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AI Can Detect Alzheimer’s Disease Six Years Before a Diagnosis
- classics2 8y agoTypically Alzheimer’s diagnoses are given with extreme reluctance, it changes how every person that interacts with that patient will view their condition, prognosis and treatment options. I think that has more to do with the extended time frame than the actual ability of family and medical providers to see changes in a patient cognition and abilities.
- djohnston 8y agoi think these early diagnostic techniques are a necessary brick on the road to curing AD. by the time people are showing clinical symptoms the disease has already progressed and has been doing so for decades. treatments that slow progression will be more effective if administered earlier on in the progression.
- rincebrain 8y agoThat seems like a problem subject to heavy confirmation bias - e.g. people decide their relative is cognitively impaired and see any transient shortfall as being more evidence, rather than any number of other possible causes. (Not that you can't necessarily see cognitive decline externally earlier than a diagnosis, just that it seems like it'd be hard to make a clinical argument about persistent decline versus several poor nights of sleep, for example.)
- vegardx 8y agoIt also triggers a lot of legal implications. In Norway your divorce is automatically approved if your spouse is diagnosed with Alzheimer's.
- tigershark 8y agoSeriously? It seems really inhuman to me.
- trisiak 8y agoYou mean the fact that divorce needs to be approved...?
- tyfon 8y agoSince a marriage is a legal binding there are procedures for a divorce. You need to live separated for one year to have it approved for one thing. And if you have children under guardianship you are required to attend family counseling or such. I assume that what is refereed to in the upper comment is the waiting period and other requirements. Personally I did not know this was the case with altzheimer even though I am Norwegian.
- AlexCoventry 8y agoIn Norway the government takes responsibility for health care, so it's less horrible than it would be in, say, the US.
- criddell 8y agoI feel the opposite. If I was unhappy in my marriage and found out my spouse now also has Alzheimer's, granting a quick exit from a situation that can only get worse seems humane to me. Why force somebody who is suffering to suffer even more?
- gjm11 8y agoMaking it easier to divorce your spouse if they get Alzheimer's is more humane for spouses of Alzheimer's victims (who get to escape that unpleasant situation more easily) and more inhumane for Alzheimer's victims themselves (who are more likely to find themselves abandoned at a time when they are increasingly unable to cope on their own).
- 8y ago
- dsfyu404ed 8y agoSeems like a great incentive to pay off a doctor to diagnose someone so you can lose less money, get the kids, have another bargaining chip in a messy divorce, etc, etc. Edit: Pointing out flaws/possible exploits in a system is not the same thing as endorsing their use.
- WrtCdEvrydy 8y agoDoesn't mean you don't have to pay alimony.
- deleted 8y ago[deleted]
- SketchySeaBeast 8y agoIn that case the same could be done with sexual assault or abuse allegations. There's no end to possible duplicity, this doesn't really extend it, especially as Alzheimer's is going to be a super specific diagnosis. What is the Venn diagram of people who are fighting over kids and also suffering from Alzheimer's?
- aaaaaaaaaab 8y agoApproved? Why is an approval even needed? They can force people to stay married in Norway by not approving a divorce?
- vegardx 8y agoUnless you want to involve a judge and a legal process I imagine you usually need two signatures, at the very least. In Norway there are other requirements as well.
- pvaldes 8y agoAnd this people can be also sort of 'legally sequestered' by the government. I know a case and is horrifying to see it.
- pvaldes 8y agoEDIT -> legally kidnapped is the correct word
- offsetr 8y agoSome people with a unique gift in sense of smell can do it even better than 6 years.
- socceroos 8y agoAnecdotally, and slightly off-topic, I was able to smell when my wife was pregnant before we were able to find out with a test or late period. Not sure if that's relatively normal or not though.
- londons_explore 8y agoThat "not a sexy person" smell in the early stages of pregnancy must kill a lot of relationships at just the wrong time...
- sierdolij 8y agoSorry, what do you mean? Are there examples?
- rincebrain 8y agoThere was a specific case of a woman who realized, after her husband acquired a peculiar smell and was 6 years later diagnosed with Parkinson's, then everyone at a Parkinson's support group had that smell, that she could smell Parkinson's in people well before any clinical tests. She went to researchers who tested her with sweat from 6 diagnosed patients and 6 controls - she identified the 6 diagnosed patients correctly, and one of the controls who was later diagnosed with it but had not been yet. https://www.telegraph.co.uk/science/2017/12/18/woman-can-smell-parkinsons-disease-helps-scientists-develop/ https://www.telegraph.co.uk/science/2017/12/18/woman-can-sme... (Also, as a fascinating aside which probably isn't what the GP comment meant, _loss_ of sense of smell is one of the earliest symptoms of Alzheimer's or Parkinson's. Why? Good question.)
- krzat 8y agoIf a human can smell Parkinson, I wonder what a dog could smell.
- jobigoud 8y ago> No cure exists for Alzheimer’s disease, but promising drugs have emerged in recent years that can help stem the condition’s progression. What are the downsides of these treatments on a healthy brain? Why are we not administering them preventively to anyone with a family history of AD?
- ralfd 8y ago> promising drugs have emerged in recent years To recent yet.
- vegardx 8y agoWe are, sort of. We've added lithium to drinking water which has been linked to decrease in dementia. People that suffer from bipolar disorder and are being treated with lithium seems rarely if ever to develop dementia, but the dosages are much much (1000 times, or so) higher than what we add to drinking water. According to my doctor the primary issue with adding higher concentration of lithium (still, way below therapeutic levels for mental disorders) to drinking water is quacks that make a lot of noise when the topic comes up. They see it as adding mind altering chemicals to water, which couldn't be further from truth.
- moreira 8y agoWell, if they’re reducing the incidence of dementia, and you would’ve gotten dementia otherwise... they -did- alter your mind. And that’s a good thing. People and their fear of chemicals though. Reminds me of http://www.dhmo.org http://www.dhmo.org
- quotemstr 8y agoLithium is linked to all sorts of behavioral changes though. Who knows what microdosing the entire population would do? I really don't think it's fair to describe opposition to this sort of project as arising from "quacks".
- justtopost 8y agoI used to see people rant about 'chemicals in the water changing our behavor' and think insanity. Now I am somewhat relieved I have a private well on a secluded aquifier. Just a byproduct of rural life, overblown I am sure, but it puts the mind at ease when I read this kind of thing. PSA: suppliment floride if on a well, your otc toothpaste is not enough.
- ThePhysicist 8y agoPresenting the true positive rate without mentioning false positives seems problematic. I couldn’t find any information about that in the article, and they don’t link the paper / publication.
- mtgx 8y agoIt's not problematic. It's on purpose and it's criminally misleading. If "AI companies" had to show their false positive rates, 99% of them would go bankrupt because then nobody would want to buy their bullshit.
- samfriedman 8y agoThe paper itself [0] claims 82% specificity and 100% sensitivity. Meaning, 100% of positive cases in the test set were correctly identified, and 82% of negative cases in the test set were correctly identified. That corresponds to a 0% false negative rate and an 18% false positive rate. The test set is 40 imaging studies from 40 patients. [0] https://pubs.rsna.org/doi/pdf/10.1148/radiol.2018180958 https://pubs.rsna.org/doi/pdf/10.1148/radiol.2018180958
- SolaceQuantum 8y agoWouldn’t 82% of negative cases being correctly identified mean that 18% of negative cases were incorrectly identified as positive(false positive), or in other words it will mistake 18% of healthy people as having Alzheimer’s, but will always identify an Alzheimer’s patient?
- samfriedman 8y ago82% true negative rate == 18% false positive rate. Your description is correct. It's likely that those statistics will be somewhat worse when the algorithm is tested on a broader and more diverse test set, which the authors claim to plan to do in the future.
- ThePhysicist 8y ago
- thegambit 8y ago*Machine Learning
- TaupeRanger 8y ago*Computational Statistics (a better name for both, given current methods, since it avoids anthropomorphism and sci-fi implications in uninformed readership).
- crb002 8y ago23–26 mSv of radiation. If the Alzheimer's doesn't kill you the PET scan will from a secondary cancer.
- ceejayoz 8y agohttps://www.nrc.gov/reading-rm/doc-collections/fact-sheets/bio-effects-radiation.html https://www.nrc.gov/reading-rm/doc-collections/fact-sheets/b... > The data show high doses of radiation may cause cancers. But there are no data to establish a firm link between cancer and doses below about 10,000 mrem (100 mSv – 100 times the NRC limit).
- sameschker 8y agoI found the publication that the article discusses. https://pubs.rsna.org/doi/pdf/10.1148/radiol.2018180958 https://pubs.rsna.org/doi/pdf/10.1148/radiol.2018180958
- smartbit 8y agoAnd the full publication can be found by entering https://doi.org/10.1148/radiol.2018180958 https://doi.org/10.1148/radiol.2018180958 into sci-hub. I often see https://outline.com/ https://outline.com/ links on HN, does HN allow sci-hub links?
- gyvastis 8y agoThanks for the cool tool, didn't knew about it!
- bougiefever 8y agoMy grandmother died from this, and it is a horrible death. I really fear becoming a victim to this disease. Anything that can help, even a little, is so encouraging.
- zwieback 8y agoHow do they compare the AI performance to that of radiologists? The abstract says that radiologists aren't as good at spotting subtle, diffuse changes but what metric did they use to compare?
- Eridrus 8y agoYou get historical PET scans from years ago and label them with whether they turned out to have Alzheimer's later in their life or not.
- gesman 8y ago"People never lie so much as after a hunt, during a war or before an election" -- Otto von Bismarck This quote need to be updated for modern times regarding performance of AI/ML models.
- m15i 8y agoI'm a co-author of this paper and happy to answer any questions.
- Traster 8y agoI find it really interesting that you used machine learning to do the diagnosis given the data you had available - scans seem to be naturally similar to images that we use neural networks on today so t he fit seems good. I was wondering though, did you have any ability to dissect the algorithm after it was trained and see what exact characteristics it was looking for? The reason I ask is because there's some description of the processes we know indicate Alzheimers, but there could be new signs this algorithm has identified that could be applied more directly?
- johnnyfived 8y agoNo questions here, but you guys might be interested to see the implementation I took with this, where I also used machine learning for Alzheimer's / dementia diagnosis. https://github.com/jddunn/dementia-progression-analysis https://github.com/jddunn/dementia-progression-analysis I was using OASIS's public dataset so I only had ~150 images to work with, instead of ~2000. I used transfer learning from ImageNet's dataset to try and get usable results. I also had super limited testing (15-20 patients), but got ~60% accuracy with ~13% false positive rate. It could be useful to apply those same transfer learning techniques in your team's model.
- alexnewman 8y agoThis is a great thing, but i wonder if it's actionable. What are the insurance impacts?
- mendelsd 8y agoInteresting that glucose levels are used, since they are significantly affected by diet: https://biology.stackexchange.com/questions/55853/what-is-the-brains-preferred-energy-source-glucose-or-ketones https://biology.stackexchange.com/questions/55853/what-is-th...