98.2°. Even if we did have it though, I don’t think having a longitudinal look at someone’s vital signs (VS) would be misleading in any sense. It establishes a baseline history of the person and deviations will be put in context with the addition charting notes from that visit.

While I do agree with a single point not being enough information, nobody is looking at body temperature alone when diagnosing a patient— unless they’re reaching internal temperatures of below 95° and above ~100.9 for hypothermia or hyperthermia respectfully. With each diagnosis there are /x/ number of signs and symptoms that go along with it so it is crucial that we gather as much information on all the VS we can, no matter how minuscule the data may seem.

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