Computers Shown To Be Better Than Docs At Diagnosing, Prescribing Treatment 198
Lucas123 writes "Applying the same technology used for voice recognition and credit card fraud detection to medical treatments could cut healthcare costs and improve patient outcomes by almost 50%, according to new research. Scientists at Indiana University found that using patient data with machine-learning algorithms can drastically improve both the cost and quality of healthcare through simulation modeling.The artificial intelligence models used for diagnosing and treating patients obtained a 30% to 35% increase in positive patient outcomes, the research found. This is not the first time AI has been used to diagnose and suggest treatments. Last year, IBM announced that its Watson supercomputer would be used in evaluating evidence-based cancer treatment options for physicians, driving the decision-making process down to a matter of seconds."
Just don't ask about airports (Score:2)
You might think it's funny, but Watson is still sensitive about screwing up on Jeopardy a couple years ago.
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It's just another tool (Score:5, Interesting)
And will the system consider the patients age/cost to treat/insurance level/likelihood of patient paying future insurance premiums to make up for expenses?
It will if you program it to. Things like this are tools. As a relatively young doctor (resident) I welcome things like this. Every doctor I know uses reference material, some are printed on dead trees and some are electronic. Today, there's not much difference. But the point it is that there's too much medical knowledge for one person to keep it all in their head at one time. If something like this were to come to market it wouldn't be replacing doctors, it would be augmenting them. Machines do what we tell them to, always have and (hopefully) always will. False rivalries like this completely miss the point. I would love to have a computer algorithm that could correctly diagnose 99% of the time even if it were flagrently wrong the other 1%. That's why humans are in the loop.
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But the point it is that there's too much medical knowledge for one person to keep it all in their head at one time. If something like this were to come to market it wouldn't be replacing doctors, it would be augmenting them.
The attitudes towards the use of expert systems is kind of interesting. For example as long ago as the early 1970s programs like Mycin would consistently outperform medical experts, and yet they've never been adopted. There seems to be considerable reluctance by people to accept diagnosis-by-computer even when told that it's more accurate than human diagnosis. I agree with your comments that it's a support tool, but most patients won't even accept it as a support tool. One hypothesis is that if patients
Re:It's just another tool (Score:5, Interesting)
A) the slashdot title is a little sensationalistic....never did TFA mention diagnosis without a physician in the loop.
B) by what standards was the final diagnosis discovered (i.e. the gold standard)? Another physician? Another program? Was the trial blinded?
C) this article mentions only one disease process - depression, I fail to accept, blindly, that their results can be extrapolated - that is the crux of medical versus scientific research....see D. Not all diagnoses are obtained by just talking with a patient, in fact short of a psychiatric diagnosis, most require a physical exam....and a competent one. Suppose someone is obviously malingering and complaining about abdominal pain....this system would not pick up on malingering and would likely recommend an operation....a totally wrong diagnosis.
D) this is a retrospective study...in medicine, this is not adequate proof of effectiveness.....you need to perform a prospective trial, preferably with randomization and blinding to adequately prove your hypothesis for treatment. Actually, upon re-reading TFA...it was _simulations_ that were performed. This is hardly world class evidence.
E) cost savings were mentioned, but not long term outcomes....who cares if I saved 75% in the cost of treatment if the patient didn't get better in the end. (yes, short term were noted, but anyone who's ever been on long term therapy knows that the short term does not dictate the long term outcome.
F) In life threatening situations - those that require the most expedient decisions, often with less than complete information, this system would be useless because the patient would die in the time it takes you to input the facts.
G) not all situations are cut and dry. I am often consulted to make decisions about patients that are not addressed in any book. In fact, there may be only 1 or 2 journal articles about the problem, and often there are none. Making a decision treatment in the absence of an established precedent is not going to be one of this systems strengths...."Oh, I'm sorry, I can't help you....I just got the blue-screen of death from the program that was supposed to diagnose you!"
H) would this program tolerate patient autonomy? What happens when the patient refuses some or all of the initial treatment plan?
So, while I point out flaws, it is not to say that this is totally without merit....I am merely pointing out the obvious short coming of this article. In certain fields this could be very advantageous.
I will tell you that in my field, this computer program borders on useless. There is very little doubt about what my diagnosis is, and when I am in doubt, my best evidence is collected by doing something. And computers are really a long way away from matching my skill set. A lot of my diagnosis is made by touching the patient during the physical exam. That exam can completely revamp my decision that started based on the history. And, since I am the one performing procedures, I also would not have a machine dictate the exact method that I use - I am the one performing the operation, I do it the way that I know will result in a safe and effective outcome. In my case, I just don't really don't know what this system would provide to me for patients.
Re:It's just another tool (Score:4, Interesting)
Those are all very good points. I just spent half an hour going through the articles, press release, and article itself (which is available here http://arxiv.org/abs/1301.2158 [arxiv.org] http://www.caseybennett.com/uploads/Bennett_AI_ClinicalDecisionMaking__Article_in_Press_.pdf [caseybennett.com] ) trying to figure out how they determined that the program diagnosed patients better than doctors. I couldn't do it. And it didn't look like it was worth another hour of trying to figure it out.
I invite anybody to explain that to me. What do they mean by a "30-35% increase in patient outcomes"?
For example, the press release says:
"This was at the same time that the AI approach obtained a 30 to 35 percent increase in patient outcomes," Bennett said. "And we determined that tweaking certain model parameters could enhance the outcome advantage to about 50 percent more improvement at about half the cost."
What does that mean -- "a 30 to 35 percent increase in patient outcomes"? Does that mean the program treated patients with diabetes and got 30% fewer foot ulcers? Or 30% lower blood sugar? Or 30% longer survival? Or did they reduce the weight of overweight patients by 30%? Did they get 30% more patients to stop smoking? Did they diagnose 30% more cases of colon cancer?
They don't seem to have defined their outcomes or endpoints.
This is one of those times when you wish they had to publish in a peer-reviewed journal where an editor would have made them answer some obvious questions.
It looks like an entirely theoretical study. I don't see where they compared their predictions to real-world data. And if they did, how would they decide that they're right and the doctors are wrong?
They're like economists who come up with clever theories that ignore the real world.
This reminds me of the story about the efficiency expert who heard a symphony orchestra. There's nothing here to indicate that they understand anything about medicine.
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Only doctors who operate independent practices that they own really care about that. But I don't see why we can't add that to the program. That is one of the easiest pieces you can put in that doesn't need AI.
After the AI finds the best DX and procedures that work. You cross reference the Fee schedule and weigh the cost into the equation.
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WTF does your comment have to do with airports?
Watson screwed up the Final Jepoardy problem in the first match, which was (category: US Cities): "Its largest airport was named for a World War II hero; its second largest, for a World War II battle."
Modern luddites (Score:5, Insightful)
An expected outcome. First machines become good and cheap at performing manual labor, then it's lowly qualified jobs such as sorting stuff or basic accounting.
In a few years, liberal professions will fall. Our salaries (I'm a doctor) have been diving as more and more people around the world can afford a career and achieve a good enough level to perform as a doctor or an engineer.
Creative and risk-taking careers will resist for a longer time.
We can hope for a future of working machines and humans enjoying themselves. The other option will be cheap-ass humans with no way of earning a living whatsoever.
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except software and hardware designers. which is why i'm both. ;)
but seriously, do you really think that's what the future will look like? all evidence from the past shows that as technology gets better, the amount of good jobs goes *up* not down. i don't see any reason why this would change. we're a LONG ways away from having machines do absolutely everything for us.
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we're a LONG ways away from having machines do absolutely everything for us.
Yeah, what happened to those Japanese sex-bots I keep hearing about?
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Re:Modern luddites (Score:5, Insightful)
If we progress to the point where all of our jobs can be done by computers... what should we do? At the point where artificial intelligence becomes genuine intelligence, it will rapidly outpace human intelligence. This is evolution. We are breeding our replacements.
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>> If we progress to the point where all of our jobs can be done by computers... what should we do?
In the future cheap unprofitable or low-margin jobs that machines will do (that might include a lot of things that today's highly-paid people struggle with) will have to be run by government. No one else want to do that work anyways.
People will want to be in control of things that matter, things that are challenging, such as finding a way to move out of the solar system. Even the computers will agree to
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OR.
We are breeding our new bodies. Those who expected a more corporeal form of "godlike immortality" will be disappointed perhaps, but we won't be overrun by "the machines" or "robot overlords" or whatever such nonsense. We will be integrating our tools to augment our selves. The mechanical and electronic prostheses we've been perfecting will eventually cease to be separate -- by design. No dissolution a la the Borg from pulp sci-fi horror, rather, the ultimate self-actualization via liberation from the con
Church-Turing thesis and non-algorithmic systems (Score:3)
Meh. You can be replaced by sufficiently advanced algorithms. I'm mathematician, FFS. There are already automated theorem provers which can solve undergrad-level problems. As computers evolve, they'll be just as good as people and loads cheaper than people at everything we do, up to and including the creation of art. If we progress to the point where all of our jobs can be done by computers... what should we do? At the point where artificial intelligence becomes genuine intelligence, it will rapidly outpace human intelligence. This is evolution. We are breeding our replacements.
Hmmm...what if there is an irreducibly non-algorithmic component to human intelligence? That would invalidate the Church-Turing thesis that your assertion seems to be relying on. Roger Penrose thinks it would at least, and he makes a pretty good argument [wikipedia.org] for that position, and against the Strong AI you are hypothesizing. He also defends his argument pretty well, too. [calculemus.org].
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Yeah, I kinda predict that the jobs of doctors will move to collecting the information the computer asks for, volunteering info that they notice from experience/sight/interaction (try a computer on a mental disease patient...) And whenever the diagnosis is wrong the doctor would do research and/or try to teach the computer what other questions steps would be required to detect and treat the special case.. That way it is improving the system for everyone. Also the computer could be smart about how it prescr
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An implementation could be built that works in a manner similar to Bitcoin but instead of cracking hashes you are performing encryption and doing processing of statistical analysis and cross indexing of data in a completely decentralized manner you could build an anonymous, safe, secure, and global system that potentially could gather statistically significant data on a scale that makes FDA controls and studies look like random speculation.
It could build a biometric finge
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We can hope for a future of working machines and humans enjoying themselves. The other option will be cheap-ass humans with no way of earning a living whatsoever.
Call me a pessimist, but I'd bet on the second happening before the first.
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The problem is the most evil of all negative side effects. Euphoria! A computer AI running as a cellphone app wouldn't prescribe things without a cause but it also wouldn't police patients. That would be the excuse at least and never mind that the AI as a gateway to scripts guarantees screening for drug interactions and informed choices thus elimi
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Perhaps eventually what you say would be true. But I bet it'll take significant time for that to happen.
And how much time and suffering that involves would depend on the path we choose.
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The upper limit = 174 petawatts of sunlight hitti
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The last few times we've had to go to a doctor we already knew what the problem was and what to do about it from Google, we just had to get the doctor to sign the prescription form. I've been convinced for years that 90% of what doctors do could easily be replaced by software.
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Probably. It's the other 10% that's the bitch.
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Not what doctors want to hear (Score:2, Insightful)
I'm sure this is not what diagnosticians would like to consider, but I think the simple truth is that computers will negate our need for human diagnosis in the very near future. I'm sure we'll hear the same "The computers will be great *assistance* to actual doctors" but I don't think that's actually true. I know the computer is likely doing a better job, there should possibly be a few overseers but the vast majority of doctors shouldn't be needed, and frankly I wouldn't want them second guessing what's l
GIGO (Score:4, Insightful)
An expert system is only as good as the information it is fed. Until we get machines that can quickly scan a human body and tell us everything there is to know about it, we will still need doctors to talk to patients, vet what they say, observe what didn't mention and ask followup questions.
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Ha! This is just another technology that the medical industry will control to suck money out of us. Here's what's going to happen.
Machines will "assist", but as "medical devices", only medical vested interests will have legal access to them. Our health care will improve, while we *continue* to get robbed by the medical industry through the rent seeking made possible by licensing laws.
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Ha ha. No, I *don't*.
Sorry, I've worked in the medical device industry. FDA tested does not mean safe and effective. Companies work around regulations, making their products less safe, but able to pass testing. At best the regulatory process only delays medical progress a decade or so and multiplies costs ten times, and at worst it completely prevents improvements for decades.
How is it that grown ups can think government apparatchiks colluding with corporate rent seekers is a recipe for effective health car
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"How is it that grown ups can think government apparatchiks colluding with corporate rent seekers is a recipe for effective health care?"
Somehow socialized medicine works in every other advanced country, with better results, lower cost, and greater patient satisfaction, so that's one data point.
Or actually it's all the data points.
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Somehow socialized medicine works in every other advanced country, with better results, lower cost, and greater patient satisfaction, so that's one data point.
As Thomas Sowell would ask, "compared to what?"
I thought we had spent the last century deciding testing whether a free market or government central planning produced better goods and services. As Reagan's strategy bore out, "We win; they lose."
At least in reality, the question was settled over which system was superior. In policy, you always can force people into an inferior system if you have the guns.
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In actual-real-reality, the answer is the same practically regardless of what data you choose to compare -- life expectancy, infant mortality rate, mortality amenable to health care, physicians available per capita, expenditure per capita, cost as a percent of GDP, percent of government revenue spent on healthcare, etc., etc., etc. It's so not even close in any of these cases (often off by a whole order of magnitude for the USA), that arguing anything else is simply delusional. Saying "we have bigger guns"
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Interesting (Score:5, Interesting)
I find this interesting, I was wondering when we'd reach the point where the accumulation of knowledge available in any given field exceeded the ability of the human mind to completely grasp in a useful manner. It's going to reach a situation where multiple experts on a given subject with a fair idea about related subjects are going to be the only unit capable of actually doing anything sooner rather than later - apparently in medicine at least computers have come to the rescue.
I suppose with the many specialisations in every area we're already there, the question is can we repeat the improved returns in areas like physics and chemistry.
Re:Interesting (Score:5, Insightful)
The problem is not in the decision making process, but in the fact finding process. THIS is the part computers and software are still very, very poor at.
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Sadly, so are most general doctors.
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Re:Interesting (Score:5, Interesting)
We could start by getting some real information instead of the pair of nearly identical fluff pieces in the TFA. While it's nice they used Markov Decision Chains, as best as I can tell they did a bunch of simulations with pre existing data and came out with 'better' information than the docs who, unfortunately, were dealing with problems in real time.
The lawyers have had this sort of thing for years. It's called a 'retrospectascope'. It tells you what you SHOULD have done after you know what the outcome is.
Very, very helpful. To lawyers anyway, to doctors, not so much.
I'd love to see some real computerized decision analysis that would be useful in real time medicine. I'd love to have "all" of the information about a patient in real time.
I'd also like a Pony and one million dollars. Before I get worried about job security and before everyone goes all Star Trek, lets see if this works in a real clinical setting.
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Re:Interesting (Score:4, Interesting)
So no, while I understand your fears, calling anything in ML a "retrospectascope" is completely wrong and ignorant. In fact, if you build such an algorithm it tends to have very poor behavior, since it looses the power to generalize for insight (the technical term is "overfitting").
Truth is, it's a good think that you would love to get some of the things you mention, since the article is saying you'll get them (and I can attest to that). Very soon. Don't believe me? Look at Watson in action [youtube.com] and think deep about what the computer is doing. It might seem a game, but really think what it is going on. It is not a movie script. It does not know the answers, it is UNDERSTANDING the questions and COMING UP WITH the right answers. Faster than the best humanity has to offer. Are you smarter/more knowledgeable than them? The truth is indeed astonishing and might look like science fiction, but it is not.
The pony though might take some time
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I think a major problem with the current approach is communication. Doctors rarely communicate with each other and for cases where a patient is trying to figure out what's wrong with them and getting bounced around by specialists, no one really has the full picture, not even the primary.
A computer can have the full picture, assuming there is enough data for it to churn on, and given enough population data to train on, it inevitably will arrive at evidence based diagnosis and treatment options better than an
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A computer can have the full picture, assuming there is enough data for it to churn on, and given enough population data to train on, it inevitably will arrive at evidence based diagnosis and treatment options better than any human...for the stuff that's understood.
Where exactly in this magical, cornocopian world, does the computer get the 'full picture'? There is this odd feeling around here that if you feed enough information into 'the computer' it will solve all sorts of difficult problems automagically. Not going to happen. Yes, it's true that data collection needs to be standardized and analyzed. That can give you suggestions where to look. But correlation is not causation and correlation is what these programs do.
That and the fact that diagnosis isn't alwa
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Medicine has always had this problem. It is a large complex field with constantly evolving "truths".
Computers are much better than humans at considering all of the options.
An early pioneer in this field, Larry Weed, used to say that a good clinician could come up with a 3 item list for a differential dx and an expert could come up with 6 items. However, the computer can come up with 20 along with a list of tests to perform to make the final dx.
Computers have consistently been shown to perform better than
Just another pdr (Score:2)
I have 2 kids and my first one was always sick until a year ago. He was on antibiotic at least once a month
After a while I picked up on a few things
There is a simple 5 point check to see if the llllness is bacterial or viral
Once he diagnoses the doctor does not choose the drug. The physicians desk reference aka pdr tells the doctor what to prescribe
The dosage is determined by the drug companies depending on the child's weight
The pdr will have every known disease, illness, condition and the drugs or procedur
Mycin (Score:5, Informative)
In the early 1970s, Mycin [wikipedia.org] achieved 69% accuracy of prescribing a "correct" treatment for a patient's condition, which was deemed better than human specialists.
The linked articles don't seem to include the absolute accuracy that it achieves, just the relative accuracy against doctors. I wonder if we've come any further than the basic expert system rules allowed 40 years ago.
big difference in technologies.. (Score:3)
The big difference here is in technologies.
Mycin used a bunch of rules to arrive at medical decisions. These had to be manually entered by medical experts which is time consuming, difficult, and outdated by the time it is completed. It was a narrowly focused, brittle system that strived to emulate the logic of it's designers.
The newer approaches (like the kind from this article) build their own probabilistic models of medical diagnosis and treatment based on statistical analysis of data. Lots and lots of da
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In fact computers have been far superior at medical diagnosis for about ten years, and there are several products commercially available. The only reason they are not routinely used is because doctors fear for their jobs.
People have died because the doctor did not run the diagnosis against the computer. Let's face it day to day medicine is nothing like "House" were they get together and debate your case. If you are not responding, doctors usually just carry on with more of the same treatment and hope for th
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If you are not responding, doctors usually just carry on with more of the same treatment and hope for the best, while the computer would say "patient not responding to Randomicine? then check the zootocite count for possible inflammation of the hyperbolerium" and in that case one of two things happen: we discover it's the hyperbolerium and treat you for that or we determine it isn't that and continue the normal treatment on the basis of actual evidence instead of just a hunch.
You probably think you're being clever, but in fact your use of Hollywood-style medibabble indicates that you haven't really bothered to learn much about the subject. It's really sad, on a site like /., to see people who work in highly technical fields with lots of meaningful jargon show such contempt for other people's technical knowledge and terminology, but I guess it's not surprising.
I'm a bioinformaticist, which means I have a pretty good idea how hard it is to model living systems in silico. A long
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but in fact your use of Hollywood-style medibabble indicates that you haven't really bothered to learn much about the subject
The use of babble is a lame attempt at a joke and it indicates nothing. It truly shows your lack of arguments that you have to base your reply on that irrelevant detail.
I'm a bioinformaticist, which means I have a pretty good idea how hard it is to model living systems in silico.
Maybe you are confused by the latest, state of the art software packages that try to read radiology directly. Those are still in development.
I'm talking about diagnostic software based on expert systems applying deduction rules over noisy data. The doctor enters the data and the computer produces all possible matches with probabilities attac
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but in fact your use of Hollywood-style medibabble indicates that you haven't really bothered to learn much about the subject
The use of babble is a lame attempt at a joke and it indicates nothing. It truly shows your lack of arguments that you have to base your reply on that irrelevant detail.
No, your medibabble indicates that you don't understand the subject. Doctors make jokes all the time. But a doctor's joke, like a programmer's joke or an engineer's joke, is based on an insight and understanding of the discipline. Your medibabble is based on ignorance.
I often see lame attempts at humor about science written by people who don't know anything about science. It comes off as really stupid. Their message is, "There's all this science stuff that none of us understands. It's OK to be ignorant. Nud
NYT times reporting on "nonexisting software" (Score:3)
I call bullshit. There is no such diagnostic software.
Here are the names of some companies producing the "non existing software":
DiagnosisPro
Isabel Health Care
Here's a recent article [nytimes.com] on the New York times about the subject, Isabel Health Care has been around since at least 2006, when we recommended the software to a local hospital.
There is no complete database of every possible disease with typical and atypical presentations.
Complete in that it contains every disease known, and no you do not need agreement about the symptoms to enter them in a database. The reasoning process handles that part, you simply enter "some reports say these are symptoms, some
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The linked articles don't tell you what a "30-35% increase in patient outcomes" is, what kind of decisions they made, or how they decided that the algorithm's decisions were better than the doctor's decisions. It seems to be strictly a simulation. They're asserting that their algorithm is better than a doctor's decision, without any supporting evidence.
One of the tip-offs for me is that they don't give the predetermined outcome in the abstract or anyplace else. That's what medical journal articles do. How d
Re:Mycin (Score:5, Informative)
Came here to mention this. Medical "expert systems" (a class of AI) have existed, and been better than humans at some things, for literally decades. However, you almost never hear about them anymore. With the vast advances in processing power, miniaturization, and power usage, we can today build pocketable devices that tremendously exceed the capabilities of something like Mycin. With the improvements in sensor technology, we can feed those systems more and better data than ever before. With widely available wireless Internet connectivity plus incredible storage densities, we can provide these systems with all the info they could ever need. With the advances in the science of AIs over the last four decades, we can make these systems "smarter" than was possible before. Finally, with the plummeting cost of such electronics, we can make such systems affordable to middle-class individuals, rather than exclusively to large and well-funded organizations.
Yet, they almost non-existent. We have a few smartphone apps that scratch the surface of what's possible. We have dedicated machines like continuous glucose monitors for diabetics, but they have very little in the way of smarts and no versatility. We have concepts and pseudo-prototypes of "medical tricorders" and such sci-fi devices, but they aren't generally set up to make recommendations. We have online web applications where users can input symptoms and be told what they might be, but those systems have no personal background or history of the user's health, and rely on the user measuring and providing data themselves.
Why haven't these things been combined?
Re:Mycin (Score:5, Insightful)
Why haven't these things been combined?
Who could possibly be opposed to cheap, automated healthcare?
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Who could possibly be opposed to cheap, automated healthcare?
Doctors [ama-assn.org]. Obviously.
People that can do math see Obamacare as infeasible [latimes.com] given current practice and the number of practicing doctors. Doctors vociferously oppose [fiercehealthcare.com] delegating anything, however.
We're going to have to break the doctor monopoly in the US. The cost has gotten too high to indulge this exclusivity any longer. Automation, nurse practitioners, whatever. It's got to end. If there is anything good about Obamacare it is that this issue will be forced.
I don't wish to see Doctors punished, but the fa
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OK, answer this: The REST of the world, including some really smart folks in some very advanced countries have yet to make the magical tricorder. You'd think SOMEBODY could do it - it doesn't have to be an American invention.
The fact that magical tricorders and snazzy, useful expert decision systems aren't available just might mean that the human race, in aggregate, hasn't got to the point where such devices are feasible.
Re:Mycin (Score:5, Interesting)
No need to go overseas. The Veterans Administration under the US DOD uses so-called nurse triage lines with an expert system to direct patients to care over the phone. They're making a mobile, tablet [govhealthit.com] based system now:
The combined solution, called ER Mobile, will make it possible for nurses to perform timely, accurate triage on a mobile device anywhere in the ER, as well as create a comprehensive record that will be recorded in the VA EMR.
Shazam. Tri-corder.
The VA isn't nearly as slavishly obedient to the AMA as private practice, and they definitely don't have employer provided health insurance systems to bilk, so things like this (delegation to nurses) get traction.
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OK, answer this: The REST of the world, including some really smart folks in some very advanced countries have yet to make the magical tricorder. You'd think SOMEBODY could do it - it doesn't have to be an American invention.
Most of the Western world has socialised medicine, and they have a very strong incentive to not put themselves out of work; if I remember correctly, Britain's National Health Service is the largest single employer in the EU.
And in the rest of the world, a doctor is probably cheaper than a computer.
Re:Mycin (Score:5, Interesting)
I'm believe they are in slightly diminished roles. The US military has triage lines, where family members call in about medical problems, a registered nurse answers and then decides if the patient should self-care, book a Dr. appointment, or go to emergency room. I handled appointment booking, and sometimes the nurse would call and no appointments would be available and they'd get annoyed at me and say "Well that's what the computer told me to do."
I figured they had some sort of system that the nurse entered symptoms into, and it used the patient history+symptoms to suggest a self-treatment or triage to appointment/emergency room. I had also read about these systems in the book AI: A Modern Approach Even when the doctor doubted the diagnosis, the computer could even explain the conclusion(this is pretty advanced for an expert system) which would usually elicit a kind of "oh I didn't consider that factor" kind of realization from the Doctor.
I assume a registered nurse must still be involved to meet legal requirements, to properly elicit symptom information, and serve as a sanity check for the system. The problem, demonstrated by their response and inability to troubleshoot problems, is that they become completely trustful of the system. I imagine the opposite problem is also common, where they don't trust the system at all.
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"I handled appointment booking, and sometimes the nurse would call and no appointments would be available and they'd get annoyed at me and say 'Well that's what the computer told me to do.'"
Actually, I don't understand this. No appointments available forever? Someone needs to see a doctor (regardless of who made the decision) and they're just flat out of luck on the issue?
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There was usually some time frame requested, i.e. within the next 3 days. They aren't out of luck, because the nurse can make the call to allow them to see a doctor later than the computer says, or go to walk-in or emergency care if they think waiting too long would be bad. It's the nurse's judgement call to make, but they would always go through this cycle of denial before they finally decide to make a decision for themselves.
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Thanks for the clarification, appreciate it.
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Since the VA has a very successful automated records system, and the military might have one too, it's possible that the nurse might be able to pull up your medical records. But as a practical matter, a lot of these records will be a hundred pages or more, and no doctor or nurse has time to paw through them. It's easier to just ask you what she needs to know. One of the easy things to do is to automate the appointment scheduling. But automating clinical decision-making is pretty difficult.
I've dealt with tr
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They have been combined and they don't work.
If they did work, doctors would use them. Doctors would love them. Medical students love iPhones. They use them to store textbooks, to look things up on PubMed, and to download journal articles.
There was an article in NEJM by a medical school professor who said his student solved a difficult diagnosis by looking up the symptoms with a Google search. The professor was crushed.
That works sometimes -- assuming you have an intelligent doctor or medical student doing t
Virtual Doctor you got leprosy (Score:2)
Virtual Doctor you got leprosy
Second Opinion (Score:2)
So, who do we consult for a second opinion? HP? Oracle?
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So, who do we consult for a second opinion? HP? Oracle?
Well, people used to go to (the) Oracle for a second opinion in the old days (ba-dum-cha)
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Old tech (Score:5, Funny)
I don't care what this article says, this is nothing new. My in-home psychiatrist in the 1990s was great at diagnosing my issues. Perhaps you were a patient of his, too? His name was Dr. Sbaitso [wikipedia.org].
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Errr, I meant psychologist. Big difference!
Idiocracy here we come (Score:2)
Because doctors are humans. (Score:5, Insightful)
The problem with doctors is their ego. Being a nurse for quite some time Ive seen countless doctors come through the hospital that do not treat a patient properly, ignore patient complaints, dont treat problems aggresively enough, are too passive, and so on and the vast majority of them refuse to do otherwise because of their ego. They are doctors, no one should question them and they hate it when you do and when you do they dig their heels in and dont budge. Doctors are also human so they get tired of their job, they get lazy, they stop caring after awhile, they worry more about what they will do later than the problem at hand, they stay up too late.
Ive also seen countless times people who swear by these doctors and will accuse of them of fault simply because the doctor has been nice to them. A doctor who is friendly can do no wrong in a patients eyes. Or a patient has some common problem that even a moron could treat, then when the doctor fixes them suddenly they become godlike.
Personally I would trust the diagnosis of a machine that has more information programmed into it than a thousand doctors do collectively from allover the world.
A machine can be a doctor because thats how doctors are trained, they are trained to be machines. They treat the problem, they do not treat the person. Treating the person is a nurses job. And treating the problem is simply nothing more than deduction. If patient has multiple problems then you take those numbers and it will lead you to the correct answer. Thats all being a doctor is, you look at the signs and symptoms, then you add them alltogether and you get the answer as to what the cause is. Its all a forumla and nothing more, there is no great mystery to it.
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Same old objection (Score:5, Insightful)
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And the solution to both objections (including doctors not wanting to be obsolete) is to have the machine *assist* the doctor, in a similar way that auto-pilots assist but do not replace pilots.
Drug Companies doing away with doctors (Score:5, Interesting)
This sort of thing is just what big pharma wants, no human interaction and careful consideration, just a pill dispenser...symptom a + symptom B == Pill 2...
How much you wanna bet this thing always prescribes expensive non generic drugs and never tries the 50-70 year old known treatments that are usually the first steps in treatment before new expensive drugs are prescribed.
Also, anyone notice the change in medical advertising and communications, they never say "ask your doctor" any more, its ask your prescriber, or ask your provider...like they want to dis-intermediate doctors and are getting the public ready.
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This sort of thing is just what big pharma wants, no human interaction and careful consideration, just a pill dispenser...symptom a + symptom B == Pill 2...
How much you wanna bet this thing always prescribes expensive non generic drugs and never tries the 50-70 year old known treatments that are usually the first steps in treatment before new expensive drugs are prescribed.
It's more difficult to bribe computers, so I'd doubt this is what big pharma wants. A properly designed diagnosis system (open source, or government-managed) should offer the cheapest efficacious drug, rather than the latest drug that has been shown to be more effective than a placebo (but curiously untested in effectiveness against the most effective generic drug).
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Don't forget, the placebo effect may also apply to doctors, who could be biased towards the latest and greatest drugs.
A computer would not ha
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The problem with a computer diagnosing... (Score:5, Insightful)
... is that the computer doesn't have, literally, hands-on experience.
For example... you have stomach pain. Okay. Where? Does this hurt? Does it hurt if I poke this? Do you have a fever? How high? ("Oh, I don't know, maybe XX" ...)...
In other words, you still need someone who *knows* what to do to help diagnose simply to *get* the information. You need someone trained to know where to poke, where to tap, where to see if something hurts. And then, of course, to try to wheedle the real information out rather than the confusing answers patients (note that I am not a doctor, I am a patient) give. :)
As a diagnostic tool, I think it would be a huge benefit. An individual simply can't keep up to date on everything, don't know everything, and can't research everything. Having a diagnostic tool that *does* do all that would be a huge benefit. There would be options and diagnoses that perhaps the doctor had not thought about. Additionally, the diagnostic tool - I hope! - would not just say "Oh, it's this" but would perhaps say "Well, it could be this, and you need to find out this information first ... or it could be this, and for that you need to do these tests..."
The idea that a patient, combined with a non-trained non-doctor, can somehow come up with all the right answers/information and a machine can simply diagnose it on the spot seems like a very simplistic view. Perhaps that works with colds, the flu, or warts... but for more complex things... it seems diagnoses tend to work on a "it could be this; let's do more specific tests to find out if it is" type of investigation.
Weather (Score:2)
Sad that this is true (Score:3)
In my experience, most doctors don't really think about problems, but just look at historical remedies and prescribe those particular drugs. They just regurgitate what is in the books. If you have something new or multiple problems (I've been dealing with this for a year now, with no relief in sight), I think I'd rather listen to watson. These guys have cost me thousands of dollars and all of my vacation time and I'm worse than when the problems started.
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The summary is misleading a best (Score:3)
Probably because its a summary of a press release, rather than the actual paper. This was a computer simulation exercise - a model. No patients were actually treated. There was no prescribing. There were no superior outcomes. Its all hypothetical.
Could an AI outperform an MD? Sure, could happen and probably will eventually. But this model doesn't show that. It just shows that its easier to model health care in silicon than the real world. Remember we can cure cancer in mice - models aren't the same thing as reality.
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Of course the simulation will side with its own kind. That's why the AI won.
(For the humour impaired, this was intended as a funny. Though, admittedly, it probably didn't succeed.)
I wanted to see this as an episode of House (Score:2)
Occasional Variation (Score:2)
One thing I would like to see in these AI systems is occasional variations in their recommendations (for each given symptom set) for experimental purposes. It would be easy to code, and the results could be used to help choose the best outcomes. If two different treatments appear equivalent in outcome, the AIs should prescribe them randomly in a 50/50 ratio, modifying the ratio as new evidence arrives.
(This sort of thing is analyzed by the online advertising industry as a "multi-armed bandit")
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If the outcome of treatment is consistently better for the automated system than for a human doctor, then the insurance premiums for the automated system will be lower than for a human doctor. Not only that, insurers will not have to worry about whole classes of problems: e.g. inappropriate interactions with clients.
If you add a human cross-checking the output of the automated system to avoid gross errors, then that would potentially help to identify bugs. Frankly, even if there are bugs which cause problem
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Great!
Now, can you just let me know how to avoid the car that suddenly swerves from the opposing traffic in to the front of me?
And while you are at it, what to do when the car sufferes a critical mechanical failure at speed, ramming me straight in to a power pole?
Since you are such a good drive, you must know something I dont..
Of course some are better (a lot better even) than others, just pointing out that doesnt help driving be safer than flying, not even close.
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Cars with human drivers are the only ones that suddenly swerves from the opposing traffic lane in front of you. And at least 1/4 of the time, those human drivers are drunk too! And quickly getting more than 1/4 of them distracted on their cell phones, as if one can read phone texts and type while they drive!
I'd take my chances with a computer controlling a car any day over the current system of allowing human drivers who daily make mistakes and kill 40,000+ Americans PER YEAR on the highways and streets!
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I don't need a fucking "heart" or bedside manner, I need precise, correct medical information processing so decisions can be made swiftly and correctly.
"Best path remains: don't get sick."
Tough shit. Barring murder or suicide etc, we will all "get sick".