H. Gilbert Welch
H. Gilbert Welch
  • 26
  • 211 020
Breast Cancer Screening Using MRI
A comprehensive accounting of all breast cancers detected in the DENSE trial...revealing 5.4 extra cancer per 1000 screens. Where are those extra cancers in the control group? Are they growing so slowly that they are still undetectable by mammography 2 years later? Or did they go away?
Переглядів: 3 224

Відео

Finding breast cancer early: What does it buy - and cost us?
Переглядів 3,2 тис.4 роки тому
Presentation given to the National Breast Cancer Coalition June 4, 2020 (in the midst of the Covid pandemic). The presentation consists of 4 sections: 1.) Breast cancer mortality 2.) Heterogeneity of breast cancer 3.) Looking for small cancers: Screening Mammography 4.) Looking harder for small cancers: MRI Screening
Cancer Screening & Overdiagnosis
Переглядів 19 тис.6 років тому
Two basic points: 1. Not all cancers progress & 2.) Cancer survival statistics can be very misleading. [March 2018 keynote at The United States and Canadian Academy of Pathology in Vancouver, BC]
Robertson's Randomization for Colon Cancer Screening
Переглядів 6387 років тому
One of the principal investigators (PIs) of the VA Cooperative Study of Colonoscopy vs. Home FIT testing gets randomized - by a coin flip - to determine how he will be screened for colon cancer.
Scatterplots & Correlation
Переглядів 8667 років тому
A brief introduction to looking at scatterplots, the meaning of correlation and the unit of analysis plus two statistics: the r and the r-squared.
NEJM Screening Mammograms II
Переглядів 17 тис.8 років тому
A brief explanation of the findings of the October 13, 2016 New England Journal of Medicine article "Breast Cancer Tumor Size, Overdiagnosis, and Mammography Screening Effectiveness".
Converting ratios to percentage change
Переглядів 4,3 тис.8 років тому
A primer for converting common medical ratios (relative risks, relative rates, hazard ratios) into percentage change (30% lower, 50% higher).
Creating Graphical Displays of Quantitative Information
Переглядів 7789 років тому
Combining Excel/Powerpoint/Word to make informative - and visually appealing - graphics. Less a step-by-step recipe, more an overview on combining the comparative advantages of each program. Disclosure: Not an endorsement of the Microsoft Corporation, merely a recognition that "Office" is likely already on your computer...
LMMH 3b - Signals of Overdiagnosis
Переглядів 9029 років тому
LMMH 3b - Signals of Overdiagnosis
LMMH 3a - The Heterogeneity of Cancer
Переглядів 1,3 тис.9 років тому
LMMH 3a - The Heterogeneity of Cancer
LMMH 2 - Spectrum of Baseline Risk
Переглядів 8269 років тому
LMMH 2 - Spectrum of Baseline Risk
LMMH 1b - Observational Studies & Confounding
Переглядів 5 тис.9 років тому
LMMH 1b - Observational Studies & Confounding
LMMH 1a - Absolute vs. Relative Change
Переглядів 4,8 тис.9 років тому
LMMH 1a - Absolute vs. Relative Change
Less Medicine, More Health
Переглядів 1,4 тис.9 років тому
Dr. H. Gilbert Welch is an academic physician, a professor at Dartmouth Medical School, and a nationally recognized expert on the effects of medical testing. He sees the value of medical care, particularly in those who are acutely ill or injured. But in many other settings, we have exaggerated the benefits of medical care and understated its harms. In this video, Dr. Welch examines some widely ...
Cancer Screening I - Benefits and Harms
Переглядів 6 тис.9 років тому
The first of four brief presentations that attempt to communicate the trade-offs in cancer screening.
Basic Skills 4: Type I & Type II Errors
Переглядів 4,2 тис.10 років тому
Basic Skills 4: Type I & Type II Errors
Basic Skills: p values
Переглядів 9 тис.10 років тому
Basic Skills: p values
Basic Skills 2: 95% Confidence Intervals
Переглядів 8 тис.10 років тому
Basic Skills 2: 95% Confidence Intervals
Basic Skills 3: More on 95% CIs
Переглядів 4,8 тис.10 років тому
Basic Skills 3: More on 95% CIs
Cancer Screening II - False Positive Results
Переглядів 8 тис.10 років тому
Cancer Screening II - False Positive Results
Cancer Screening IV - Overdiagnosis (longterm RCT followup)
Переглядів 2,4 тис.10 років тому
Cancer Screening IV - Overdiagnosis (longterm RCT followup)
Cancer Screening III - Overdiagnosis
Переглядів 4 тис.10 років тому
Cancer Screening III - Overdiagnosis
NEJM Screening Mammograms
Переглядів 20 тис.11 років тому
NEJM Screening Mammograms
Lead time Bias
Переглядів 15 тис.12 років тому
Lead time Bias
Overdiagnosis bias
Переглядів 13 тис.12 років тому
Overdiagnosis bias
Sensitivity & specificity
Переглядів 53 тис.12 років тому
Sensitivity & specificity

КОМЕНТАРІ

  • @inthehouse1111
    @inthehouse1111 25 днів тому

    A lot of crap in this talk!

    • @inthehouse1111
      @inthehouse1111 25 днів тому

      What percent of all Americans will die of cancer, vascular disease or neurological disease! 60% of all humans!

  • @billbill6886
    @billbill6886 Місяць тому

    Wow this presentation!!! I love your work!!

    • @billbill6886
      @billbill6886 Місяць тому

      I was overdiagnosed with thyroid cancer, and now in medical school, this presentation has really opened my eyes! Thank you!

  • @billbill6886
    @billbill6886 Місяць тому

    Man this video fire AF, love your sense of humor

  • @emmak2463
    @emmak2463 2 місяці тому

    good video king

  • @sagemountainspirit8592
    @sagemountainspirit8592 3 місяці тому

    Maybe the reason the U.S. won't move to universal health care is because it will expose how grossly over-diagnosed we all have been by for-profit private hospitals and doctors🤔also, how many cancer patients have died from the chemo and not the cancer?

  • @lulimo2683
    @lulimo2683 3 місяці тому

    best vedio for this topic !! thank you so much

  • @jacquesbergman7629
    @jacquesbergman7629 4 місяці тому

    Briljant! 7 minutes of lessons in “less is more”. I definitely going to read this book.

  • @barbaraberwick8993
    @barbaraberwick8993 6 місяців тому

    24 percent overdiagnosis with all the horrendous treatments. More doctors need to be shouting this from the rooftops!

  • @TatianaAsmal-cx8we
    @TatianaAsmal-cx8we 6 місяців тому

    Thank you sir!

  • @karolienlipkens6502
    @karolienlipkens6502 7 місяців тому

    even the video is 5j old... i am glad i watched it. thank you for the stream! grts from belgium xxx

    • @karolienlipkens6502
      @karolienlipkens6502 7 місяців тому

      in belgium they fired al docters this month from 1 hospital becausse they never saw anything on the scans.missed al lot off diagnoses.like by my boyfriend they nerver see anything and looking for cancers they say..

  • @joannepigliavento7930
    @joannepigliavento7930 7 місяців тому

    Wish he had more completely answered the first question

  • @timmcgrath9708
    @timmcgrath9708 8 місяців тому

    Great video! Same as COVID; test more people and VOILA you have a “pandemic”

    • @kitsuchii5825
      @kitsuchii5825 2 дні тому

      I know your comment is seven months old, but no. Sorry. The entire point of this presentation is that we should be basing our measure of test efficacy on the mortality rate of a disease. There was an increase in respiratory illness mortality since 2020, and vaccination programs did decrease it. The pandemic was real; as much as I wish it wasn't.

    • @timmcgrath9708
      @timmcgrath9708 2 дні тому

      @ Really? Can you send me the evidence of your claims about respiratory mortality? I’d love to see that.

  • @KetovoreAnita
    @KetovoreAnita 8 місяців тому

    Great video. Would love to know this man’s thoughts on how Covid was handled my the medical profession. I doubt he’d think testing and treating people without symptoms of disease was smart or useful.

  • @garysattman4609
    @garysattman4609 8 місяців тому

    Concerning Thyroid cancer--ever heard of Thyroseq? Talk about a $ making scheme. It takes advantage of the limitations of Thyroid FNAs and churns even more money from the system over turtles generally.

  • @Healing_Decibels
    @Healing_Decibels 9 місяців тому

    Thank you for making this video not only educational but also hilarious at times! It’s pretty rare that a medical professional retains their sense of humor. And thank you for making complicated things easy to understand!! Dr Welch is a great teacher!!😍

  • @cherylkoski7184
    @cherylkoski7184 10 місяців тому

    Dr. Welch, you are my hero.

  • @Endahsusi-d1s
    @Endahsusi-d1s 11 місяців тому

    Yeah, alot over diagnosis and over treatments now, make people sicker.

  • @audreystrein6062
    @audreystrein6062 Рік тому

    I am 59 in shape and healthy. My dad's mom died at age 39 of metastatic ovarian cancer. No siblings. My dad died of aggressive prostate cancer at age 79. my mom no cancer. I don't know whether I should get the BRCA test or not. What are the real risks? And if it comes up positive. Is it overkill to remove breasts and ovaries? It is major surgery. I actually have cosmetic implants now, but actual breast removal is much more serious. I know even after menopause ovaries are good for your heart and stroke prevention still. Also there are all these other genetic reproductive cancer tests (PAL B etc.) that could definitely have you going down the rabbit hole. I am 59 and am concerned about putting it off since my 60's are approaching of the riskier age. Please guide me if not yourself to a Dr that is unbiased to make an informed. My kids just lost their dad to esophageal cancer and my one son of 29 died June 2022. My daughter has Down Syndrome and I can't let anything happen to me that could be preventable. She needs me. Thank You Audrey

  • @catherine5446
    @catherine5446 Рік тому

    Gilbert Welch is my hero

  • @ruthm5123
    @ruthm5123 Рік тому

    thank you

  • @kathya1956
    @kathya1956 Рік тому

    This guy is a huge socialist. Oh well, I’ll try not to think about it.

  • @arinarakhteenko579
    @arinarakhteenko579 Рік тому

    Thank you!

  • @quietstormaps
    @quietstormaps Рік тому

    I have his book "Should I Test For Cancer, Probably Not and Here's Why". He's such a great presenter. Very informative and not boring at all.

  • @daisycow0006
    @daisycow0006 Рік тому

    So 90 yr olds shouldn't get care for being sick... people should just be dying.... doing a regular pap saved me ... such bs and propaganda to try to convince you that money doesnt need to be spent on screening

  • @michaelanthony386
    @michaelanthony386 Рік тому

    God bless this man.

  • @edithaleicjen
    @edithaleicjen Рік тому

    it make sense medical explanation. Doctors tell women to have annual mammogram for early detection! I think doctors should focus on prevention not routinely screening unless patients in the category of risk groups. Thanks. It is important inform and educate patients.

  • @MK-ih6wp
    @MK-ih6wp Рік тому

    Brilliant. Bless this man!

  • @sadeghshams4625
    @sadeghshams4625 Рік тому

    Thank you!

  • @Zakariah1971
    @Zakariah1971 2 роки тому

    Terrible presentation Doc. Just BAD!

  • @Zakariah1971
    @Zakariah1971 2 роки тому

    Terrible

  • @Zakariah1971
    @Zakariah1971 2 роки тому

    Terrible. Let Dr. Brianne Barker handle this content and not a clinician. Fail.

  • @saurabhpatel3576
    @saurabhpatel3576 2 роки тому

    Thankyou sir. This is by far the best explanation i found on confidence intervals, P value.

  • @seattlecathy
    @seattlecathy 2 роки тому

    Mammography discussion starts at 32:27

  • @jeannerieck4337
    @jeannerieck4337 2 роки тому

    I like how he presented ,so I was able to understand easily,what he was trying to teach us.❤

  • @jeannerieck4337
    @jeannerieck4337 2 роки тому

    I also have stage 3kidney damage.

  • @jeannerieck4337
    @jeannerieck4337 2 роки тому

    I’m trying to find. Out if I have throat cancer.I cough so loud, until I can’t breathe.❤ Also ,I can feel that my vocal chords have been damaged.

  • @joelmulder
    @joelmulder 2 роки тому

    “South Florida, they’re always high on everything” this presentation was both very insightful, and hilarious!

  • @Alghamdiim
    @Alghamdiim 2 роки тому

    I think the lead-time bias can only exist if there is no available intervention, and in that case it would be pointless to have a screening test to begin with

    • @davidobrien4209
      @davidobrien4209 Рік тому

      I think you are exactly right. Mr. Welch's presentation is missing the whole point of screening, which is early intervention due to screening with increase survival time.

    • @AjaySensei
      @AjaySensei 7 місяців тому

      @@davidobrien4209 No he’s explaining what lead time bias is. He says we assume its longer survival but it may also mean just earlier an earlier diagnosis with no change in outcome. Yes, with interventions you can and often will have a longer survival in general, but an earlier detection and diagnosis will result in a longer survival on paper regardless of treatment.

  • @pennykattack5789
    @pennykattack5789 2 роки тому

    Excellent lecture. I have been talking about this for decades. I am a Physician and prefer to avoid screening. Just trying to keep my mind sane and active until death gets me.

    • @40pianos
      @40pianos Рік тому

      Don't you want to know if you have a rabbit or a turtle? Seems there's nothing wrong with screening, it's the response to findings that can be misguided.

    • @pennykattack5789
      @pennykattack5789 Рік тому

      It depends on your area of practice. Here, where I live, it is too common the misinterpretation of such "screenings"; which generates panic and anxiety in patients. Dare I say... even suicides...?@@40pianos

  • @haruspex54
    @haruspex54 2 роки тому

    You've been my hero for quite a long time now. Thank you for your integrity and contributions to the public good, Dr. Welch, from a fellow Coloradan.

  • @hejinjeong9550
    @hejinjeong9550 2 роки тому

    Thank you for such an amazing explanation! Crystal clear

  • @UsmleUniverse
    @UsmleUniverse 2 роки тому

    Thankyou for simplifying this harsh topic which i never understood during my medical school.

  • @formerfundienowfree4235
    @formerfundienowfree4235 2 роки тому

    I so appreciate this perspective. I will not be shamed into tests I do not want.

  • @nickgowen7737
    @nickgowen7737 2 роки тому

    Thanks Dr. Welch, great series!

  • @oldschool8292
    @oldschool8292 2 роки тому

    Than you. I look forward to watching every day.

  • @aliaatchekzai6753
    @aliaatchekzai6753 2 роки тому

    Hi from Paris, je vis ici à Paris avec diagnostic de kidney cancer de 5cm, par hasard (incidentaloma). Aucun hôpital, aucun médecin, n' accepte ma demande de active surveillance, Ils pensent que je suis folle de demander ça. Ils me proposent uniquement la néphrectomie. 😩😫😫. Je suis désespérée, aidez moi please

  • @heejinjun6949
    @heejinjun6949 2 роки тому

    Thanks! Very clear explanation11

  • @jennyrose1333
    @jennyrose1333 2 роки тому

    My thyroid was removed for a 1.2 cm nodule. Ruined my life I was 29 when it was taken out. I'm 33 and it was the worst decision of my life. Those doctors ruined my life I have so much fatigue I had to quit my job. Along with many more problems

    • @cuppasilverbullets
      @cuppasilverbullets Рік тому

      Did you have Graves’ disease?? Or were you just fine?? And they removed it anyway because the nodule???

    • @lindajones4849
      @lindajones4849 Рік тому

      Hi Jenny What form of thyroid hormone replacement did they give you? Some people feel better on combination of T3 and T4 instead of a medication with just T4. I ASsSUME THEY GAVE YOU HORMONE REPLACEMENT!!?

    • @jennyrose1333
      @jennyrose1333 Рік тому

      Yea it was suspicious of cancer. But yea I've been to 3 different endos and they all say no to the t3

    • @lindajones4849
      @lindajones4849 Рік тому

      Hi Jenny Rose1333- so sorry you had doctors who were such pains in the u know what . I go my combo of two meds one with t3 one t4 med from Dr. Darren Lynch at Northampton Integrative Medicine Northampton Ma. Dr .Ridha Arem has written a great book on thyroid management for the general public. Last I knew he was in Texas. I don't know if you are close enough to access either of these options. Good luck

    • @jennyrose1333
      @jennyrose1333 Рік тому

      @@lindajones4849 thankyou so much for the info but I'm in New York lol that's really far. I wish things just weren't si hard and on top of it everytime I get an increase in my levothyroxine I feel a rage that I cant explain I drive like a maniac and yell at people. My poor mom had to deal with me the last 2 years of her life and she unexpectedly died of covid. My fiance is a saint because idk how he deals with me, I cant even deal with myself sometimes. Life didnt go in the direction I had expected

  • @joyhuntington8092
    @joyhuntington8092 2 роки тому

    I have read so many resources on this subject, and have done pages and pages of calculations trying to understand the significance of an Odds Ratio, how it's calculated and figure out just what it means. Finally! Finally I ran across this video and you made it so simple and so clear. Thank you! You should write the biostatistics for dummies book! You beat the actual author hands down!