brandonb
Joined 16 years ago
Karma
10,029
Submissions
1,488
Member since
Jan 17
Recent submissions
Comment · 17 hours ago
Every article I've seen about Galleri mentions false positives as the main objection.
So I ran the numbers. For adults age >50 (the recommended group), standard cancer screening generates 33 false positives per cancer case detected. Standard screening + Galleri detects 236% more cancers with just 8% more false-positives for this age group.
The numbers would be slightly worse for a younger cohort, but still better than I'd have thought.
Comment · 20 hours ago
Lp(a) is stable since it's mostly genetically determined.
ApoB is very responsive to diet and medication--you can lower it by about 85%.
Comment · 22 hours ago
A few reasons:
- If you made a dietary change (e.g., more fiber and less saturated fat), the tests tell you whether it actually worked.
- Statins are dosed based on the LDL or ApoB reduction you need. The most powerful statins cut cholesterol by 50%, but at higher doses the risk of side effects does go up.
- Other medications like PCSK9 inhibitors and ezetimibe exist, and whether to use them depends on the other numbers. For example, PCSK9 inhibitors have a secondary benefit of lowering Lipoprotein(a), and statins and GLP-1s have a secondary benefit of lowering inflammation.
- If blood pressure, HbA1c, etc is high, then there's a slightly different set of diet advice and a very different set of medications. For example, lowering blood pressure through diet is mostly about reducing sodium and increasing potassium.
Comment · 22 hours ago
Coronary CT calcium scans are getting more popular. But before getting one, I'd do these simpler tests first:
- ApoB - about 20% of people with normal cholesterol results will have abnormal ApoB, and be at risk of heart disease.
- Lp(a) - the strongest hereditary risk factor for heart disease.
- hs-CRP - inflammation roughly doubles your risk of heart disease
- HbA1c - insulin resistance is a risk factor for just about everything.
- eGFR - estimates the volume of liquid your kidneys can filter, and is an input to the latest heart disease risk models (PREVENT).
These are simple blood tests. You can get them for <$200 through my company or others:
https://empirical.health/product/comprehensive-health-panel
Imaging is great for detecting calcified plaque in your coronary arteries. But before you have calcified plaque, the above risk factors tell you about the buildup of soft plaque. And 4 out of 5 of them are modifiable through lifestyle, exercise, and medication.
Comment · 1 day ago
Very fair caveat!
Co-Founder at Empirical Health (https://empirical.health). Don't die of heart disease.
Before: Co-Founder @ Cardiogram (ML for heart health)
twitter.com/bballingerbrandonb.cc