Technology will replace 80% of what doctors do

(faux image obv 4 effect)

http://tech.fortune.cnn.com/2012/12/04/technology-doctors-khosla/

  Quote

Today's diagnoses are partially informed by patients' medical histories and partially by symptoms (but patients are bad at communicating what's really going on). They are mostly informed by advertising and the doctor's half-remembered and potentially obsolete lessons from medical school (which are laden with cognitive biases, recency biases, and other human errors). Many times, if you ask three doctors to look at the same problem, you'll get three different diagnoses and three different treatment plans.

The net effect is patient outcomes that are inferior to and more expensive than what they should be. A Johns Hopkins study found that as many as 40,500 patients die in an ICU in the U.S. each year due to misdiagnosis, rivaling the number of deaths from breast cancer. Yet another study found that 'system-related factors', e.g. poor processes, teamwork, and communication, were involved in 65% of studied diagnostic error cases. 'Cognitive factors' were involved in 75%, with 'premature closure' (sticking with the initial diagnosis and ignoring reasonable alternatives) as the most common cause. These types of diagnostic errors also add to rising healthcare expenditures, costing $300,000 per malpractice claim.

Healthcare should become more about data-driven deduction and less about trial-and-error. That's hard to pull off without technology, because of the increasing amount of data and research available. Next-generation medicine will utilize more complex models of physiology, and more sensor data than a human MD could comprehend, to suggest personalized diagnosis. Thousands of baseline and multi-omic data points, more integrative history, and demeanor will inform each diagnosis. Ever-improving dialog manager systems will help make data capture and exploration from patients more accurate and comprehensive. Data science will be key to this. In the end, it will reduce costs, reduce physician workloads, and improve patient care.

Pre-med students are fuct, amirite?

Thank goodness. Bring on the machines that go ping!

IBM's Watson AI as a Doctor: Progress report

http://www.fastcompany.com/3001739/ibms-watson-learning-its-way-saving-lives

Excerpt:

  Quote

This fall, after six months of teaching their treatment guidelines to Watson, the doctors at Sloan-Kettering will begin testing the IBM machine on real patients. The Ms. Yamato app shows how it will work. After Kris inputs the results of her medical tests, Watson begins deliberating. "It's going through its algorithms," Kris says as we stare at the iPad. "It's seeing where the data sends it today." On the screen, a colorful globe spins. In a few seconds, Watson offers three possible courses of chemotherapy, charted as bars with varying levels of confidence--one choice above 90% and two above 80%. "Watson doesn't give you the answer," Kris says. "It gives you a range of answers." Then it's up to Kris to make the call. He regards the options on the screen and wonders how they might change if Ms. Yamato happened to develop a common symptom: hemoptysis, or coughing up blood.

"Let's try that," he says. He inputs the information and shows me the result approvingly. Watson has dropped one drug from the top chemo regimen. That's just what Kris would have done.

...

Saxena now commands a team of about 200 people who are working to adapt Watson's skills for various IBM clients. He and I are discussing his progress over lunch one day near IBM's upstate New York headquarters when he leans back and tells me that after creating two successful tech startups, both of which he sold (the second to IBM), his current job is far and away the most meaningful endeavor of his life. Those startups, he confides, were exciting, important. "But this," he says of the Watson rollout, "this is stuff that is going to change the course of history."

Over the past year, IBM executives have come to believe that Watson represents the first machine of the third computer age, a category now referred to within the company as cognitive computing. As Kelly describes it, the first generation of computers were tabulating machines that added up figures. "The second generation," he says, "were the programmable systems--the mainframe, the first IBM 360, PCs, all the computers we have today." Now, Kelly believes, we've arrived at the cognitive moment--a moment of true artificial intelligence. These computers, such as Watson, can recognize important content within language, both written and spoken. They do not ask us to communicate with them in their coded language; they speak ours. And perhaps most important, they can learn, so they improve without constant human instruction.

LifeBot 5 - The Portable Emergency Room

AliveCor Patient Heart Monitor for smart-phones gets FDA approval (this is relevant to my interests... I recently had to "rent" a portable heart monitor for 30 days and it cost my insurance over $1000, wtf? it was just a sensitive microphone; it didnt even send data remotely).

And of course, there are new and interesting moral questions to be raised about the ownership, copyright, and privacy of your medical data. Who owns it? Your body made it, right? Implant Devices Collect Patient Data, but Patients Denied Access

MEDIBOT

Watson won't be a great doctor for a while IMO, it'll be like WebMD treating you personally. Once AI doctors start having years of geographical/national/individual/academic research health data, and they have long-standing records with you, ie can remember their past diagnoses and recall what dataset caused them to give that analysis, etc, and comparing it to your current data... THAT will be a step up from our current doctors. As it is, we just have doctors informing robots. They will learn from each other though. Exciting, interesting, scary times abound for the privacy-loving patient.

Is it immoral to sell medical data to the highest bidder?

so what gonna grabs my balls when I have to cough?

this

or this?

  On 12/27/2012 at 8:19 PM, soundwave said:

so what gonna grabs my balls when I have to cough?

the doctor will see you now:

I'll probably die of cancer before I can afford it

I don't know much about the medical world so maybe this does exist in some form but some sort of mandatory central database of all diagnosis, treatments and outcomes seems extremely useful to improve healthcare. It would increase healthcare transparency and we would be able to put analysis algorithms on these large collections of data to highlight anomalies like the one in the article. All this talk about learning from the data is all nice science fiction unless the data is actually collected and brought together.

^^ check out this talk, Wilbanks has good ideas:

I promise to stop spamming this thread now.

needs more alien movies!

  On 12/27/2012 at 8:34 PM, luke viia said:

^^ check out this talk, Wilbanks has good ideas:

 

 

I promise to stop spamming this thread now.

Yes, but I don't like the approach of his project. His site is demanding all my personal information to tie it to my genotype. Why? My name is irrelevant. Why not anonymize the data a bit to protect privacy? Maybe even by limiting the detail on stuff like date of birth so it's harder to trace a profile back to me given enough personal information?

Edit: apparently they do anonymize the data that's publicly available. But it still irks me that it's not anonymous to begin with and my name would be tied to the profile on their servers somewhere.

I believe the first step is to be able to get a computer to recognize differerent objects at random...

Are you actually an A.I., Compson? All I see in your posts are links and quotes...

I think the quote in the thread starter misses on essential point, which is our current state of knowledge in healthcare. There' s only a small amount of diseases we completely understand and cure. Most medicines on the market don't do what is often assumed. Namely, curing a disease. So the argument that some algorithm could perform better than doctors, is pretty crippled, imo. In many cases it's pretty hard to come to any diagnosis at all. We may miss the proper data, or we lack understanding of what's actually going on behind the symptoms, or a couple of diseases work at the same time and it's not clear which problem causes which symptom, etc.

The use of algorithms in medical science/research is pretty accepted though.

  On 12/28/2012 at 8:26 AM, goDel said:

I think the quote in the thread starter misses on essential point, which is our current state of knowledge in healthcare. There' s only a small amount of diseases we completely understand and cure. Most medicines on the market don't do what is often assumed. Namely, curing a disease. So the argument that some algorithm could perform better than doctors, is pretty crippled, imo. In many cases it's pretty hard to come to any diagnosis at all. We may miss the proper data, or we lack understanding of what's actually going on behind the symptoms, or a couple of diseases work at the same time and it's not clear which problem causes which symptom, etc. The use of algorithms in medical science/research is pretty accepted though.

This is a good point, however we continue to learn more and more about things we don't understand... it's not as if the article suggests this is the cure for cancer.

It does make it a bit presumptuous, imo.

But to keep the argument rolling, i'd add that technology wont replace doctors, but instead will provide doctors with the (diagnostic)tools. Simply because of the care people need.

Even if a patient could use technology to make a proper diagnosis, and there's a medicine available which could cure him, even then the patient could be needing some basic care, or some doctor to check the developments. (How do you think technology would deal with complications, or sudden changes in the symptoms?)

The statement could be put next to the statement made in the 1960's about robots and AI. It's wildly optimistic and naive, imo.

  On 12/28/2012 at 8:43 AM, goDel said:

It does make it a bit presumptuous, imo. But to keep the argument rolling, i'd add that technology wont replace doctors, but instead will provide doctors with the (diagnostic)tools. Simply because of the care people need. Even if a patient could use technology to make a proper diagnosis, and there's a medicine available which could cure him, even then the patient could be needing some basic care, or some doctor to check the developments. (How do you think technology would deal with complications, or sudden changes in the symptoms?) The statement could be put next to the statement made in the 1960's about robots and AI. It's wildly optimistic and naive, imo.

And diagnostic tools will speed up processes, which will decrease the total amount of doctors needed. As the article doesn't suggest 100%, but 80%.

in the case of birth control, technology (condoms/the pill) has already replaced 80% of what doctors do (abortion)

maybe, dunno, but it sounded good in my brain

In other words, that percentage is wildly optimistic (or you could argue pessimistic wrt the current doctors). I'll retract the naive part I've said earlier, though. Because I do actually support the direction - less doctors/healthcare.

Algorithms don't treat wounds, or hold your hand. I don't think technology will be some substitute for doctors. At least, not in some significant way. The best substitute for doctors are healthy people.

I can't say I agree with this downgrading of Dr. status to just some asshole who hands out medicine. I quite like thinking of doctors as upstanding people who do a great job and work hard.

Fuck technology.

  On 12/28/2012 at 8:54 AM, goDel said:

In other words, that percentage is wildly optimistic (or you could argue pessimistic wrt the current doctors). Algorithms don't treat wounds, or hold your hand. I don't think technology will be some substitute for doctors. At least, not in some significant way. The best substitute for doctors are healthy people.

People aren't living longer? As someone who had cancer and observed the practices of a standard hospital and a cancer care alliance specialized hospital, the differences in diagnostic/methods was the same... determining surgery location is done by a machine with a visual display that anyone with eyes can see. Surgery itself is a completely different thing however, but diagnosis is already streamlined to the point that we are just inflating health care costs by having people do what technology can do better.