6 ms·

If a doctor misdiagnosis an eye ailment, they might end up with a malpractice lawsuit. If an ML program misdiagnoses an eye ailment, what is going to happen?

melling 9y ago
If a car has to decide between killing ... The trolley problem: https://www.youtube.com/watch?v=21EiKfQYZXc&feature=youtu.be&t=1h25m50s https://www.youtube.com/watch?v=21EiKfQYZXc&feature=youtu.be...
otoburb 9y ago
The commercial entity backing the ML program should be responsible. If one doesn't exist then the comparison fails, as one would presumably not be willing to trust the competency of a public domain ML program without a true, commercially and medically backed "second" opinion (algorithmic or otherwise). Perhaps one day, ML programs running eye diagnostics will be as cheap and disposable to use as pregnancy stick tests: "Point and diagnose."
- TuringNYC 9y ago
  Yes, the commercial entity backing the ML program, and possibly multiple associated entities would be held responsible, or at least dragged into litigation. You can get insurance companies to write custom policies for such things, but I dont think there has yet been a standards-setting case -- anyone know of existing or in-progress case law in this arena?
- solomatov 9y ago
  Most likely all these models have TOS or EULAs which shift liability in such situations.
dguaraglia 9y ago
This is why these tools are generally described as "decision support" systems and not "diagnostics" systems. There are many reasons why you don't want to be classified as a diagnosis device (FDA approval is a big one), but ultimately letting the doctor make the final decision removes the ML controversy out of the picture. EDIT, for context: https://en.wikipedia.org/wiki/Clinical_decision_support_system https://en.wikipedia.org/wiki/Clinical_decision_support_syst...
- Jedi72 9y ago
  How long until Doctors spend 10+ years studying only to sit in the chair and copy-paste diagnosis from software as some kind of legal blame game piece?
  - killjoywashere 9y ago
    Any doctor that can be replaced be a computer, should be.
  - faceplanted 9y ago
    You should see how long radiologists train to push a button. I got that joke from a radiologist.
robertelder 9y ago
In this case I think most jurisdictions would treat the AI as just another tool or piece of equipment. If you asked a similar question about who would take the blame if a piece of X-ray equipment was not working properly and caused some form of harm, the liability might fall on the X-ray machine manufacturer who guaranteed a certain level of accuracy, or it might fall on the hospital that procured the (potentially unsafe/certified) equipment. It might also fall on the physician who wasn't following the proper protocol for using the equipment.
- spynxic 9y ago
  The coverage of chain-in-command in this answer is so on point. One could literally follow each sentence to determine the culprit of any issue. Bravo - A+ in troubleshooting.
  - bluetwo 9y ago
    Sure, but a jury doesn't have to follow the logical chain of events. Look at the recent talcum powder lawsuits. No solid evidence it causes cancer, yet multiple million dollar lawsuits against J&J saying that it did.
TuringNYC 9y ago
I'm working on this full-time. We sell our model as a pre-diagnosis tool. We tune the parameters to ensure low false negatives (less than human doctor), though the false positives are higher. However, it whittles down the queue substantially. For non-clinical uses, depending on your use case, you can actually skip the negatives designated by the model. For clinical use cases, you might use it to prioritize your read queue and/or highlight areas of interest. Feel free to reach out to me if you are curious. I can talk in great detail. BTW, you can purchase insurance for activities like these, though I cannot say I've seen a legal case yet, so I dont know exactly how it would work out.
- bluetwo 9y ago
  Thanks for the info. I don't want anyone to get hurt but it was only a matter of time before there is a suit and I am curious how this will play out. I don't buy the argument that it is the same as any other equipment, although I can see companies trying to push the liability on the healthcare provider as the one making the final call.
sohilv 9y ago
AI will be tool for Doctors & patient as 2nd opinion on diagnosis. And at least it will be the initial diagnosis tool where doctors are not present.
xxSparkleSxx 9y ago
If a doctor misdiangosis someone based on an outside errant lab test, what happens? I think the situations would be viewed identically. I don't know the exact processes, but lots of documentation would go into it and if the lab that gave the errant lab test has a history of poor results, they may get investigated and closed down. If this was a one-off error, that will get chalked up to a one-off error. Even if the patient dies.
londons_explore 9y ago
The AI program would say "I think there is a 99% chance you have this eye ailment." If that turns out to be wrong, the programmer will just point to the other 99 people successfully treated and shrug.

melling 9y ago

If a car has to decide between killing ... The trolley problem: https://www.youtube.com/watch?v=21EiKfQYZXc&feature=youtu.be&t=1h25m50s https://www.youtube.com/watch?v=21EiKfQYZXc&feature=youtu.be...

otoburb 9y ago

The commercial entity backing the ML program should be responsible. If one doesn't exist then the comparison fails, as one would presumably not be willing to trust the competency of a public domain ML program without a true, commercially and medically backed "second" opinion (algorithmic or otherwise). Perhaps one day, ML programs running eye diagnostics will be as cheap and disposable to use as pregnancy stick tests: "Point and diagnose."

TuringNYC 9y ago
Yes, the commercial entity backing the ML program, and possibly multiple associated entities would be held responsible, or at least dragged into litigation. You can get insurance companies to write custom policies for such things, but I dont think there has yet been a standards-setting case -- anyone know of existing or in-progress case law in this arena?
solomatov 9y ago
Most likely all these models have TOS or EULAs which shift liability in such situations.

dguaraglia 9y ago

This is why these tools are generally described as "decision support" systems and not "diagnostics" systems. There are many reasons why you don't want to be classified as a diagnosis device (FDA approval is a big one), but ultimately letting the doctor make the final decision removes the ML controversy out of the picture. EDIT, for context: https://en.wikipedia.org/wiki/Clinical_decision_support_system https://en.wikipedia.org/wiki/Clinical_decision_support_syst...

Jedi72 9y ago
How long until Doctors spend 10+ years studying only to sit in the chair and copy-paste diagnosis from software as some kind of legal blame game piece?
- killjoywashere 9y ago
  Any doctor that can be replaced be a computer, should be.
- faceplanted 9y ago
  You should see how long radiologists train to push a button. I got that joke from a radiologist.

robertelder 9y ago

In this case I think most jurisdictions would treat the AI as just another tool or piece of equipment. If you asked a similar question about who would take the blame if a piece of X-ray equipment was not working properly and caused some form of harm, the liability might fall on the X-ray machine manufacturer who guaranteed a certain level of accuracy, or it might fall on the hospital that procured the (potentially unsafe/certified) equipment. It might also fall on the physician who wasn't following the proper protocol for using the equipment.

spynxic 9y ago
The coverage of chain-in-command in this answer is so on point. One could literally follow each sentence to determine the culprit of any issue. Bravo - A+ in troubleshooting.
- bluetwo 9y ago
  Sure, but a jury doesn't have to follow the logical chain of events. Look at the recent talcum powder lawsuits. No solid evidence it causes cancer, yet multiple million dollar lawsuits against J&J saying that it did.

TuringNYC 9y ago

I'm working on this full-time. We sell our model as a pre-diagnosis tool. We tune the parameters to ensure low false negatives (less than human doctor), though the false positives are higher. However, it whittles down the queue substantially. For non-clinical uses, depending on your use case, you can actually skip the negatives designated by the model. For clinical use cases, you might use it to prioritize your read queue and/or highlight areas of interest. Feel free to reach out to me if you are curious. I can talk in great detail. BTW, you can purchase insurance for activities like these, though I cannot say I've seen a legal case yet, so I dont know exactly how it would work out.

bluetwo 9y ago
Thanks for the info. I don't want anyone to get hurt but it was only a matter of time before there is a suit and I am curious how this will play out. I don't buy the argument that it is the same as any other equipment, although I can see companies trying to push the liability on the healthcare provider as the one making the final call.

sohilv 9y ago

AI will be tool for Doctors & patient as 2nd opinion on diagnosis. And at least it will be the initial diagnosis tool where doctors are not present.

xxSparkleSxx 9y ago

If a doctor misdiangosis someone based on an outside errant lab test, what happens? I think the situations would be viewed identically. I don't know the exact processes, but lots of documentation would go into it and if the lab that gave the errant lab test has a history of poor results, they may get investigated and closed down. If this was a one-off error, that will get chalked up to a one-off error. Even if the patient dies.

londons_explore 9y ago

The AI program would say "I think there is a 99% chance you have this eye ailment." If that turns out to be wrong, the programmer will just point to the other 99 people successfully treated and shrug.