https://doi.org/10.1136/bmj.k2387

Let’s go through a bayesian analysis hypothetical.

Rates of incidental findings on MRI are about 30%. So if 100 people get a scan 70 are reassured. 30 find something. Of those 30, about 2 to 5 percent are malignant so rounding up 2 find malignancy and 28 find a mass that needs follow up/biopsy. 28 are measurably harmed. Now let’s look at the 2. You have identified cancer “early” in these two people. Did you help them, well that depends on what you find. Some cancers (pancreatic, breast, melanoma) finding early is really the only chance at cure. For others, all you have done is make them worry about their disease for longer (lead time bias). If treatment in the preclinical ( pre-symptom) phase does not help more than treatment after symptoms then all you have done is given someone the knowledge that they have cancer for months or years longer than they otherwise would have needed it. You did not improve their mortality or morbidity.

Most of the diseases that have a preclinical phase where intervention is helpful already have screening recommendations. So odds are whatever you find is not one of those cancers that would be helpful to find early.

Ultimately, it’s your health and your choice. If you are having symptoms or have a genetic history that puts you at higher incidence it might make sense. For the general, asymptomatic population, the positive predictive value of this test is very low. So low that it is clearly harmful and should not be done.

Everyone has heard that story of the friend or family member that “was in an accident” but it ended up saving them because they found cancer. While That certainly has happened, it is exceedingly rare and often not the full picture.

*Edited a typo

You do NOT want an unnecessary scan. There is a common misconception that knowledge in this arena is good. While the scan itself is not dangerous, what you would be required to do with the information is. Almost everyone has some abnormalities, we call them “incidentalomas”. Knowing about them will cause unneeded biopsies and months to years of worry that “you have cancer” or " something is not right". There is a reason that there are strict screening recommendations in medicine. Unless a disease has a long preclinical (pre-symptom) phase with a clear improvement in outcomes from early treatment ( no lead time bias) then screening ( testing without symptoms to make sure nothing is there) is openly harmful and should not be done.

Not to mention the cost for license, malpractice, and billing agents. Also, remember that the insurance companies end up actually paying between 50 and 70% of claims so so for every paid 200 dollar claim there may be one that is done “for free” since it will never be paid. It gets averaged out to be much less.

There is literally an army of people employed on both ends to just argue about these things. That’s where our healthcare dollars go.

The world needs as many highly educated people as possible. The problem becomes when you make higher education a business and attach publication as a requirement for advancement. Then you are diluting the quality of research in pursuit of a “high volume” model. In this model people don’t follow passion they follow the path of least resistance and we all suffer for it.

I usually don’t engage in conversations like this but let’s try. The condition you are describing is an autoimmune disease known as Gillain-Barre (Also, sometimes called acute inflammatory demyelinating polyneuropathy or AIDP). It is a devastating disease and I am sorry that your loved one has had to cope with it.

This disease can be triggered by any number of exposures including vaccination not just to COVID but to any vaccine. It is truly something to be concerned about and an important thing to understand when making health decisions. Essentially, when your immune system is exposed to something it thinks is foreign (Like a virus, viral protein from a vaccine, or bacteria) you body trys to fight it by making antibodies. The anti bodies attach to it and inactive or kill the virus. Rarely (like 1 in 100000ish) the body makes antibodies that also attach to something that it should not like your own body. If that thing happens to be a spinal nerve you develop this disorder.

If you are concerned about it, you should ABSOLUTELY get the vaccine. You are orders of magnitude more likely to get AIDP (Gillain-Barre) from contracting a native virus than you are from the vaccine. Also, you are more likely to spread the virus causing death and the same low chance of AIDP (Gillain-Barre) to others.

When a vaccine is deemed “safe and effective” that is not to say it is without any risk. Any exposure carries risk. It means that our society is more likely to be healthy with it than without it. Both on an individual and population level. People are concerned about the antigens (things that generate an immune response) in vaccines but you have many more antigenic exposures in the world without vaccines than with them.

Wait. Let me guess. It’s about 600 dollars overpriced, requires proprietary wiring, is not repairable (because Tim Cook believes you are leasing it from apple), requires an Internet connection to perform a basic function that has worked for over 100 years without AI, oh and it doesn’t have an actual button to reduce waste. You are supposed to use your old one or buy an apple button for another 600 dollars. Also, it stops working or slows down after a year and for some reason you need a subscription to use it.

I would also ask yourself how often and how long you work compared to this doctor. I think standard for nurses is 3-4 shifts per week. Doctors work much more than this and often have out of work responsibilities as well. The hourly rate is much closer than you make it out to be.