Overdiagnosis

[ca1ore]

Was having separate discussions with two friends recently, both of whom are physicians and reefers. Got to talking about overdiagnosis - the notion of screening for early disease. Although some lives may be saved or extended, probably more people will become patients unnecessarily and treatments may be either pointless or even harmful. Does this now extend to our reef tanks? I generally am of the view that more data is better than less data - as long as we exercise good judgement about what constitutes appropriate intervention. I suppose most will, but some will not. I always think about measuring ORP. I go back in the hobby long enough to remember when ozone was a common tool. ORP was at least modestly useful then - I’d argue its useless now. I slavishly monitor it still yet can recall no instance when a divergent reading actually resulted in some kind of useful intervention. Reading drops ..... apex shrills .... panic ensues ..... self runs around trying to determine cause .... no cause found ..... self is an idiot .... pointless. Probably better just not to measure ORP in the first place .... oh and I just don’t react to it anymore.

Recent innovations in automated testing are great, but I think they are useful mostly as longer-term trends and not as input to short-term intervention. I’ve seen a few thread recently about folks looking to mitigate daily alk fluctuations. Classic overdiagnosis. Far more likely, in my view, to create a cascading problem than improving the health of a reef tank. If you observe that your tank looks out of sorts (a vanishing skill in the era of automation IMO), that’s when data is invaluable.

I have acquired a trident, and it is very cool. It shows fluctuations throughout the day that I had expected to see but had never bothered to measure before. Tank looks fine even with those fluctuations. Trident measures alk four times a day apparently as part of keeping the unit in calibration. OK, that’s fine, but its not really necessary for tank maintenance, and potentially problematic as a trigger for unnecessary intervention.

Just my opinion; probably a minority one, but that’s OK.

 

[KrisReef]

Having the machines providing "all the data" is helpful to speed up diagnosis after a problem starts but if the only problem is our reaction to the data while the tank inhabitants are not impacted? If so, then less information could be the solution.
Edit:
(Do I need more punctuation?)

In summary, I agree.

 

[Gregg @ ADP]

My approach to reef keeping is more analogous to cooking. There’s a recipe, but beyond that, it’s mostly feel.

Having so much data on hand pushes us to process and manage data. For people who have been ‘cooking’ for a long time, this can be useful in honing things.

For those not as versed, the number chase begins.

 

[saltyhog]

The key is in wisely applying the information and deciding if acquiring the information is even useful or possibly even detrimental.

As a physician one question I ask myself before ordering any test is, "will the results of this test change my treatment plan or the patient's outcome". If it won't it doesn't get ordered. I'm starting to apply that same thought process to my tank.

A real life example is PSA screening in elderly males. Almost weekly I get a guy in his late 70's or older come in for prostate cancer screening. Usually because he's been doing it for decades and read somewhere he should do it. I carefully explain that although prostate cancer is very common in his age group it almost never causes problems or shortens the patients life. I also explain that no surgeon worth his weight is going to operate on a prostate cancer in his age group. Some are ok with that but some insist they want to know......even if treatment is not needed!