No you didn't, you gave me a simulation study that discussed what kind of sample size might be necessary to find statistically significant effects in all-cause mortality. There's not a single mention of QALY in there. Please stop misrepresenting things.
> You're making the claim there's more than a negligible negative effect not me.
The cost itself is a nonnegligible negative effect.
> Did I say there is a sizable positive effect on overall survival? I said it's irrelevant.
You're wrong.
It's borderline fraud, in my humble opinion, to go around suggesting that massive interventions should be evaluated based on their effects only on the people who benefit most, ignoring the negative effects on the other 98% of the population. Which is exactly what you did in your first reply to me:
> What you want to do is look at stage at presentation, treatment costs by stage, and screening costs. These were done for nearly every recommended screening program.
> The available evidence behind currently recommended screening programs unequivocally shows improved cancer-specific survival and earlier stage at diagnosis.
This approach to evaluating an intervention is intellectually dishonest and emotionally manipulative. Any evaluation that does not take into account the other 98% of the population--through overall survival or QALY or some other metric--is giving an extremely biased picture of what the intervention is actually doing to the population as a whole.
