What on earth is this?

Radiation oncologist here. My time to shine! This appears to be an old machine used for treatment of early-stage colorectal or anal cancers. When I was in training we had a handheld unit like this. We would (me, because I was the resident) place this inside the anal canal directly adjacent to the area of a previously-resected small anal cancer and deliver radiation to the area where the tumor was located. The treatment worked really well to prevent recurrence after surgery, but because no one made the machine anymore it’s not done these days. Edit: I should add that the cure rates for surgery alone for T1 anal cancers is at least 95%, and our data at the time showed a 98% chance of preventing recurrence at 2 years, so while I say “worked really well”, that’s with the caveat that the cure rates are already very high for surgery alone. The radiation did not add any toxicity from what could be discerned.

Thank you for the actual answer haha

This is how reddit used to be. Someone would post something interesting and someone who knew about it would make a post like this and it would skyrocket to the top. And you would feel like spending so much time on reddit was ok because you learned interesting and informative stuff.

I really miss old Reddit

Those were some good times. The grammar nazis really helped me improve on my grammar. People willingly providing interesting facts or explanations instead of telling you to just Google it.

Tell me more about jackdaws.

Here’s the thing

You said a “jackdaw is a crow.”

rip unidan

He’s not resting, he still posts and comments but pretty rarely (on the accounts we know are his, anyway), and he deserved the ban he got.

Wow. this makes me feel old some how.

Because that shit was 11 years ago?

I had to look it up because I was so sure you were wrong. You are exactly right. God damn.

They are the Caldari T3D in Eve Online. Lots of fun to play a kitey style of engagement using light missiles.

Are you sure this isn’t where we post an irrelevant aside like “Nice that you could go to college” or something like that? Yeah, that feels more normal.

Now we get banned from our favorite sub-reddits if you share an opinion different than that of the reddit demigods.

What do they do instead now?

Resection alone for T1 anal cancers. Rate of cure is still 90-95%. Our machine took it to 99%.

What the hell?! We gave up 5-10% efficacy just because no one can be arsed to make the machine anymore??!

We cannot exactly force people to keep making machines; all we can do is incentivize them to want to do it. I imagine the reason they stopped making it was either because they were losing money doing it, or because the model they were making became illegal to sell, and it wasn’t worth designing a new one that would satisfy the new regulations. That’s just an educated guess, though.

That’s not 5-10% efficacy. It’s more like 1000%. The difference between 90% -> 99% is HUGE. People don’t generally understand how significant each percentage point in the 90s is: To illustrate in “You have cancer and might die” numbers. 90% vs 99% is: You have a 1/10 chance of dying. You have a 1/100 chance of dying. I hope this clarifies that its not “10% better”

The thing about jackdaws…. In your comment that’s the exact same math as the difference between 80 and 90% efficacy though. I think you may have fallen victim to a bit of semantic trickery. “80% is a 2/10 chance of dying, 90% is 1/10, that must mean that its actually a 50% difference. I hope that clarifies that it’s not “10% better”. That’s just re framing which percent you are using as the defining label. 50% of the remainder is not the same as 50% of the total, and the last ten percent isn’t more than ten percent just because it’s approaching totality. Else, the same would be true in the reverse of the last ten percent… etc. Every percentage point is exactly equal, and represents an equal step towards the total or away from the lack. They aren’t worth more in the 90% and up range, it is just easier for you to conceptualize the value as the absolute is being approached because mentally you are just counting the missing percent down instead of the existing up. It’s the same reason the original percent coming up from 0 are easier to conceptualize. **Edit: Thought of a better way to articulate this:** Suppose we have 1,000 patients: 90% cure → 900 survive, 100 die. 100% cure → 1000 survive, 0 die. Difference: +100 survivors per 1,000. Now compare 80% vs. 90%: 80% cure → 800 survive, 200 die. 90% cure → 900 survive, 100 die. Difference: +100 survivors per 1,000.

You’re not wrong that there are semantics at play, and maybe I’m wrong about the use of the word efficacy, but you are ignoring the inverse nature of percentages: Saying that this pill cures “90%->99%” is only a 9% difference is true, but its also not true. 90% cured means 10/100 dead. 99% cured means 1/100 dead. 10/100 -> 1/100 IS 9%, but its also a difference of 10x (1000%) more effective. Put another way. If I were to release a drug that cures 1/100 people of lupus, and another company put out a drug that cures 10/100 people of lupus, they could rightfully say its 1000% more effective.

Hey man, I hope I can communicate this in a way that is non-combative and pleasant, I have a very confrontational way of writing so please don’t hold that against me. What’s happening here is a classic fifth grade math word problem where you aren’t accounting for the different “labels” on the numbers for what “units” they represent, and treating them as the same absolute units. I’ll put the TLDR at the top here: you are forgetting to convert your percent to a real decimal when you are doing this, so your number is inflated by 100%, which is why the real truth is getting obscured. In your lupus analogy, the question is what is the percent difference between 1/100 and 10/100, or (How many times can 1/100 go into 10/100). When I phrase it that way I am sure you can see the answer is ten. 1/100 goes into 10/100 ten times. Now that is the multiplicative difference, but in actuality to find the percent difference you would just subtract them. 9/100 = 9%, the second company has a product which scores 9% higher in the benchmark question and which is ten times more effective than the competition. It is not “1000%” more effective, because there you would be failing to first adjust the % numbers back to decimals, or you would be conflating the labels. You are getting “1000%” because you are not converting percent to decimal properly and adjusting the labels. I’ll show you what I mean below, but basically you’re using the benchmark as the other product rather than the absolute test. If you mean to do that, ignore literally everything that comes after this and instead know that mathamatically that same “function” can be applied to every percentage point along the way, not just the last ten percent. The function that provides a multiple of a percent is not changing from the bottom ten percent to the top ten percent, as you’ve just illustrated with your new lupus analogy. That analogy starts at the bottom and is getting the same ” 1000%” number you were getting in your “the final ten percent matter so much more” analogy earlier. Now if you didn’t mean to measure those numbers against themselves, then: You are articulating that “90% cured means 10/100 dead. 99% cured means 1/100 dead.” Each one percent here represents one person. As the percentage goes up, you are just adding one additional person. It is true that 1 x 10 is 10, and that is a difference of 10 times, but then you are missing a step and jumping to percentages without converting them to the decimal value. This is because you have not converted the label “percent” to what it means in reality as far as actual numbers go, so in the case of dead people from a cure a “percent” of people who lived would not be the same unit as a “percent” of people who died. Your first percent is a percent of the 99% of people cured, your second percentage is a percent of 1% of the people not cured. In fractions, if we keep the same label your first is 90/100 and second 99/100 And now we are keeping the same label, what percent lived. You are then taking the difference in the top number (9), but instead of properly translating it across the same denominator to a new label you are then creating a new fraction with it to measure what percent the difference is of the remainder (the 1% not measured). IE: your first percents are percent of the sample size of humans cured, your second percent you are dividing by is the percent of humans not cured. By changing the measure from the percent cured to the number dead and trying to flatly apply the same raw numbers without making that adjustment, you are getting results that aren’t true. So lets do it this way, 90% cured means 10/100 dead. 99% cured means 1/100 dead. So, here if we wanted to see the difference between 90% cured and 99% cured, we could either subtract the percentages themselves and see the difference is 9%, or subtract the totals and see the difference is 9 less dead. This lines up mathematically, each percent is one single life. Therefore we can say each percent is equal, each represents a difference of one life saved. We now know that this is a difference of 9% in efficacy if the measure is “what number of people survive”. What you are then trying to do is another math equation after this where you are forgetting to convert percentages back to real numbers, asking essentially “What percent of one(percent) is ten(percent)” which is why you are getting the huge multiplier on percentages of “(1000%) more effective.” Here, what you are actually proving mathematically is that one percent times one thousand is ten, or 1% x 1000 = 10 This is because you didn’t convert your 1% to the actual decimal translation which is .01 If you do that properly, and game it back out, you’ll see that the question you are asking is already answered in the data you provided, each percent comes out to one person. so, The difference in efficacy is .99 – .90 = .09 next step: .09 x 100 people = 9 Now what is the percent difference in efficacy? It’s 9%. You can translate it back and forth from here pretty easily and see it all makes perfect sense and does not get you weird non-mathematical results like the last ten percentage points of something being worth more than the other percentage points.

It was a very specific machine for a very specific indication so I don’t blame the company. 90% is probably low- cure rate is probably closer to 95% with surgery alone.

Ok, so what am I missing, if it’s got better rates surely it would be made. The difference between those given rates is insane!

So what you’re saying is, there’s an untapped market for radioactive butt plugs?

Sorry Bobby, the treatment would work really well, but not one makes the machine anymore. 🤷‍♂️

Woah, thanks.

So an anal butt plug with a dose of radiation?