But The Machine Said So…
from the relying-on-technology-too-much dept
There was an interesting article recently in the NY Times about various patients who had physical problems misdiagnosed due to a bad MRI scan. Apparently, a number of people continued to suffer from very serious problems for many months, until they finally returned and had another (better) MRI done, which found the problem the first one missed. It’s certainly no secret that an MRI (or a technician reading the output of an MRI) might miss something, but it’s interesting to see people whose natural inclination is to simply trust that initial ruling. We still have this infatuation with the idea that the machines are always right, so if an MRI says there’s no break, it must be true. At some point, though, we need to kick that habit, and recognize that the output of such machines is also fallible, at times.
Filed Under: computers, data, false results, mri, reliance
Comments on “But The Machine Said So…”
correction
Radiologists interpret MR’s and other imaging studies, and they are MD’s(or other licensed medical doctor). Technologists run the machines to produce the images.
RadDoc
Comment
It’s true, sometimes, we become to dependent on machines. It’s good to have 2nd or 3rd opinions on these type of technologies; otherwise, we can be misdiagnosed and could lead to other serious cases.
No.
In any field that takes training to work with expensive machinery, the first thing you learn is to trust your indications. Opinions differ and clerical errors can happen, but saying one should not first and foremost “trust your indications” is a huge step backwards. If you can’t trust the indications, then you cannot practice medicine. Might as well call a damn witch doctor.
Re: No.
That may be true, but it is also important for doctors to realize and acknowledge inaccuracies in their equipment and methods. If we all blindly trust in the newest technology then we “might as well call a damn witch doctor.”
excellent point
my dad had an mri after surgery and treatment for his brain cancer. they said he was looking good. i can’t even remember why we went for a second opinion at a nearby hospital, but we did.
turns out they had somehow missed a good chunk of stuff still in his brain.
It's mostly the right machine at the right time.
My wife knew that there was something wrong. She always had regular check-ups including blood tests, mammograms, pap smears and x-rays. She had an uncanny ability to know when things just weren’t right. She related her symptoms to her doctor, tests were done, misdiagnoses made, important indicators all but ignored, foot dragging and untimely follow-up. Finally, another doctor listened, looked at the findings and chose some tests; Complete blood chemistry, a CT scan, a bronchoscopy and biopsy, then a PET scan and an MRI.
Findings: Ovarian and possibly breast cancers with spread to the right lung, which is inoperable, right ribs and right femur.
The early indicator: Over a year ago the CA-125 blood protein for ovarian cancer was found and, essentially, nothing was done.
She probably has one year, hopefully more. We are left to wonder, if only…
Re: It's mostly the right machine at the right time.
This happens more than it should, because doctors put more faith in their tests than in their patients. What is reported as pain, for instance, is written into the records as malingering, depression, hypochondria, and the like when in reality the tests fail more often than anyone ever lets on, and the reading of them fails too.
My sympathies to you and your wife. I hope her last year will be filled with rich and rewarding experiences.
Re: Re: It's mostly the right machine at the right time.
If the tests fail, what else can you do than retest or open the patient up and take a look?
We also have to keep in mind that it isn’t always the doctors fault. I can’t tell you how often the doctor has many of the same conclusions as the patient, but the patient’s insurance won’t allow the doctor to proceed because the tests disagree.
Few things to consider ... regarding MRIs
Not all MRI’s are are the same. There are high and low field strength MRs (some as low as 0.2 Tesla, others for clinical use 3.0T or greater). This can produce 10 fold increase signal to noise ratios (newer scanners), which usually lead to better images (and more sensitive, specific and accurate diagnosis). Another consideration are the quality of the coils (possibly more important than the field strength). The general public has been GROSSLY mislead that “open” MRI is somehow better (usually these are lower field strength and have suboptimal coils). These “open” scanners should be used ONLY if you can’t tolerate a full field strength closed MR system.
Thanks James for your incredibly...
Thanks James for your incredibly insightful idea.
However, it seems slightly misplaced. Have you considered taking your case to http://www.lolcats.com , or maybe to the forums at http://www.icanhascheezburger.com/ ?
James, What are you thoughts on MRI scans? Have you had one performed on yourself recently to ensure a brain exists?
Thanks for contributing to the MRI discussion!
In Hawaii in 1969 I had a ...
In Hawaii in 1969 I had a head-on motorcyle accident thanks to a drunk driver going the wrong way down a one-way street without his lights on at 4 am.
To make a long story short, after a set of xrays were taken, the duty doctor at Tripler Army Hospital told me nothing was broken or damaged and I should go back to my ship (I was stationed on the USCGC Mellon). I.E. I should walk out of Tripler by myself to the ships van when it arrived. I couldn’t walk as I couldn’t put any pressure on my left foot and couldn’t bend my right knee. The Army doctor, and the two duty medics, refused to give any aid at all, no crutches, no nothing, as he insisted that nothing was wrong with me and it was all in my imagination.
I had to make myself stiff-armed so the guys from the ship could pick me up and put me on the vans floor cargo deck. Getting me onto the ship and down one deck to sick bay was a painful major production. That was at about 5:30 am. At 8 am Tripler called and told the ships duty officer to send me back immediately as I had broken bones in my left foot and significant trauma to my right knee. My knee was already starting to swell up and by 4 pm the knee was the size of a kids basketball, so swollen that they had to cut the bell-bottomed pants leg off as it had a very tight friction fit around my knee. By the time I got to the hospital my temper was riding a thin edge, and my hospital stay pretty much went downhill from there (which I won’t bother to detail here).
The night duty doctor (a 2nd Lt intern) completely mis-read the xrays. Even worse, he refused to believe the evidence of his own eyes when I could barely stand and kept insisting that I couldn’t possibly be hurt. That I couldn’t be hurt because he was a doctor and he knew what he was doing, and anyway I was a mere uneducated E4 and my saying my left foot and right knee were hurting like hell to the point that I couldn’t walk wasn’t worth listening to and, anyway, even if I was hurting it was just because shock was wearing off. That, by the way, is a fairly accurate paraphrase of what he said to me. Sad to say, during at least the late 60’s he wasn’t the only arrogant and incompetent doctor working at Tripler.
The first thing you ...
The first thing you should learn, however, is how to make sure those indications remain as consistently trustworthy as the limits of the technology permit. If your equipment is outdated, if your equipment is sub-optimal for the specific task in hand or if your bosses are cutting corners on routine maintenance for it, it is vitally important to take that into account.
Years ago I read that one in ...
Years ago I read that one in seven medical lab results are wrong. Always get a second opinion if there’s any real chance of a bad outcome from the error. I lost my dad to an MD that chose to believe the results of a bad biopsy in the face of clear symptoms of prostate cancer. Doctors are far less competant than they want you to believe.
Why is the machine wrong or ...
Why is the machine wrong or right? The people relied on the diagnosis from the doctor, not the MRI machine. Machines don’t give diagnoses. Once we recognize that, how is this different than any other medical misfortune involving a person that accepts what they are told?
So sorry to hear about your ...
So sorry to hear about your wife. 🙁
I feel my father-in-law in coming into the same situation. He’s very in-tune with his health and a few months ago he just didn’t feel right. He went through lots of tests and the diagnosis of the 1st doctor based on some blood tests was "stop smoking"; problem is, he’s NEVER smoked in his life (and isn’t regularly around anyone who does smoke). He told the doc just this, and the doc’s response was "Ok, well stop smoking. *winkwink*".
WTF!?
Thankfully we’ve got him going to good doctors now, but this delay may have cost him. 🙁
The infatuation is also with ...
The infatuation is also with thinking medical professionals are always right. People have a blind faith in the superiority of doctors. Hopefully, the equalizing power of the Internet will change this culture.
I'd have to disagree with that....
I’d have to disagree with that. For the vast majority of cases the medical professionals are right, but that isn’t to say they are completely infallible.
Medical applications of imagery are supremely complicated, and often open to multiple interpretations, may of which rely heavily on other information (medical histories etc).
It is a supreme arrogance to assume that you know better then someone with at least seven years training and x number of years experience just by reading something off the internet.
Unfortnatly there are good doctors and bad doctors, but that is why you can get second opinions.
Don't be so harsh on james Mr....
Don’t be so harsh on james Mr. Coward… James has a good point here! Perhaps instead of using MRI machienes or any medical equiptment at all we should diagnose people with absentee ballots! It’s just crazy enough to work! (Heavy on the sarcasm)
…stupid @$$-hat… (@james)
I am currently reading a book ...
I am currently reading a book called "How Doctors Think". It explains so many of the things I have noticed in doctors over the years. What is really scary, is the studies mentioned where 10-20 of x-rays are misread by some radiologists, and how some doctors decide your case in seconds, and don’t let facts influence there decisions. I was literally told once, "I don’t care what the test results say, you have …". Really fascinating, but I guess understandable in a way, doctors are just people to.
Sorry to hear about your wife, ...
Sorry to hear about your wife, Slimcat – my mother died from Ovarian Cancer about 5 years ago…
One of the over-arching reasons for this problem with diagnosis, (and I’m not just talking about medicine here, either), is that in order to give an accurate one, it requires someone, (in this case a doctor), to be able to look at things in an objective manner – (i.e. to see what’s actually there, not what they THINK is there).
Unfortunately, I’ve long since come to the conclusion, that 80% of the population thinks subjectively, whether they realise it or not, and so it’s not surprising that some of them will become doctors, and still remain subjective thinkers, even with all of their training.
Unfortunately, in medicine, subjective thinking costs lives…
Insurance
Bet they had to pay out-of-pocket for the second MRI or were forced to wait for a “prescribed” amount of time to get the 2nd MRI.
Insurance is a business but medicine is a practice.
Thank you!
To those who offered condolences, a heartfelt ‘Thank You’ from me and my wife, to whom I passed them on.
I will tell you also that we have not given up hope. My wife is a very strong person in every respect and is determined to win this fight. Sure, she has some moments that she calls her ‘pity party’ but, for the most part, she is doing very well under the circumstances. Again, thank you.
Bad MRIs and CATs are just fraud
The machine is old, obsolete, or not calibrated. The radiologist is in on the scam. You don’t know and if you don’t ask for the images, you will never know. My last ear,nose,throat doctor demanded the images instead of simply relying on the report. If yours doesn’t do the same, why?