Modern medicine is a very technological industry. Today there is a huge the number of studies that can be used for the undoubted benefit of patients. But they can also be harmful. When and for whom? aif.ru told about this Chairman of the Moscow City Scientific Society of Therapists, Professor Pavel Vorobyov.
What kind of studies do doctors question?
1. Computed tomography. During the covid pandemic, it suddenly turned out that CT of the lungs is the main method for diagnosing coronavirus infection. “People with any symptoms of SARS were immediately given CT scans,” says the professor. – Almost everyone found changes in the lungs, many were hospitalized. “You have 60% lung damage,” many patients have heard. What is a CT lesion? These are “clouds” on the lungs. What is really behind this picture, what changes in the structures are unknown. The same changes in the lungs can be seen in heart failure and other conditions. People could feel normal, and hospitalization was imposed on them, mixing pneumonia and vascular changes in one heap. Simply because they diagnosed “high degrees of damage” by CT. Without any change in the exchange of oxygen in the lungs. People were taken to hospitals, then nosocomial infection developed there, and patients died from this nosocomial pneumonia. But not from covid. And if they had not been taken to the hospital under a far-fetched pretext, many would have been alive.
And before, doctors warned about the risk of frequent use of CT scans. I had to hear the report of the chief radiologist of the United States, made by him fifteen years ago at our Medical Academy (RAMS), that they had more frequent radiation burns from CT. Let’s say a patient is lying, he has something with his stomach. And the doctor, instead of thinking about the diagnosis, did a CT scan every day. The result is a radiation burn. It’s the doctor’s fault, not the method’s.
CT is an excellent diagnostic tool, but not essential in most cases. When something goes wrong with the diagnosis, then it probably makes sense to do a CT scan.”
2. MRT. Often, if a person comes to the doctor with complaints of back pain, he is immediately advised to do an MRI. However, back pain is most often caused not by herniated discs or osteochondrosis, but by muscle tension. A competent doctor can make these diagnoses without an MRI based on a survey and examination of the patient. Moreover, disc herniation is a normal condition of our spinal column, they do not require medical manipulations, let alone operations. With rare exceptions. “It has long been proven that the effectiveness of operations to remove spinal hernias is zero. That is, without surgery, people live with the same absolutely manifestations of the disease as before the operation. Hernias cannot compress the nerves, it is almost impossible, ”says the doctor.
Moreover, there are cases when patients die from an allergy to a contrast agent, which is injected with some types of MRI. Why do it for everyone? Is the desire to make money on an expensive method stronger than the desire to help the patient?
3. ECG. “They do the same for everyone, but no one knows what they are looking for,” Vorobyov comments. – The efficiency of electrocardiographic diagnosis in myocardial infarction is 36%. That is, more than 60% of myocardial infarctions are not visible on the ECG. Today, everyone knows that the diagnosis of myocardial infarction is based on biochemical tests. Blood is taken, several indicators are looked at, which can not only say that a heart attack has occurred, but even how many hours have passed since its onset. There was even a team of inventors in Russia who developed such a test strip. Like during pregnancy. In the case of signs of myocardial infarction, it was enough to drop a drop of blood and, by the nature of staining, tell if there was a heart attack and how long ago.
There is such a diagnosis – “not a Q-heart attack.” This concept came to us from the West. The patient is told: you know, you have a heart attack, it’s just that it’s not quite visible on the ECG. And then medicines are prescribed (you need to feed Bigpharm), they get good treatment effects. In fact, this is usually menopausal cardiopathy, by the way, our, domestic development. But in the West it is not recognized. And so do we.”
What else can be “found” on the ECG? A mysterious disease called “metabolic changes”. What it is, how to treat it – no one knows, because this is pure fiction. But people are starting to be treated with some kind of “metabolic drugs”. This is the same muck that athletes take. It is clear that there are no effects from such treatment.
An electrocardiogram is needed only to detect and control heart rhythm disturbances. Here, with arrhythmia, it is definitely worth using.
4. Ultrasound. Of course, this is a good method, every normal doctor should have a portable ultrasound machine on his desk. This is the case in most countries. But it’s important to know how to use it. As it happens. They did an ultrasound of the liver and give out: we found some kind of focus in your liver. The patient is in a panic, he thinks he has cancer. They begin to drive him to doctors, they can reach a biopsy (examination of a micropiece of organ tissue under a microscope) to find out what kind of focus is there. In fact, such foci in the liver can be full due to inflammatory reactions and other reasons. Then they dissolve.
So a very good and necessary method gives wild overdiagnosis. First of all, in the hands of bad doctors.
5. Mammography. Over 20 years ago, it was proven to be ineffective in prolonging the life of women with breast cancer. Dozens of scientific articles have been written about this. “The fact is that treatment has changed. Previously, the main method was surgical removal of the tumor, explains the professor. – And now – complex hormonal treatment, targeted (by purpose) therapy has come to the fore. The effectiveness of this therapy does not depend on the stage of the tumor. Women who are diagnosed with a tumor early live with it longer. But they die at the same age as those who were identified and treated later. This does not mean that you need to pull to the last. The best way to detect a breast tumor is by self-feeling. If a woman sees that she has a hardening, then you need to go to the doctor and start treatment when the diagnosis is confirmed. I emphasize: what has been said applies only to a specific type of cancer – breast tumors.
6. PSA blood test (prostate-specific antigen). Prostate cancer is a slow growing tumor. It develops, as a rule, in older people and is quite easily controlled. However, after the diagnosis is made, people are actively treated. Treatment does not prolong life. Not only is it stressful, but also castration (surgical or chemical). At this age, men are more likely to die from other causes – heart attack, stroke, etc. than to wait until the tumor interferes with health. Of course, active therapy is indicated for someone, but not as widely as it happens now.
7. Blood and urine tests. Quite useful for diagnosis. The problem is that doctors often do not know how to read them. Sometimes patients come with changes in blood tests. It turns out that these changes are 5 or 10 years old. But none of the doctors paid any attention to it. Meanwhile, there is, for example, such an indicator as an increased number of platelets – many doctors simply do not see it. Although it is a chronic tumor of the blood. Yes, a long-term disease, well treated. But a diagnosis would have to be made.
8. Radiography of the lungs (fluorography). How many total tuberculosis cases are detected in the country during total fluorography? Several cases a year, up to ten. Why then should everyone do it? To detect lung tumors, X-rays should be done only in risk groups. These are smokers with a long history and they need to do x-rays twice a year. Lung cancer grows quite quickly, and in a year or two it may be too late.
9. Express texts. For covid, influenza, other infections. Can be done. But what to do with this knowledge? Everyone knows that there are no effective antiviral drugs against viruses. It’s fun to see what you have. But please note that in official medicine, doctors do not use any express tests.
What should patients do?
If you are told that after 40 or 45 years you need to go through some expensive research, do tests, but you don’t have any symptoms, it’s hardly worth agreeing. Most often, this is just a business and a desire to make money. Not only can you lose money, but also lose your health.
If you really want to check your health or it seems that there is some kind of illness, the best option is a remote check-up, a symptom checker. This is an electronic questionnaire that uses artificial intelligence. The neural network analyzes whether there are risk factors, symptoms of the disease, and whether any tests and examinations need to be done. Artificial intelligence is impartial and does not work “for the average bill”.