Bad science Clinical trials Medicine

“Whole body scans”: Back from the grave and ready to party

Two decades ago, I cut my skeptical teeth countering advertising for whole body scans by companies making extravagant promises for their products. This particular medical fad faded for a while, but now it’s back with a vengeance…with AI! Looking at these products, what I see is basically the quackery that is functional medicine on steroids and powered by AI.

It just struck me the other day that, in less than a year and a half, I will have been at this blogging thing for two whole decades. I’ve been writing for SBM for over fifteen and a half years, having started my first blog more than three years before that and having been active on Usenet countering quackery and antivaccine pseudoscience for five or six years before that. (Yes, I’ve been at this in one form or another since the late 1990s.) I was reminded by a recent spate of laudatory (or at least very unskepticalstories about Neko Health last week touting their “lofty promise of preventative healthcare via full-body scans backed by AI software” of the very first time that I actually put my then relatively recent turn to combatting dubious medicine into action with respect to a medical fad that had been going on for quite some time, that of whole body scans for preventative healthcare.

Reading some of these stories, I immediately felt a profound sense of what Yogi Berra would have called “déjà vu all over again”:

Neko Health, a healthcare technology company co-founded by Hjalmar Nilsonne and Spotify founder Daniel Ek, announced the successful completion of a €60 million ($65 million) series A funding round. The company aims to revolutionize the health industry through artificial intelligence (AI)-driven full-body scans, specifically focusing on preventative healthcare.

Do tell. What, exactly, does this “whole body scan” involve? Let’s find out:

Neko Health has introduced an innovative medical scanning technology that enables extensive and non-invasive health data collection, prioritizing speed, accuracy and convenience.

The company operates private clinics with proprietary and off-the-shelf diagnostic products, including its own 360-degree full-body 3D scanner integrated with over 70 sensors. The scanner can collect 50 million data points within minutes.

This data undergoes analysis by a “self-learning AI-powered system,” providing doctors and patients with insights.

So Neko Health is a bit more than what I dealt with, lo, those many years ago. Clearly, the industry hawking “whole body scans” as a health panacea has evolved since I last seriously dealt with these products. Two decades ago, when I first started complaining to a local NJ radio station about ads by a company called AmeriScan making unrealistic and extravagant claims for “whole body scans” and “screening MRIs” that’s all it was, CT scans and MRIs. Now it appears that “whole body scans” involve so much more, both a proprietary “its own 360-degree full-body 3D scanner integrated with over 70 sensors” and a raft of other test, to the point that it reminds me very much of how I once described “functional medicine”: reams of useless tests in one hand, a huge invoice in the other. the only difference being that companies like Neko Health add artificial intelligence to the mix, because it’s the latest tech fad.

In fairness, the invoice for Neko Health’s “whole body scan” isn’t that huge (€250), but it’s still at least not insubstantial. None of this changes my perception that Neko Health simply represents the latest iteration that, consistent with the latest tech fad of the times, just adds AI to a very old idea, that some variant of “whole body scans,” whatever the form they take, is a magical tool for finding disease super early and managing health.

You think I’m being unfair by using the word “magical”? Take a look at this LinkedIn post by one of the company’s founders, Hjalmar Nilsonne:

Again, the sales pitch is very much like the sales pitch favored by practitioners of “integrative medicine,” including naturopaths and “functional medicine” practitioners, representing their methods as The One True Preventative Medicine. I note that, among the many commenters praising Neko Health, there was one commenter who exhibited the appropriate level of skepticism, a question that I will expand on as I look at Neko Health’s product and products like it:

Instead of alleviating pressure on our health systems this will probably just add to it. All scans find ‘something’, will Neko help ‘solve’ them or just refer the patient to the already struggling general practitioners and public hospitals?

Excellent question, Mr. Bateman! Did Nilsonne answer it? Nope. Only one person did, and he appears not to be affiliated with the company:

Why rely on human eyeballs when computer vision can easily detect and track hundreds of 2mm skin lesions over time?

We say the same thing to physios and personal trainers about recording movement in pixels and milliseconds, and some insist they can see/measure and report dysfunction with their eyes, and adequately report it with text.

If Mona Lisa were to be described in words alone, she would have many faces!

The cost of bias, malpractice and delayed intervention will easily outweigh the cost of early diagnosed and early intervention.

In any case, this seems like out of pocket for now. They should be paid a % of saved future costs for early detection, based on historical data IMHO.

Mr. Bilby’s faith in computer algorithms is….touching, as is his faith that screening everyone willy-nilly like this will do anything more than cost more money in downstream confirmatory tests and procedures. It’s not as though we haven’t gone down this road before many times. It is up to the promoters of a new technology like this to show that it does what it says, not to critics to show that it doesn’t, but for some reason it never seems to work out that way. I do like the Mona Lisa analogy, though. It sounds so profound without actually saying anything substantive about the technology. I also note that, if all this does is to take images of skin lesions and track whether they grow over time or not, it’s just a more sophisticated way of doing skin screening exams in a way that more systematically records every lesion on the skin, of which most people have dozens, if not hundreds.

Moreover, there is also already a rather extensive scientific literature on the use of AI to classify skin lesions and carry out skin screenings, particularly for people with darker skin, (Does Neko use recommended best practices for its image acquisition, for example?) for which AI could be particularly useful given the difficulty in identifying and classifying moles as benign versus potentially malignant in darker skin types. However, as this recent review put it, for non-melanoma skin types, AI has “sensitivity and specificity that are not inferior to those of trained dermatologists,” which is hardly a ringing endorsement. Neko Health will have to show that its system is superior to the many existing systems under development and testing. Can it? I sure can’t tell from what I can find out.

Also concerning is this:

What’s perhaps most notable about Neko at this juncture is its aversion to interviews, particularly against the backdrop of high-profile health techs such as Theranos’ spectacular fall from grace after making bold claims with little foundation. Indeed, Neko Health declined to give interviews to international media when it formally launched earlier this year, and little opportunity was given to ask questions ahead of today’s funding announcement.

It is, of course, difficult not to get a Theranos vibe from Neko Health, although the difference here is that, unlike the case with Theranos, where the technology was clearly half-baked and arguably even impossible, the technology clearly exists to produce the devices and tests that Neko Health markets. Indeed, as you will see, other than the “whole body scan,” Neko appears to be doing nothing particularly novel, not even coupling AI with existing technology The main problem is the assumptions behind this raft of tests and the seeming lack of concern about the well-known negatives of screening people for so many measurements at once. The company claims it is doing clinical trials, but searching PubMed failed to find any published results, as did scanning the Neko Health website. I found the latter observation particularly telling, because, if there’s one thing companies marketing a new medical test love, it’s to tout their scientific publications on their websites.

What is Neko Health selling, though?

Neko Health’s “whole body scan”

I noted when I first visited the Neko Health website to see what it says about its whole body scans that the website is incredibly slick but rather lacking in much detail, coupled with language that sounded very much like that used by AmeriScan, the company whose “whole body CT” and screening MRIs had caught my attention back in 2003. Touting its products as “Your health checkup got upgraded, Neko Health brags:

Try the Neko Body Scan, get instant results, and let us monitor your health—so you don’t have to.

Sounds nice, but doesn’t the paternalism of this message conflict with the “take control of your own health” pitch going on elsewhere? And:

Detect. Prevent. Relax. Your body is constantly changing. By measuring, analyzing, and following millions of data points, we create an individually tailored overview of your health.

This is just another form of a favorite advertising buzzword among both conventional physicians and quacks designed to make patients feel special—”individual”—if they use the product being touted. Which use of the “individually tailored” or “personalized” view is being touted here? Let’s take a look.

First, however, let’s see what Neko Health promises with “its own 360-degree full-body 3D scanner integrated with over 70 sensors” (plus, as you will see, a lot of other tests). Neko Health’s Twitter feed touts three main aspects of its products.

First, skin:

Doesn’t one have a risk of skin cancer on one’s breasts, buttocks, and…other…regions?

I see many punch biopsies in this woman’s future.

Then there’s the scans of the cardiovascular system:

And, finally, the scan itself:

The scanner itself reminds me of an over-wide version of the cryogenic tubes featured in Lost in Space in the 1960s:

And, because I couldn’t resist, here’s what I mean, dedicated to those of you too young to remember the original Lost in Space:

Lost in Space cryotube versus scans
Yes, I grew up on this stuff and so couldn’t resist. Of course, I’m guessing that if they were undergoing Neko Health whole body scans they wouldn’t be wearing 1960s-era tinfoil space suits.

But what, exactly, does Neko Health do at its clinics, in particular its Stockholm clinic that is currently the only location where it has its super-duper-AI-powered whole body scanner? It’s clearly popular. The website brags that all the available appointments are booked and that, if you want one of these whole body scans, you need to get on a waitlist.

First, let’s look at how Neko Health characterizes its whole body scans:

Start with a 360-degree skin scan

Everyone knows it’s important to take care of your skin and regularly check for birthmarks, but seeing a specialist can take months. Neko Body Scan images every centimeter of your skin in less than 20 seconds and tracks every birthmark—so you don’t have to worry.

  • Full body scan in underwear

  • Detects birthmarks, rashes and age spots

  • Follows changes as small as 0.2mm

This is basically a dermatologic skin screening on steroids and AI. While it is true that skin screening is an important modality to detect early cancers, particularly melanoma, one has to wonder how this AI system will do better than the experienced eyes of a dermatologist or melanoma surgeon in detecting suspicious lesions. One way that I could envision such a system having utility would be if it can decrease the number of false negative skin biopsies done on suspicious lesions, but there seems to be nothing on the website even addressing the question. Also, why exclude parts of the body covered by underwear? You can get skin cancer on your buttocks, perineum, and anywhere else covered by underwear.

As I read through Neko Health’s website, I was surprised at how mundane most of it was. For instance, part of the screening involves taking a fasting blood sample for routine labs like a lipid panel and a “full-body blood pressure with 8 non-invasive sensors.” A more detailed description of the tests can be found here, where Neko touts its three clinical trials, which it calls Cardio Alpha, DermaFlow Alpha, and Spectrum 1.

Cardio Alpha is described as a clinical trial “about evaluating the suitability of a novel Laser-Radar-based technology, to assess arterial stiffness and its correlation to cardiovascular risk and diseases” and consists of collecting heart sounds, pulse wave analysis, pulse wave velocity, blood pressure, ECG, and cardiac ultrasound images, none of which is particularly novel or even all that interesting.

Next up, there’s DermaFlow Alpha:

This clinical trial is about evaluating the suitability of multi-modal imaging technology that virtually covers the entire body, to assess the potential of screening and early detection of disease.

The multi-modal technology is based on camera systems, which can capture high-resolution color images (visible spectrum), 3D, and thermal images (infrared spectrum).

By studying the correlation and sensitivity between disease states, gradients, and asymmetries in collected image data, the potential can be evaluated.

Did they say “thermal images”? Holy thermography, Batman! Neko Health is using a fancy, tarted up version of thermography coupled with high resolution images. It’s hard for me not to recall that thermography is an imaging modality that’s long been a favorite of naturopaths, “holistic practitioners,” and other quacks (but I repeat myself), who make extravagant unsupported claims about its ability to detect many diseases, but in particular breast cancer. (Christine Northrup is a big fan, as I first noted in 2010.) To me, this sounds suspiciously like nothing more than an observational study designed to collect a dataset to train Neko’s AI. Recruiting patients to evaluate and test a new technology and train its AI is nothing nefarious in and of itself, but such a mundane goal rather conflicts with all the company’s hype for its products. Do patients who pay for these tests know what they’re signing up for? They expect to be given reassurance (no disease) or to find disease early, the assumption being that finding disease early will result in a better outcome. Do they know that in many cases such tests will trigger further tests and even invasive procedures?

These first two studies are just the buildup to what Neko Health obviously considers its main accomplishment, its “whole body scan.” (I’m surprised that the company didn’t come up with a pithier name for it.) So let’s look at how it describes its Spectrum 1 trial:

Most skin conditions affect and/or are caused by the skin’s microcirculation (blood flow in the smallest vessels). Microcirculation in the skin is also affected by many systemic diseases, such as for example, diabetes and autoimmune diseases.

The disease of large vessels (macro-circulation) can also be caused by basic problems with microcirculation.

Today, there is little opportunity to detect microcirculatory problems early, and it is often discovered when the course of the systemic disease has gone quite far.

This clinical trial will evaluate a trial device that uses a projector to depict patterns on the skin, which the skin absorbs, reflects, and spreads depending on skin composition and structure.

There’s a lot to unpack here. First of all, it is true that many diseases have dermatological manifestations, but certainly by no means do all diseases manifest themselves on the skin in a manner that can be picked up by a system like this. Yet the company makes grandiose claims for this system, which, besides the visual images it records, also measures concentrations of oxyhemoglobin (oxidized hemoglobin) and deoxyhemoglobin (non-oxidized hemoglobin), as well as the “oxygenation within the measured skin area,” to which the wag in me can’t help but say: Congratulations! You’ve reinvented the pulse oximeter as a whole body pulse oximeter! In fairness, the device also measures the concentration of water and melanin in the skin area examined, but in reality it is sounding more and more like a glorified pulse oximeter that measures a few other things.

Again, like the others, this clinical study looks to me like nothing more than a method to gather a training dataset for the company’s AI, which, again, is nothing nefarious in and of itself. What is dubious to me is having your patients fund the research and development of your technology by paying for an unproven test to be part of its AID training dataset. This is the sort of activity that should be funded by the company developing the experimental technology, not patients, but that’s not what appears to be happening. Moreover, the company appears to be enticing patients by making promises, albeit vague ones, about their test being the ultimate in preventive medicine. If that’s not what the company is doing, I have been unable to find any evidence telling me what the specific questions they are asking are.

I was particularly taken by this quote:

Nilsonne said that the company has already proven the resonance of its unique approach to preventative healthcare. Strong demand signals a genuine need and desire for change, which has propelled the company to broaden its horizons and accelerate its growth by forming partnerships with external investors for the first time.

This is nothing more than an appeal to popularity. All it says is that Neko Health’s marketing of its as yet unproven device has been effective.

“Whole body scans” as functional medicine?

Having perused the company website and as much as I could find with Google and PubMed, I was left…dissatisfied. I understand a company wanting to protect its proprietary intellectual property, but the vagueness of the claims was frustrating, especially coupled with the lack of detail about what, exactly, Neko Health’s scans will actually be used for other than a generic “health screening” that will somehow revolutionize preventative medicine. I was interested in learning the identities of the physicians running the clinical development of this technology, because screening asymptomatic populations for occult disease in the hopes that early intervention will result in better outcomes is an area of medicine that is highly complex and fraught with pitfalls, such what to do with “incidentalomas” (lesions or abnormalities found incidentally on a test that a patient is undergoing to look for something else, but more importantly the problem of overdiagnosis, lead time bias, and length bias. Yet, under the “leadership” and “transparency” section of Neko Heath’s website, all I could find were the identities of the founders of the company and its systems for safety, documentation, and quality improvement, which apparently are in accordance with Swedish law. Its press kit was no more informative, consisting mainly of photos of its device.

As the late Dr. Harriet Hall, who was a family physician who served as a flight surgeon in the Air Force, pointed out well over a decade ago, even the yearly physical examination with routine bloodwork is a medical screening tool that has come into question given its low yield in most healthy, asymptomatic patients who have no symptoms or signs of disease and are not a high risk of certain specific diseases.

She also noted:

We are increasingly questioning screening tests that were formerly recommended. The annual chest x-ray, tine test, and urinalysis are long gone. The recommended age limits for mammography have changed. Routine PSA testing is being discouraged. A recent study suggested that a woman whose DEXA scan shows normal bone density or mild osteopenia need not be rescreened for 15 years.

We don’t need to examine all the published literature on screening tests, because the U.S. Preventive Services Task Force (USPSTF) has done all the work for us.  They continually update recommended screening testsfor different age and risk groups based on the latest studies. There are other organizations in the US and elsewhere that make similar recommendations but that may differ to some degree in different countries. In general, a specialty organization is likely to recommend more screening in its particular area of interest, based on a different focus in interpreting the same published evidence. The American Academy of Family Physicians, with a broader perspective, generally follows USPSTF recommendations.

Any new screening test needs to be viewed very skeptically in the light of these observations. For some reasons why, feel free to review some of my articles that discuss the issues involved with any screening test. I discussed mainly screening tests for cancer, like mammography for breast cancerPSA for prostate cancer, and thyroid ultrasound for thyroid cancer, all of which can artificially inflate survival statistics for cancer, but all involved problems of overdiagnosislead time bias, and length bias. (It’s not just these cancers, either.) In fact, let me cite a couple of graphs that I always like to cite whenever the topic of screening comes up. First, here’s an illustration of lead time bias:

Lead Time Bias
Lead time bias.

As a result of lead time bias, it’s very easy for screening to make it look as though patients are doing better after early detection of their disease, whether they are, in fact, doing better or not. One of the best explanations of the concept of lead time bias that I’ve ever encountered can be found here.

The other factor most relevant to cancer screening is overdiagnosis and length bias illustrated here with the concept of overdiagnosis:

Overdiagnosis scans

The above graph demonstrates how screening favors the diagnosis of relatively slowly growing cancers, known as length bias. Fast growing cancers, like Tumor D, grow so fast that they become symptomatic or detectable on physical examination between screenings. As a breast surgeon, I see this occasionally, the woman who laments that she gets her mammograms regularly but felt a lump 6 months after her last mammography that turned out to be cancer. This graph also illustrates the problem of overdiagnosis that also results from length bias, as Tumor B is what happens when a slow growing cancer reaches the stage of being detectable by a screening test but is so slow growing that the patient will die of other causes before it causes any problems. Also, remember that this whole discussion only applies to patients who have no symptoms or physical findings. If the patient has symptoms or physical findings, then the test is no longer a screening test but a diagnostic test. If you have symptoms or physical findings that are worrisome for serious disease, you should always see your doctor to have them checked out.

None of this is to say that screening tests are useless, don’t save lives, or at the very least allow less invasive and radical treatments to succeed. Several are not. However, what these entrepreneurs selling new unfocused screening tests for even healthy people always seem not to understand (or even be much concerned about) is that screening for any disease involves a difficult balancing act between disease biology and natural history versus any benefits of intervening in the disease process in its asymptomatic phase. Remember, overdiagnosis is not a false positive, although that is a frequent misunderstanding of the concept. For example, breast cancers and prostate cancers overdiagnosed by mammography and PSA, respectively, are real cancers. Upon biopsy, they look like any other cancer under the microscope to the pathologist. Overdiagnosis represents the diagnosis of a real medical disease or condition that progresses so slowly that, if left alone, it would never put the patient’s life at risk or significantly impact the patient’s health but ends up being overtreated because we currently have no reliable tests to differentiate overdiagnosed disease from disease that needs intervention. These issues are why some screening tests (e.g., mammography) make the cut for clinical utility while others (PSA for prostate cancer) are increasingly questioned. It’s also why the indications for screening tests like mammography (e.g., age to begin screening, interval between tests, etc.) undergo continuous reevaluation based on new science.

One Twitter doc noticed the issue right away, this issue is a problem that we have seen in the past many, many times with these sorts of technologies. The only difference nowadays is that tech people think that adding AI will fix the problem; that is, if they ever even bothered to consider this problem at all, which Neko Health appears not to have:

If there’s one area that AI might have utility, it’s in identifying factors that allow us to differentiate between overdiagnosed disease detected by screening and disease that requires treatment. Frustratingly, from what I’ve observed during the last two decades that I’ve been paying attention to these issues, companies like Neko Health never seem particularly interested in attacking this more difficult problem, again, because they lack the necessary domain evidence and. Again, it “just makes sense” to people without the requisite background expertise who might tell them that their misconception that finding things early will always be good is often not true, or, as one Twitter user put it:

They don’t know what they don’t know likely describes Hjalmar Nilsonne and Daniel Ek quite well. It’s a common occurrence whenever tech entrepreneurs venture into healthcare.

Unfortunately, we know from long experience that in some cases screening for disease does more good than harm (e.g., breast cancer, hypertension, hyperlipidemia, and others), but more often all these sorts of screening tests do is to trigger additional tests, some invasive, that can result in harm. You need physicians and scientists with the necessary expertise and a proven track record demonstrated by peer-reviewed publications evaluating the sensitivity, specificity, and positive predictive value of screening tests in addition to your AI experts. In fact, you probably need an even rarer breed, the physician or scientist with experience assessing screening tests who also understands AI and AI algorithms.

One commenter nailed it:

It won’t save money, but it could make the creators of this device very rich.

Before I move on, though I have to contradict one thing that Dr. Mark said. If there’s one thing the history of such tests demonstrates, it’s that the worried well will shell out far more than a mere $317 to undergo various iterations of the “whole body scan.” In fact, there is a whole area of pseudomedicine that tells us that: functional medicine, and Neko Health’s whole body scan and other companies adding AI to a very old idea of doing whole body scans reminded me of this

The comparison between functional medicine and its “everything but the kitchen sink” approach to lab tests was driven home when I found this chart on the Neko Health website:

Neko Health Table for Scans

Here’s where Neko Health reminds me of functional medicine. Remember how I characterized functional medicine as “reams of useless tests in one hand, a huge invoice in the other“? That’s because functional medicine takes a very similar approach of doing lots and lots of tests (both standard and nonstandard) and then correcting every abnormality, whether it’s truly an abnormality or not given that all tests have false positives and if you do enough of them you will by random chance alone get a few abnormal test results, and whether it needs to be “corrected” or not. I’m very much getting a functional medicine sort of vibe from Neko Health.

The whole body scan—with AI!—gold rush

I don’t want to pick on just Neko Health though. It’s far from alone in its rush to raise venture capital to fund the development of this sort of product and suite of tests. It appears to be quite the gold rush out there to add AI to the very old (and discredited) practice of offering whole body scans to the healthy worried well as “preventative medicine.” For example, there’s one startup, Ezra, that’s marketing whole body screening MRI scans. The company claims that “its full-body MRI service monitors for possible cancer and more than 500 other conditions in up to 13 organs,”  offering “three-year memberships for $5,300 or five-year plans for $7,000. They include annual exams along with a 45-minute follow-up consultation.” Another company, Prenuvo, is backed by Cindy Crawford and offering another AI-fueled whole body MRI scan direct to consumers for a mere $2,499, showing that, yes, the worried well will pay a lot more than $317 for tests more likely to cause them harm than good, although price competition is coming to this industry, with companies like SimonMed Imaging trying to undercut companies like Prenuvo, although its product doesn’t appear to use AI.

Most of these startups are covered pretty credulously by the press, but I have to give credit to Radiology Business for including some serious skepticism about at least one of them, Prenuvo:

However, some are expressing concern that the service could cause more harm than good. Catherine Livingston, MD, a family medicine specialist who served as lead author of a 2016 report recommending against this practice, is one such skeptic.

“There is certainly not enough known about the use of [artificial intelligence] in direct-to-consumer imaging services,” Livingston, an associate professor of family medicine at Oregon Health Sciences University School of Medicine, told the newspaper. “We don’t even know that the benefits outweigh harms for whole body scans in asymptomatic people. Adding in … AI is a Pandora’s box.”

And, from a December story about Prenuvo:

Dr. Matthew Davenport, the vice chair of the American College of Radiology’s Quality and Safety Commission, said that using MRIs to screen the general population is not likely to improve patient health.

“It is a terrible idea,” he said.

Davenport said there’s a big risk with using a scan as sensitive as an MRI of finding abnormalities that are later found to be benign. Screening may make sense for people with a higher risk for disease.

But Davenport said that for the general public, imaging every organ with such a sensitive test “will harm the patients.” Even if the scan itself doesn’t pose much of a risk, he said, more procedures down the line might pose a bigger risk.

“You find all sorts of stuff that would never occur to the patient,” he said. “And you end up triggering workups, biopsies for imaging studies, operations, for findings in the body that would never have any importance for the patient.”

Precisely. This is the aspect of screening healthy people for everything under the sun that the general public doesn’t understand. Unfortunately, neither do the tech bros who think that AI will make everything better. As always, the devil is in the details, and from my perspective it’s profoundly unethical to charge patients large sums of money merely to provide you with another data point in your training dataset for your AI.

None of this phases the tech people running these startups, unfortunately. For example, listen to Andrew Lacy, founder and CEO of Prenuvo:

“The current healthcare system is reactive. For many, health information comes too late, once a disease or condition has progressed, has symptoms, and is more difficult and expensive to treat,” Lacy said in a statement last fall announcing the $70 million fundraising round. “Our series A financing is validation of Prenuvo’s mission to catch conditions before they become crises and transform the healthcare approach as we know it to one that is rooted in proactive health.”

I love how Lacy equates success in raising venture capital with the medical and scientific value of its technology, which it claims to be unique, because all these companies claim that their AI is unique and better than the others. For example, last year Lacy said:

Lacy said Prenuvo uses proprietary software and artificial-intelligence tools invented by Attariwala to make its whole-body scans different from other scans offered in hospitals.

“Most MRI scans rely on anatomical imaging, which simply shows organ structures,” Lacy said. “Core to Prenuvo’s imaging protocols is a heavy reliance on the combination of anatomical imaging together with newer functional imaging techniques, which increases the ability of MRI to accurately discriminate many conditions.”

Prenuvo’s website indicates it charges $1,000 for a torso scan, $1,800 for a head-and-torso scan, and $2,500 for a whole-body scan, and it doesn’t take insurance. The website says the scans are performed by MRI technologists and analyzed by radiologists trained to read Prenuvo scans.

Lacy said that if a scan finds something abnormal, it shows up in a patient’s dashboard — that patient can take the result to their primary-care physician.

My experience is that primary care physicians are not fond of this sort of thing, because they often don’t know what to do with the results of such scans—or at least are unsure—because these tests are prone to discover all sorts of things that might or might not be harmful but then require a workup. Unsurprisingly, like all companies imaging such imaging systems, Prenuvo claims that its technology avoids pitfalls described by  because of its special proprietary technology. How does Prenuvo know this?


Prenuvo has not published any studies finding that these scans catch diseases early and improve people’s health. Lacy said Prenuvo is recruiting for a clinical trial.

I’m shocked—shocked!—to find that Prenuvo started selling its test for big bucks first and only now is trying to prove that it works. I’m also shocked—shocked!—that a search of PubMed for the name of the company showed no clinical trials open, although a search for “MRI” and “artificial intelligence” resulted in dozens of hits for clinical trials looking at AI in imaging. Add the term “screening,” and you’ll find a bunch of clinical trials utilizing AI-fueled MRI to screen for specific diseases, such as breast or pancreatic cancer. Add the term “whole body,” and the number drops to basically zero.

Perhaps this is why I found no clinical trials from Prenuvo:

Andrew Lacy, Prenuvo’s founder and chief executive, said his company plans to partner with researchers to further study its model. It has not yet published data but plans to soon in concert with the American Academy of Neurology conference, among other events.

So, not only has Prenuvo not published any clinical trial results, but it seems to have no clinical trials registered with Does anyone want to bet that what Prenuvo plans is just a large case series of all of its customers who have purchased its scans, a study that without controls is highly unlikely to be informative.

While it’s nice that Prenuvo plans to “partner with researchers to further study its model,” my retort is always; The time to partner with researchers to study your model is before you market it to the public, not after. Also note the utter lack of understanding of the potential complications of using such screening tools. At the very least, event thought the gadolinium used as contrast for MRI scans is safe, gadolinium is not without risk. That’s why yearly doses of gadolinium should at least trigger a risk-benefit analysis, something that none of the companies marketing whole body MRI screening using AI appear to have done, just as AmeriScan never bothered to consider the risk-benefit ratio of yearly doses of gadolinium, plus all the other potential unnecessary workup and biopsies, compared to the potential benefits of its yearly screening.

AmeriScan and a number of “whole body CT scans” and “whole body MRI scans” proliferated two decades ago, only to disappear (for the most part) for several years. Unfortunately AI has provided a seemingly reasonable rationale to resurrect these discredited screening modalities in the likely vain hope that AI will somehow eliminate or at least mitigate the problems associated with old-fashioned whole body scans, be they CT, MRI, or Neko Health’s fusion of photography and thermography coupled with cardiovascular scans. Unfortunately, whether AI can succeed in this is very much an open question, but that doesn’t stop these companies from using AI as a marketing buzzword to sell their product before it’s been proven superior (or at least not inferior) to existing diagnostics.

Truly, these companies are the AmeriScans of the 2020s.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

67 replies on ““Whole body scans”: Back from the grave and ready to party”

Why call it Neko? Do they do lots of cat scans? Neko is cat in Japanese. Or N + EK+ Oh.
So clever. /s

I’m surprised they didn’t try to jam ‘quantum’ into the name somewhere, to make it sound even more high-tech and science-y to their… clients?… consumers?… victims? (I dunno–go with whatever you’re comfortable calling the people who throw money at the legions of oleaginous and fast-talking charlatans, who sell all these dubious ‘tests’, patent ‘cures’ and supplements that They™ don’t want you to know about).

Are there testing criteria for medical AI? An exam if you will? It strikes me that any claim for superior, proprietary, performance not only needs testing against real world situations but also leads to ethical considerations. If it proves genuinely more effective, then keeping it at ‘Our state of the art medical facility in the stunning alpine scenery of X’, rather than marketing it, is like saying ‘we have this drug that cures all cancer but we’re only going to use it on a few people a year because they can come to our state of the art medical facility in the stunning alpine scenery of X’.

Not very well phrased but….

Great post, doctors will make a lot of money handling healthy people with false positive 2mm “irregularities” found by AI, lots of drama in families where whole-body scan patients will be alarmed unnecessarily, and likely zero survival benefit.

Benefits from “early detection of cancer” seem quite marginal. The 5-year survival is increased simply because diagnosis is made earlier.

This reminds me of “drugs”, like blood pressure medications raising blood sugar, blood sugar medications raising blood pressure, weight loss medications causing cancer etc.

I hope for more non-anti-anti-vaxx posts like that! (anti-anti-vaxx posts are good also as food for thought)

@ Igor:

Don’t you think that physicians weigh the possibility of side effects against the benefits of an important med? For example: a bp drug might decrease the chances of serious CV events yet cause relatively minor side effects- diltiazem can regulate arrhythmias, bp and tachycardia yet cause a slight cough or hypotension. In addition, there are many different meds that can be tried for bp if the side effects are not acceptable to the patient, who has a say in the process; different meds, different mechanisms of actions, different costs: they are not ONE thing.

Also don’t confuse legalese package inserts about side effects with what is truly likely to happen.

Denice, I am dealing with a version of this myself, the BP drug I was prescribed raised my blood sugar considerably.

I am not even obese, I am only overweight.

I decided to lose weight and get off this drug asap – it is difficult but I have no choice. I have been dieting for the last 19 years.

I have no idea what goes in the mind of doctors prescribing those drugs and I am not a mind reader – but sadly, in this specific instance, the harm is about equal to the benefit.

@ Igor:

Do you really think the med is the cause of high blood sugar?
Take a look at Medical News Today /high blood pressure medications options and side effects website : none list that as a side effect.
You’ll notice that doctors have many choices. Listings are grouped by how the drug works: beta blocker, Calcium channel blocker etc.

There could be more to your condition than just the drug.

The listings may give you insight into how meds are prescribed.
Maybe another drug would work better. Ask your doctor about that.

If medication causes side effects to you, just stop using it. Try another one. Really simple, is it not ?

And would you prefer individuals with chronic conditions to not risk the potential side effects of their medications and die sooner and/or in misery?

Because I’m starting to get the feeling that it’s not just vaccines you’re opposed to, but anything at all that could improve people’s lives.

Benefits from “early detection of cancer” seem quite marginal. The 5-year survival is increased simply because diagnosis is made earlier.
Early detection and early diagnosis is raher same thing

I won’t make a cent some radiologist will or another jackass with an MBA will.

This will make my life a living hell when scared patients start flooding in with the “results.”

@ Igor Chudov

You write: “Benefits from “early detection of cancer” seem quite marginal. The 5-year survival is increased simply because diagnosis is made earlier.”

Just how STUPID are you? If one detects cancer before it has metastatized, that is, when still at a local location, then eradicating it prevents its spread and, thus, saves lives. Not always; but often. Again, I don’t see world in idiotic extremes of black and white as you do.

However, I repeat that early detection of cancer can literally save lives.


Yes, that is good in theory. In practice it metastacizes much sooner than thought. I remember reading (though I do not have the source) that early detection of cancer did not improve overall outcomes. I had two relatives die of cancer and back then I did a lot of reading.

I hope that you are right and I am wrong.

@ Igor Chudov

You are WRONG; but as I wrote, early detection saves many lives; but not everyone.

You remember reading????? Given you have been wrong on the vast majority of your comments, all that tells me that you believe you read something, not that you actually did or you read it and did NOT understand it. You live in your own illogical intellectually dishonest unscientific biased world. Nothing more, nothing less.

One recent article: David Crosby et al. (2022 Mar 18). Early detection of cancer. Science; 375(6586). Available on line.


you have an MBA and have never indicated that you have done any studying of medicine, infectious diseases, epidemiology, etc.; but keep on making a fool of yourself.

“that early detection of cancer did not improve overall outcomes”

This is one of the most PROFOUNDLY ignorant things I have ever read. I mean that.

Ladies and gentlemen, I give you Exhibit A proving what happens when we devalue science education.

Of course you picked only one part. Article says
Because of these biases, the only reliable way to know if a cancer screening test reduces deaths from cancer is through a randomized trial that shows a reduction in cancer deaths in people assigned to screening compared with people assigned to a control (usual care) group. In the NCI-sponsored randomized National Lung Screening Trial (NLST), for example, screening with low-dose spiral CT scans reduced lung cancer deaths by 15% to 20% relative to chest x-rays in heavy smokers. (Previous studies had shown that screening with chest x-rays does not reduce lung cancer mortality.)
Besides of that early detection is not same thing as screening, like woman detectin a lump in her breast.

Unsurprisingly, you leave off the fact that we often catch it BEFORE it metastasizes doing routine low dose CTs. Guess this is a zero sum game and only mortality matters, huh?

I think I’ll keep ordering them. (Rolling eyes)

@ Igor Chudov

One other point that I have made several times. The internet is huge, anyone can post somewhere, and there are literally thousands of journals. One can probably find one or two articles or websites that support a variety of positions; however, I do NOT base my position on one or two articles, and even when I do refer to articles, I have carefully evaluated their methodologies, etc, given that I am extremely well-trained in research methodology. You have NO background and just jump on any article or articles that support your position.

And it doesn’t matter how many times Orac, myself, and others shred your comments, you just keep on. Proof positive that you are mentally disturbed and/or extremely stupid.

@ Igor Chudov

You write: “I am not against cancer screening, but its helpfulness is, unfortunately, very limited. For example, in heavy smokers, early CT scans improve lung cancer mortality only by 15% (compared to X-rays which were earlier shown not to help).”

You friggin ASSHOLE. You pick one example, as I wrote above, ignoring all the various screenings that have a range of success. And ASSHOLE, going from no help to improving by 15% in my opinion is a great improvement. I valued human life and going from zero to 15% is a positive achievement; but using heavy smokers as your example, just one more example of what an absolute ASSHOLE YOU ARE! !

I realize that nothing that I write, that Orac writes, that anyone writes will get you to even consider you may be wrong since you live in a sick fantasy world untouched by reality.

Regarding “trusting science”: it turns out that top “scientists” and “virologists” knew that Sars-Cov-2 was made in lab.

Then they lied in the infamous article “Proximal Origins”, alleging that SC2 came from nature.

We were admonished to “trust science” on this. Fact Checkers confidently defended what was obviously untrue.

Only the greatest critical thinkers resisted this pressure and patiently explained that Sars-Cov-2 is a lab product, with HIV genetic inserts and more.

Here, for example, is what the leading scientist “Kristian Andersen” privately wrote on Feb 1, 2020: “I think the main thing still in my mind is that the lab escape version of this is so friggin’ likely to have happened because they were already doing this type of work and the molecular data is fully consistent with that scenario.” (search google for this quoted sentence to find the source) A bit later he wrote the opposite in the “Proximal origins” paper – and he knew that what he wrote was untrue.

Peter Hotez, who no doubt knows enough to also understand that Sars-Cov-2 was designed in a lab, is also doing rounds complaining to the media about “antiscience aggression”. The “antiscience aggression” he is complaining about is simply the truth that scientists developed Sars-Cov-2 and then lied about its origin.

Can truth be antiscience?

Or, alternatively, is science of virology and vaccines in need of a great reset?

knew that Sars-Cov-2 was made in lab.

That is, of course, just more of your pure bullshit. The lab possibility has not been completely ruled out but it is at the bottom of possibilities.

Again, why are you in the habit of telling lies at all, let alone such blatant ones? Is it your desire to con money from your subscribers by saying what they want to hear or is it simply a massive flaw in your character?

The author of the paper firmly denying lab origin of Sars-Cov-2 (Kristian Andersen) privately believed in lab origin of Sars-Cov-2, but chose to lie about how lab origin is “ruled out” in order to augment his career and make money from NIH grants.

That’s what the above-mentioned story is about.

I love the fact that I can make money (amounting to really good pocket change at most) by telling the truth!

You basically chose to trust the wrong people, who pretend to be “the science”.

I am not asking you to trust me instead of them, I am asking you to start thinking.

Oh, I’m thinking all right. I’m thinking you’re a bullshit artist and an idiot.

Regarding Andersen’s “statement”, that’s an isolated sentence taken entirely out of context. As such, it’s completely worthless in supporting your argument.

“The author of the paper firmly denying lab origin of Sars-Cov-2 (Kristian Andersen)”

I thought you said ‘scientists’. Plural.

Surprised you still haven’t grasped the whole HIV insert thing yet. Or the concept that ‘personal opinion isn’t fact’. Were you always a slow learner?

So you now know her private thoughts ? Actually, she considered the possibiliy but decided that evidence shows otherwise. Read the data, not the spin.

Igor, so your story is just repeating another conspiracy theory? You think that makes it better?

As for your “telling the truth!” line: that’s the largest load of bullcrap you’ve put into 3 words so far. You’ve never told the truth here.

I guess everyone is free to interpret the last 3+ years anyway that they want. But you seem unable to bring any actual evidence to support your claims. We both know that this is not your strong suit, as opposed to cherry picking…

It’s funny that you call for people to start thinking, but are suppressed when they come to the conclusion that you are wrong. Are you really unable to accept that people (many of which have much more knowledge of this matter than you) have given this subject much though, and still find your statements to be incorrect. Doesn’t that make you think at all?

I get that it’s easier to simply disregard al of those that disagree with you, but that makes you claim to be one of the ‘greatest critical thinkers’ ridiculous. But have no doubt that you will ignore this comment as well. After all, people are paying you to tell the ‘truth’.

I am quite glad that my opinions on the pandemic (such as that SC2 was engineered intentionally) are now being confirmed.

The story of private messages of Kriatian Andersen shows that, while stridently insisting publicly that SC2 came from nature, he privately believed that it was engineered.

I have a lot of links, but I am not sure if they are appropriate to cite here. ==> Top Scientists Misled Congress About Covid Origins, Newly Released Emails And Messages Show

While confirming one theory (that was called a conspiracy theory) does not make other theories automatically correct, it does confirm that we need to remain open minded.

I am quite glad that my opinions on the pandemic (such as that SC2 was engineered intentionally) are now being confirmed.

If you really think that the notion of SC2 being engineered is being confirmed you are more delusional than I thought.

@Igor Chudov Even Substack has this:
“As is almost always the case in science,” explained Andersen, “this change in belief was not based on a single piece of evidence, but a combination of many factors, including additional data, analyses, learning more about coronaviruses, and discussions with colleagues and collaborators.”
Of course, there are many oher papers about the mater.

@ Igor:

” I love the fact that I can make money…by telling the truth!”.

But you’re not! You leave out relevant material, habitually slant things one way and choose language that gives particular impressions.

I read a few people on Substack ( Wolf, Margulis, Farber, Rose) and notice that NOT one of them advocates a SB position but rather caters to more altie/ anti-vax/ contrarian positions. Why is that?

Standard news, social media, professional sites already present SBM so there is no need- if you want reality based material, go to fact based and SBM sites. There are many debunkers around also.

If I wanted to have a Substack, I’d probably have to exaggerate or misrepresent research to gain supporters or attract the admiration of Big Guns like Kirsch. Who would want to read Greater Depth of Processing Leads to Students’ Better Long Term Memory or Some Meds Help Some People Cope Better with Depression Sometimes? No, I’d have to create an intriguing title or run contrary to general information. Meditation Will Improve Your Memory Problems No Matter the Cause! or “A Carnivore Diet Will CURE Depression Right Away!*. Those title actually reflect stuff I hear or read and neither is realistic.

Orac’s regulars include many talented writers/ educators so why do none/ few of them write Substacks? Because we’re all so overloaded with money? Or that we understand that that site attracts a particular audience that greatly resembles the people we deconstruct. RFKjr or Naomi Wolf will attract more attention and subscribers than any of us would – although we have several natural comics and entertaining outsiders.

When social media cracked down on misinformation during the pandemic, the extremes had to migrate elsewhere: Substack, Rumble, Brighteon, Truth Social et al. Now Twitter gets them.

Denice, you are a talented writer who comes across as a very thoughtful, articulate, and personable individual.

Therefore, you should open a substack.

Do not look at it as a commercial enterprise – look at it as a chance to broadcast your thoughts and have nice subscribers.

I am sure that you will succeed, not necessarily in revenue (where I also did not succeed all that much), but definitely in being heard and having great people follow you and discuss your posts.

You do not have to compromise even a iota when it comes to your views and ideas.

I’ve thought of moving the blog over to Substack, but not for money. I’m just tired of paying my own hosting charges and trying to figure out how to fix things when the site gets slow or goes down.

Denice: “Standard news, social media, professional sites already present SBM so there is no need- if you want reality based material, go to fact based and SBM sites.”

You may not feel a need to get information from Substack, but a lot of people rely on it, Twitter and other social media sites for info. If science-minded folks ignore those platforms, they’re ceding them to denialists and nitwits.

And you don’t have to cater to the worst elements to have a successful Substack. For instance, here’s a science-based newsletter that has 5 times as many subscribers as Vinay Prasad’s Substack, and over 7 times as many as the dribblings of Meryl Nass.

Many people are illogically convinced that mainstream media and fact-checking sites are not be trusted. Those who are not completely down the rabbit hole can still be swayed by facts and logic.

But you have to go where they congregate.

I responded to Igor but it got lost.
Short form-
I don’t think a Substack is for me. I work better as part of a consortium of sceptics. That site attracts scoffers and denialists
that I don’t want to deal with on a regular basis. I also wouldn’t want to function as an unpaid counsellor. It would involve much greater periods of time to research and document material. Most of my computer skills include commenting on others’ sites, looking up stuff and scheduling flights, hotel reservations, rental cars.

Substack for Orac’s use?
it might be bombarded by anti-vaxxers and loons to drown out meaningful conversation amongst mostly SB people.
For a while, RI was overwhelmed by two anti-vax HCWs who never seemed to shut up. RI is not in the mainstream and may be a little protected from an onslaught ( serious Substacks like that Yale prof’s aren’t targets for altie crap).
I read comments on a few Substacks – they are abysmal.

Who knows? It might work but I imagine readers might have to trudge through dreck to get to gold. Orac dd successfully switch from other venues.

@ Dr Bacon:

Of course, there are decent Substacks but wouldn’t reality based accounts in today’s climate just become places for scoffers to congregate and scoff?

I don’t think that I am a potential agent of change for alties/ ati-vaxxers but rather someone who encourages sceptics and those already or nearly in our camp. The commenters I read on selected accounts are miles away from the usually genteel, thoughtful average response at RI. It could be the writers though. who attract them ( Wolf, Farber, Rose, Margulis etc).

Also women, except complicit alties, can become targets on most venues. In the late aughts, I thought I might be better off as Denis or Walter but didn’t do that because… feminism – is this the 19th Century where we need to use masculine pseudonyms a la the Brontes? Maybe sometimes.

In other news….

RFKjr’s unhinged Covid CTs are being roundly criticised by reality based people BUT alties/ anti-vaxxers stick up for him despite his antisemitism, racism and fictional dystopian worldview: Naomi Wolf ( Substack, today) agrees with him wholeheartedly! He has a “passion for the truth” and he was right to compare vaccines/ PH measures to the early activities of the Nazis as a warning to us.

Her essay is so awful it exceeds my meager capacity to describe it. Read it and weep.

“passion for the truth”

Heh! He has a passion for many ‘truths’ but he’s not the messiah, he’s a very naughty boy.

I know.
He’s advocated for hiv/ aids denialism, vaccines causing autism ( and just about everything else), chemicals in water causing gender issues/ LGBTQ, 5G causing cancer, SSRIs causing school shootings etc.
Any ONE of those alone should lead to his disqualification from being considered a serious person or source of information.

His writing is a mass of interwoven CTs. He uses his famous name to garner credibility but his own family members disavow him. He sounds as bad as alties/ anti-vaxxers I survey – claiming knowledge far beyond his ability and leadership largely based upon posturing and play acting.

Robert Reich said ( paraphrase) I knew RFK and he’s NO RFK.

The more I think about it- though I never dx anyone- is that there is something really wrong with him- emotionally, psychologically, who knows- there’s just something off about him.

His dad – RFK the original – always thought the CIA killed JFK. From the moment he was told the news. RFK knew the covert operations directorate well and that they were furious with the President for not invading Cuba at the Bay of Bigs or the Missile Crisis, trying to normalize relations with Castro in 1963, his order to start withdrawal from Vietnam and initiatives to end the Cold War. RFK wanted to reopen the assassination investigation if he became President. This is not a “theory.”

Junior kept quiet about the family’s understanding until 2013, that’s a lot of bottled up trauma to cope with. Not an excuse and probably not a complete explanation, but it’s a factor to consider.

I heard yesterday about a couple I know who are big fans of Junior (although I doubt he knows them). I hadn’t heard from them in a while and was wondering how they’re doing. A mutual friend told me they finally caught covid and spent time in the hospital and are suffering from long Covid that may have caused permanent damage to each of them. Mid 60s. I hope they at least thanked the nurses and doctors who tried to heal them but I’ve heard they haven’t rethought their anti-vaccine views. Viruses don’t care about opinions. Choices sometimes have consequences.

I am just curious Mark, what kind of Long Covid are they suffering from. I believe in Long Covid and always try to remember personal stories of people who have it.

You do not have any links, of course, Jonhson did no change the policy. It was just anger then ?

The value of cancer screening depends strongly on which cancer, which patients, and which screening procedure are considered. For example (quoting the CDC’s evaluation), screening by PSA test for prostate cancer is of marginal value for men under 70 (“individual decision”) and is not recommended for men over 70 (“should not be screened”). On the other side of the line, CDC strongly recommends screening for colon cancer (stool tests, colonoscopy, etc) for persons ≥45. The evidence for benefit of colon cancer screening for the right patients is clear. Even then, we don’t screen for colon cancer in younger patients. Blanket statements covering all screening tests are ill-advised.

Common sense would tell us that screening tests are a good thing. However, there are several criteria that need to be fulfilled for a screening procedure to be effective. First, the test needs to be simple and inexpensive. Second, the test needs to be sensitive (detects a good percentage of abnormalities) and specific (low detection rate of false positive results). The disease in question must be frequent enough that screening isn’t a futile search for a rarity among millions of people. Investigations to confirm a positive result need to be available and relatively simple. Finally, the test has to be able to detect a disease that is treatable and at a stage where it can be treated and make a difference in well being, if not lifespan.
These are difficult criteria to fulfil. Most proposed screening tests fail a multiple number of these requirements. Sometimes common sense isn’t enough.

Well put – common sense is not enough – critical thinking is required

I’ve diagnosed five men in the last three years with prostate cancer. Only one of the was over 60. Luckily, only two has the aggressive form.

This is a very complex subject and the recommendations are shifting back toward screening.

“Whole body scans”
“Whole wallet scans”
The grift continues…
I, too, had “Theranos” as the first thing that popped into my head upon reading their advertising tripe.
Orac’s Functional Med. comparison is quite apt… While the rational medical community is trying to get control of needless over testing there is a “health” industry which depends and promotes over testing as a means of increasing revenue. Shades of chiroquackery.
Have fun.

@ Igor Chudov and Ldw56old

Overwhelming evidence indicates that SARS-Cov-2 came from natural sources. The evidence includes sequencing of genomes of Corona viruses in 10s of thousands of bats around the world, finding a number with genomic sequences only a few nucleic acids different from SARS-Cov-2 and, so, either a few more mutations or because several viruses found in same bats could exchange nucleic acids, came from natural world. However, no one has completely ruled out possibility it escaped from lab, just highly unlikely; however, whatever the source, if the US had implemented similar measures as South Korea, Japan, and New Zealand, instead of 1.2 million deaths, deaths would have been more likely around 200,000. So, whatever the source, it was US failure to act appropriately that resulted in huge number of tragic deaths

And Igor, typical of you to find one person, Peter Hotez, who confirms your bias and ignore all the other experts who disagree. Regardless of how credentialed someone is doesn’t mean they don’t have their own biases or just wrong conclusions. As I’ve written several times, I never base my positions on any one or even two experts because historically even the most brilliant people in the world have been wrong on occasion. You, given your absolute ignorance of science, base your stupid conclusions on whoever confirms your ignorant biases.

So, I repeat, the overwhelming evidence, given the sequencing of corona viruses in bats, is it came from natural sources; but even if escaped from lab, the huge death rate in US was because of our government having stupid biased idiots like you who don’t subscribe to the precautionary principle.

You have an MBA with NO indication you understand even the basics of immunology, infectious diseases, epidemiology, etc; but just keep posting stupid comments.


Overwhelming evidence indicates that SARS-Cov-2 came from natural sources.

I realize that Joel. No need to flame at me.

@ Ldw56old

Sorry, I was tired and misread you. Again, sorry.

@ Igor Chudov

As I wrote, even geniuses of history make mistakes, so I don’t rely on one or two people. There is a fascinating excellent book you should read; but you won’t:

Mario Livio. Brilliant Blunders: From Darwin to Einstein: Colossal Mistakes by Great Scientists.

So, ASSHOLE, just one more example of why, not just based on over 40 years of advanced studies; but continuous in-depth reading, I know what I am talking about and I repeat, I don’t base my positions on one or two people, regardless of how brilliant and accomplished they may be

Low hanging fruit for Orac and Company..

Republicans allowed RFKjr to speak to Congress today and he behaved as exactly as we would predict. Three women, a representative, a delegate and an educator/ activist**, countered his nonsense effectively with quotable responses.
Hopefully, there will be video so we can listen to their criticism.

** Debbie Wasserman Schultz, Stacey Plaskett and Maya Wiley

Plaskett unfortunately misinterpreted RFK Jr.’s description of having had his kids vaccinated as hypocrisy, failing to recognize that his descent into antivax advocacy occurred well after his youngest child was born.

In other words, the old “I’m not an antivaxer, I’m an ex-vaxer” routine.

In other news… with a special alert to surgeons and pathologists

NN today: Mike Adams “nearly lost a finger” ( most likely due to ranch work) 2 months ago: rather than seeking out emergency care, he treated it himself with herbs, supplements, nutrition, silver, iodine, tuning forks, light and prayers. He didn’t see a doctor until 5 weeks later. We can observe the depths of his medical “knowledge” as he shows photos of the accident and explains his miraculous “healing” ( most relevant – about 40 minutes in to about 1: 05 despite what he says).
Actually, Mikey turns his whole ordeal into an ad for his products.

Pffft. Try being back at work nine weeks after an open fracture of the femur and a snapped tib/fib, all courtesy of some nice orthopaedic surgeons and proper medicine.

SRSLY, my dude! Don’t you realise that ultrasonic frequencies’ healing vibrations will re-awaken senescent zombie cells ( his words, not mine) fixing damaged nerves and ligaments assisted by Lion’s Mane mushrooms and turmeric!
-btw- he didn’t get a Tetanus vaccine because…..he’s Mikey!

A lot of effort and work goes into recommending or not recommending screening programs, and targeting them. If anyone is interested, and as our host knows, there are several centers in NIH that send out detailed draft reports and final reports of these guidance document, with lots of data and opportunity to comment.

One of the things this does – and you nicely detailed the risks and harms of over screening – is throw out that careful thought.

Great. Bring on the incidentalomas. Can’t wait to explain to patients who bring these in that they are not riddled with cancer.

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