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dontreacton Half of women will get a false positive 3D mammogram, study finds

Yes, it's not a 50% chance of false positive. It's 50% chance of false, given positive test.

dontreacton Half of women will get a false positive 3D mammogram, study finds

No one just treats a mammography or tomography positive without other follow up tests. It's not the standard of care. The next step is to get an ultrasound and then a biopsy.

dontreacton Half of women will get a false positive 3D mammogram, study finds

https://pubmed.ncbi.nlm.nih.gov/33141657/

"Long-term follow-up of the UK Age RCT" "There was a statistically significant 25% reduction in mortality from breast cancers diagnosed during the intervention phase at 10 years' follow-up"

dontreacton Half of women will get a false positive 3D mammogram, study finds

It will take a long time to sort this out. I think that eventually, the ability for AI to review 3D in greater detail will improve on false positives and false negatives.

For CT vs. XRay there have already been 2 long term randomized controlled trials that look at outcomes for lung cancer screening. PLCO, the XRay study, was not effective in improving long term outcomes like mortality. NLST, the CT study, showed a 20% reduction in mortality. With more modern techniques that actually look at the tumor in 3D NELSON in Europe has seen even better mortality reduction.

DBT is newer so A) Radiologists are not as good at reading it yet B) the long term evidence hasn't accumulated yet, but I am definitely optimistic that it will present a big improvement over the previous state of the art.

As mentioned elsewhere in the thread, this false positive number is already better than the existing state of the art for 2D.

dontreacton Half of women will get a false positive 3D mammogram, study finds

You don't, you just measure long term outcomes like mortality in a treatment and control arm. Potentially you have to use a synthetic control.

I am most familiar with NLST which actually was a long term randomized trial.

dontreacton Half of women will get a false positive 3D mammogram, study finds

Yes exactly. No one is going to put you on chemo because of a mammogram. There are several followup tests including ultrasound and biopsy.

dontreacton Half of women will get a false positive 3D mammogram, study finds

This is all certainly true but it's important to look at the bigger picture. What is the overall impact of catching cancer earlier and saving lives? That is enormous as well. One way this is sometimes talked about in public health literature is by looking at the QALYs of an intervention. On the whole, breast cancer screening does seem to be an effective intervention

https://pubmed.ncbi.nlm.nih.gov/31098856/

dontreacton Half of women will get a false positive 3D mammogram, study finds

It's good to be publishing stats like this so that the psychological harm of false positives is lower. It's scary to get a false positive.

However, in my opinion, there has been a systemic resistance to screening because of statistics like this, and that is misguided. This is not the right number to use for determining whether or not screening is useful.

A 3D mammogram will have false positives, yes. And some women will need to either get an uneccesary ultrasound (annoying, but not harmful) or worse, an uneccessary tissue sample (biopsy). This type of biopsy is done with a needle and is certainly uncomfortable, but carries little to no risk. This is all true. But it needs to be balanced against the fact that catching cancer early gives you an immensely better chance of surviving.

The right numbers to look at are more like: How much does a screening program reduce overall mortality rates? How much does the screening program reduce breast cancer mortality rate? What are the impacts of this in terms of QALY (quality adjusted life years)? What are the impacts of the false positives in quality adjusted life years?

I believe on balance the answer to these questions is that screening for breast cancer is on the whole beneficial. Here is one example study https://pubmed.ncbi.nlm.nih.gov/31098856/

Now the question is, how will 3D affect these questions? That is as of yet unanswered as far as I know but we shouldn't let numbers like this influence the conversation prematurely.

dontreacton Half of women will get a false positive 3D mammogram, study finds

Yeah this is why in practice the followup to a mammogram is never going to be another mammogram. It's a different test which is more invasive but also produces far less false positives: taking a tissue sample.

dontreacton Half of women will get a false positive 3D mammogram, study finds

However, despite the high false positive rate, breast cancer screening is a net beneficial procedure (though not without controversy) in that when applied in a population, long term outcomes like mortality improve.

(edit yes of course cancer is not beneficial thank you)

dontreacton Half of women will get a false positive 3D mammogram, study finds

Yes exactly. In fact mammograms are already double-read and agreement is quite high, so this is definitely one of those types of tests. There are benign masses that are radiologically impossible to distinguish until you get a biopsy.

dontreacton 'Worm-on-a-chip' device could someday help diagnose lung cancer

This is actually a really cool idea. Looking forward to see how/if it scales up to humans.

Would be a sad but hilarious example of why lab bench testing and testing in humans or animals is such a large gap

Bench: The worms swim towards the cancer cells on this 3 inch, 2D glass media!

Animal trial in mice: The worms swim towards the cancer cells!

Humans: Oh shit the worms are totally lost in this huge space. Also the patient has a lot of worms in their lungs.

dontreacton Google “hijacked millions of customers and orders” from restaurants – lawsuit

Probably not a good idea for Google to go after other companies in this way given all the antitrust specter.

NYTimes headline

“Google abusing monopoly position to muscle out delivery startups”

dontreacton Google “hijacked millions of customers and orders” from restaurants – lawsuit

I thought it was Grubhub/Doordash actually taking the orders, Google is just providing a link to their service.

dontreacton Google “hijacked millions of customers and orders” from restaurants – lawsuit

Funny how there is pushback on the YCombinator forum to an attempt to hold accountable a YCombinator company that actually has a direct hand in doing this to restaurants.

How would Google know which postings are fraudulent and which aren't? The vast majority of these postings are fine/legitimate/consented. Why does it have to be Google that spends time and energy going after the bad actors, and if they don't, they become one?

In other words, I really don't see how Google is in the best position to figure out which restaurants have been posted without the restaurant's consent. I think that would be the companies putting up the original post.

dontreacton DNA data of sexual assault victims exposed in breach at US laboratory

So then the hospital or lab are under HIPAA, but not the forensic lab.

dontreacton DNA data of sexual assault victims exposed in breach at US laboratory

A forensic lab doing things with DNA may have no business relationship whatsoever with any covered entity (in fact I would guess that this is the most likely case).

dontreacton A gentle introduction to vector databases

Yes but my sense it is coming pretty soon for ES, and switching to Pinecone has a huge rewrite cost. As NNs keep getting better, vector search keeps becoming more important, and it becomes more and more existential for elasticsearch to do this well. I wonder if there actually some fundamental reason they won't be able to do so.

dontreacton A gentle introduction to vector databases

The way that vector indices work typically can make doing CRUD with them a real challenge. There is definitely novelty in being able to do both ANN indexing and fast high throughput CRUD.

In addition, the R of crud is hard to combine with vector indices. Case in point I am still waiting for elastic search to support both ANN and regular, structured filtering together well.

dontreacton Ask HN: New web service idea that you would pay for?

I pay 25$ a month to Textedly to enable me to easily send text messages to a group of people and enable signups to a list via a short code.

dontreacton GoFundMe pauses donations to Canada truckers

I agree with you, but I also see violence as an inevitable consequence of growing inequality. If we continue to let wealth inequality grow, more and more people will feel the game is unfair, and choose to play another game, even if the "rising tide that lifts all boats" is lifting their boat somewhat.

dontreacton Cruise is opening driverless cars to the public in San Francisco

I saw a presentation at a conference that pretty strongly suggested they will have a remote driver take over at certain points (the car will assess it can’t continue and remote driver takes over)

dontreacton Non-Tesla Supercharger Pilot

Interesting how much hate I have seen for how Tesla didn’t do this before and how little enthusiasm or support there seems to be for this. This seems great!

dontreacton Nature Neuroscience offers open access publishing for $11k per article

No, you have to pay 11k to publish

dontreacton Jan 6 committee subpoenas Meta, Google, Reddit etc. after 'inadequate responses'

If pelosi were murdered (and potentially other senators too)

Do you think the senate would still have certified the election? Or would Trump still be president?

I think the fear is that the mob was almost able to make it so that Trump’s lie about a stolen election would have overridden the democratic process.

If such an event happened, it would have been fair to say that event “killed democracy”

dontreacton Jan 6 committee subpoenas Meta, Google, Reddit etc. after 'inadequate responses'

What do you think would have happened if things went a little differently and the mob got to Nancy Pelosi? They were very close to doing so.

dontreacton Health care is turning into a consumer product

I totally agree that culture is a big factor. I just think the conversation in the US around healthcare is kind of limited to pro or anti “Medicare for all” when there are actually many ways of doing things which do not require a single payer. Japan is just one example, Germany is another.

Obviously we shouldn’t just exactly copy the system of other countries, but it’s equally shortsighted to not learn take away anything from other existing systems. The possibility for universal coverage and higher cost efficiency without the need for single payer I think is a valid thing to take away from those examples.

dontreacton Health care is turning into a consumer product

The Japanese system is not a single payer healthcare system and in terms of outcomes vs. cost is one of the best in the world, so I am not so sure that single-payer is the most reasonable solution. Particularly in the US where voters are averse to giving up their private insurance.

Japanese system does have a public option and much tighter price controls, which we are missing here.

dontreacton 20 year study of global wealth demolishes the myth of ‘trickle-down’

Yes but if the game you’re playing will only hand you losses time and again, then you will look for a different game, or lose motivation/give up.

dontreacton Tell HN: Azure is having a major outage

I know this from working there, but it’s kind of a shameful “secret” as far as I can tell?