Bizarre twisty argument about medical diagnostic tests

My cobloggers sometimes write about “Politics Everywhere.” Here’s an example of a political writer taking something that’s not particularly political and trying to twist it into a political context. Perhaps the title should be “political journalism everywhere”.

Michael Kinsley writes:

Scientists have discovered a spinal fluid test that can predict with 100 percent accuracy whether people who already have memory loss are going to develop full-fledged Alzheimer’s disease. They apparently don’t know whether this test works for people with no memory problems yet, but reading between the lines of the report in the New York Times August 10, it sounds as if they believe it will. . . . This is truly the apple of knowledge: a test that can be given to physically and mentally healthy people in the prime of life, which can identify with perfect accuracy which ones are slowly going to lose their mental capabilities. If your first instinct is, “We should outlaw this test” or at least “we should forbid employers from discriminating on the basis of this test,” congratulations–you’re a liberal. People should be judged on the basis of their actual, current abilities, not on the basis of what their spinal fluid indicates about what may happen some day. Tests can be wrong. [Italics added by me.]

By the time Kinsley reached the end of this passage, he seems to have forgotten that he had already stipulated that the test is 100% accurate. Make up your mind, man!

Also, what’s that bit about “congratulations, you’re a liberal”? I think there are conservatives who believe that “people should be judged on the basis of their actual, current abilities.” Don’t forget that over 70% of Americans support laws prohibiting employment discrimination on the basis of sexual orientation. I don’t think all these people are liberals. Lots of people of all persuasions believe people should be judged based on what they can do, not who they are.

We’re always hearing about the problems caused by political polarization, and I think this is an example. Medical diagnostics are tough enough without trying to align them on a liberal-conservative scale.

P.S Kaiser has more on that “100% accuracy” claim.

1 thought on “Bizarre twisty argument about medical diagnostic tests

  1. For an arguably better way to deal more fully with the uncertainties in diagnostic test – see Mossman and Berger. Intervals for Posttest Probabilities: A Comparison of 5 Methods.

    But also here – a false dichotomy – there is something in the spinal fluid _right now_ and its doing _something_ right now that will _likley_ make things worse in the near future.

    Like saying one should not be wary of gas fumes because they have not yet come in contact with an open flame and might not.

    K?

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