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My usual example is the NHS. A lot of medical imaging AI papers are published using NHS data with great claims like "Normal chest radiographs were detected by

by riahi 7y ago

My usual example is the NHS. A lot of medical imaging AI papers are published using NHS data with great claims like "Normal chest radiographs were detected by our AI system with a sensitivity of 71%, specificity of 95%, PPV of 73%, and NPV of 94%. The average reporting delay was reduced from 11.2 to 2.7 days for critical imaging findings (P < .001) and from 7.6 to 4.1 days for urgent imaging findings (P < .001) in the simulation compared with historical data." https://pubs.rsna.org/doi/10.1148/radiol.2018180921 https://pubs.rsna.org/doi/10.1148/radiol.2018180921 Except their baseline image interpretation turnaround times (TAT) are completely incompatible with the US. If any radiology group sat on an exam for 11 days, they'd fired by the end of the month. Many hospital medical staff bylaws require final signed reports within 24-48 hours, not even including the professional fee interpretation contracts which can set TATs at 30 minutes. You can't provide that level of service with NHS-type funding. Oz is probably one of the few systems that's currently functioning well. There's a ton of reasons British consultants leave for there.

kirrent 7y ago
> You can't provide that level of service with NHS-type funding. The crisis with the NHS is not only a mismanagement crisis but also a funding crisis so I think they'd agree. Happily, healthcare funding could be increased to more normal levels (in comparison to other well functioning public healthcare systems as a share of GDP) and still be well short of the high costs of the US. The UK government just prefers austerity over properly functioning healthcare.
joe_the_user 7y ago
So combining your comments with the other comments on the thread. Radiology has to have a 48 turn-around but it's OK if many patient don't actually see a doctor without multi day waiting times and some portion can't see doctors in any reasonable timeframe. But radiology, we got that covered! It is an important part of health care but it is clear US priorities as reflected in "standards of care" are completely off-kilter (if you're not seeing a doctor at all, radiology turn-around can't help you or is there something I'm missing). The way standards of care drives up costs seems like a scam but I know not all of it's a scam. In ways it's worse, in the sense it's harder to get a handle-on and stop, being a spectrum that shades from mostly scam to actually good but sometimes too-expensive approaches and so-forth.
tim333 7y ago
>You can't provide that level of service with NHS-type funding Places like Singapore do well at providing good service on sub NHS funding. Also people actually like the system there unlike the US and to some extent the NHS. (Brit here - NHS is ok but a bit rubbish at times). I think it's worthy of study / emulation. I think they are something like 1/3 or 1/4 of US spend and #1 life expectancy in 2019 vs like #30 something for the US.
- VRay 7y ago
  I hate the US' health care system as much as anyone, but I don't think it's reasonable to compare Singapore to the USA that way Singapore is the size of a US city and has a population of 6 million

by riahi 7y ago

kirrent 7y ago

> You can't provide that level of service with NHS-type funding. The crisis with the NHS is not only a mismanagement crisis but also a funding crisis so I think they'd agree. Happily, healthcare funding could be increased to more normal levels (in comparison to other well functioning public healthcare systems as a share of GDP) and still be well short of the high costs of the US. The UK government just prefers austerity over properly functioning healthcare.

joe_the_user 7y ago

So combining your comments with the other comments on the thread. Radiology has to have a 48 turn-around but it's OK if many patient don't actually see a doctor without multi day waiting times and some portion can't see doctors in any reasonable timeframe. But radiology, we got that covered! It is an important part of health care but it is clear US priorities as reflected in "standards of care" are completely off-kilter (if you're not seeing a doctor at all, radiology turn-around can't help you or is there something I'm missing). The way standards of care drives up costs seems like a scam but I know not all of it's a scam. In ways it's worse, in the sense it's harder to get a handle-on and stop, being a spectrum that shades from mostly scam to actually good but sometimes too-expensive approaches and so-forth.

tim333 7y ago

>You can't provide that level of service with NHS-type funding Places like Singapore do well at providing good service on sub NHS funding. Also people actually like the system there unlike the US and to some extent the NHS. (Brit here - NHS is ok but a bit rubbish at times). I think it's worthy of study / emulation. I think they are something like 1/3 or 1/4 of US spend and #1 life expectancy in 2019 vs like #30 something for the US.

VRay 7y ago
I hate the US' health care system as much as anyone, but I don't think it's reasonable to compare Singapore to the USA that way Singapore is the size of a US city and has a population of 6 million