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>But it's still happening, starting with EKG and ultrasound. Whole-body ultrasound? How would an AI understand how to interpret images with low signal:noise? W

>But it's still happening, starting with EKG and ultrasound. Whole-body ultrasound? How would an AI understand how to interpret images with low signal:noise? Who will be performing the actual ultrasound image capture? Who will be ordering the imaging tests? How will an AI understand a patient that can't meaningfully interact with an AI? What's the utility of "EKG" [sic] for diagnosing non-cardiac problems? Or, do you come from the perspective that all medical problems can be diagnosed with an ECG, urine analysis, ultrasound (of what?), blood test, and CT scan? Do you realize that an ECG is more complex than a single vector ECG via Kardia mobile? I thought we were trying to reduce healthcare costs, but you're recommending over-utilization of expensive diagnostics? Why are you limiting treatment to doctors only, why not have AI do everything? Everything you've written demonstrates an extremely limited understanding of the practice of medicine, a characteristic far too common shared by those who are trying to "disrupt" medicine.

m0zg 8y ago
Sure, I realize there's much that the current tech does not cover. But you gotta start somewhere, and through extremely wide deployment tens of thousands of lives will be saved, and important feedback will be collected to improve products. $400 watch that does a dozen other things and that the user would buy even if it didn't have ECG is not "expensive diagnostics". This is where things are at, whether you like it or not, especially for the working poor who can't afford to fork over a few hundred dollars every time something feels "off". The current crop of devices is not affordable to them, but 5-10 years from now they'll be bundled in cereal boxes. Hook up sensors to wearables, catch diseases early and at a massive scale, cure or treat them before they get extremely expensive. To me it looks like it's the only way out of the ripoff "healthcare" scheme we're in right now. I'm pretty convinced the solution to the US healthcare problem will be technological in nature. And don't tell me universal healthcare will fix things. It won't, because US doctors (unlike their counterparts elsewhere) expect to be earning a pretty penny after they go through the trouble (and expense) of educating themselves for a decade, and that's not going to change. There simply needs to be less demand for doctors, and the ones that remain should be able to use their time efficiently.
- whymauri 8y ago
  Smart/Self-serving diagnostic tools occasionally fail for legal feasibility reasons before they are adopted by the market. Consider a smart heart monitoring system, maybe connected to a canary that will alert a healthcare professional or first responders if something is amiss. Absolutely nobody wants to be liable for misdiagnosing acute symptoms, which may lead to death or false positives. It doesn't even have to be acute symptoms, either. A large healthcare company a friend worked at was working on a smart heart monitor that for some reason they wanted to connect to an app. In their head, the app would be used by both the patient and their doctor who would check on the patient. If they have a lot of patients, that's an overwhelming amount of data streaming in 24/7. The time commitment to really evaluate those data for anomalies was too high, as were the stakes. Doctors were scared that if they missed something they might be held liable for unrelated medical emergencies which is terrifying for them. At the time, algorithms were really not good enough to catch the really subtle markers of an impending medical problem. At least according to the guy that told me this, he was a biomed/hardware engineer not a programmer or statistician by any means. Even if you had some legalese associated with the product to make this a non-issue, doctors still wouldn't trust the idea. So they pivoted the technology to something else that was more traditional. It is much harder to pursue justice for an algorithm than a human. I guess what I want to get at here is: sometimes the software and hardware are working as intended, but subtleties can be lost on the technical side (programmers, biomed engineers) can kill a product. Stuff like market research, liability and legality, and public perception of the tech.
  - m0zg 8y ago
    Sure, there will be cases where your device will say "I'm at a loss here, go see a doctor". The point is, right now the majority of (very expensive!) doctor visits are a total waste of everyone's time, and your money. There's no rational reason why I need to drive to a lab for bloodwork or simple diagnostics, and have a human do it: a robot at a local convenience store should be able to do the job. There's no rational reason why I need a doctor to misdiagnose my elbow pain as something requiring surgical intervention (I just stopped using my laptop in bed and it went away). Another doctor ordered a ($900) MRI to diagnose pain in my left shoulder and then told me I have a SLAP tear there based on extremely blurry results (again $$$$, surgical intervention, and 6 months of recovery). Bullshit, bud, I don't - it's a non-dominant arm, and I'm someone who doesn't do a lot of throwing or work above shoulder level. It was that dang laptop in bed again. Someone with weaker critical thinking skills and google-fu would be thousands of dollars poorer thanks to taking that doctor's "advice". In fact they could end up with a permanently fucked up shoulder and elbow, too. Did you know that medical errors are the third leading cause of death in the US, right after heart attack and cancer? Seems to me that "human" doctors are also a dangerous proposition.
dpatru 8y ago
You don't have to be rude... > What's the utility of "EKG" [sic] … What’s the Difference Between ECG and EKG? The fact of the matter is that an ECG and an EKG are the exact same thing. That’s right, the most surprising difference between an ECG and an EKG is that there is no difference at all. Both ECG and EKG stand for electrocardiogram. So, if an ECG is the same thing as an EKG, then why are there two different abbreviations? It’s actually quite simple—when the word electrocardiogram is translated into the German language, it is spelled Elektro-kardiographie. EKG is just the way some people choose to say ECG based on this translation. From http://neurosky.com/2015/05/ecg-vs-ekg-whats-the-difference/ http://neurosky.com/2015/05/ecg-vs-ekg-whats-the-difference/
- whymauri 8y ago
  EKG also avoids confusing patients. ECG and EEG are a little to close to each other. And don't get me started on explaining what EGG is when you already have ECG and EEG to worry about.

m0zg 8y ago

Sure, I realize there's much that the current tech does not cover. But you gotta start somewhere, and through extremely wide deployment tens of thousands of lives will be saved, and important feedback will be collected to improve products. $400 watch that does a dozen other things and that the user would buy even if it didn't have ECG is not "expensive diagnostics". This is where things are at, whether you like it or not, especially for the working poor who can't afford to fork over a few hundred dollars every time something feels "off". The current crop of devices is not affordable to them, but 5-10 years from now they'll be bundled in cereal boxes. Hook up sensors to wearables, catch diseases early and at a massive scale, cure or treat them before they get extremely expensive. To me it looks like it's the only way out of the ripoff "healthcare" scheme we're in right now. I'm pretty convinced the solution to the US healthcare problem will be technological in nature. And don't tell me universal healthcare will fix things. It won't, because US doctors (unlike their counterparts elsewhere) expect to be earning a pretty penny after they go through the trouble (and expense) of educating themselves for a decade, and that's not going to change. There simply needs to be less demand for doctors, and the ones that remain should be able to use their time efficiently.

whymauri 8y ago
Smart/Self-serving diagnostic tools occasionally fail for legal feasibility reasons before they are adopted by the market. Consider a smart heart monitoring system, maybe connected to a canary that will alert a healthcare professional or first responders if something is amiss. Absolutely nobody wants to be liable for misdiagnosing acute symptoms, which may lead to death or false positives. It doesn't even have to be acute symptoms, either. A large healthcare company a friend worked at was working on a smart heart monitor that for some reason they wanted to connect to an app. In their head, the app would be used by both the patient and their doctor who would check on the patient. If they have a lot of patients, that's an overwhelming amount of data streaming in 24/7. The time commitment to really evaluate those data for anomalies was too high, as were the stakes. Doctors were scared that if they missed something they might be held liable for unrelated medical emergencies which is terrifying for them. At the time, algorithms were really not good enough to catch the really subtle markers of an impending medical problem. At least according to the guy that told me this, he was a biomed/hardware engineer not a programmer or statistician by any means. Even if you had some legalese associated with the product to make this a non-issue, doctors still wouldn't trust the idea. So they pivoted the technology to something else that was more traditional. It is much harder to pursue justice for an algorithm than a human. I guess what I want to get at here is: sometimes the software and hardware are working as intended, but subtleties can be lost on the technical side (programmers, biomed engineers) can kill a product. Stuff like market research, liability and legality, and public perception of the tech.
- m0zg 8y ago
  Sure, there will be cases where your device will say "I'm at a loss here, go see a doctor". The point is, right now the majority of (very expensive!) doctor visits are a total waste of everyone's time, and your money. There's no rational reason why I need to drive to a lab for bloodwork or simple diagnostics, and have a human do it: a robot at a local convenience store should be able to do the job. There's no rational reason why I need a doctor to misdiagnose my elbow pain as something requiring surgical intervention (I just stopped using my laptop in bed and it went away). Another doctor ordered a ($900) MRI to diagnose pain in my left shoulder and then told me I have a SLAP tear there based on extremely blurry results (again $$$$, surgical intervention, and 6 months of recovery). Bullshit, bud, I don't - it's a non-dominant arm, and I'm someone who doesn't do a lot of throwing or work above shoulder level. It was that dang laptop in bed again. Someone with weaker critical thinking skills and google-fu would be thousands of dollars poorer thanks to taking that doctor's "advice". In fact they could end up with a permanently fucked up shoulder and elbow, too. Did you know that medical errors are the third leading cause of death in the US, right after heart attack and cancer? Seems to me that "human" doctors are also a dangerous proposition.

dpatru 8y ago

You don't have to be rude... > What's the utility of "EKG" [sic] … What’s the Difference Between ECG and EKG? The fact of the matter is that an ECG and an EKG are the exact same thing. That’s right, the most surprising difference between an ECG and an EKG is that there is no difference at all. Both ECG and EKG stand for electrocardiogram. So, if an ECG is the same thing as an EKG, then why are there two different abbreviations? It’s actually quite simple—when the word electrocardiogram is translated into the German language, it is spelled Elektro-kardiographie. EKG is just the way some people choose to say ECG based on this translation. From http://neurosky.com/2015/05/ecg-vs-ekg-whats-the-difference/ http://neurosky.com/2015/05/ecg-vs-ekg-whats-the-difference/

whymauri 8y ago
EKG also avoids confusing patients. ECG and EEG are a little to close to each other. And don't get me started on explaining what EGG is when you already have ECG and EEG to worry about.