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I was thinking more like ultrasound. If some crude scanner was cheap enough for every GP's office to have, and an AI could decipher the noisy signal which is pe
by exporectomy 5y ago
I was thinking more like ultrasound. If some crude scanner was cheap enough for every GP's office to have, and an AI could decipher the noisy signal which is perhaps too messy for a human to read, it could be used routinely like blood pressure measurement and stethoscopes are.
If it's a regular screening test rather than a response to the patient's complaint, then false negatives wouldn't be as much of a problem because at least it's better than nothing.
- gjulianm 5y agoUltrasound scanners are fairly cheap. But operating them is not easy, you still need training to use them and know what you're looking at. > it's better than nothing. Not necessarily, that's the issue with screening asymptomatic people. You have to balance the consequences and rates of false positives with the benefits of true positives. If ultrasound screening mostly catches indolent diseases, or those where catching them so early doesn't affect outcomes too much; and you have a lot of people going through unnecessary/risky tests, you might end up doing more damage with those screenings. It's not so easy.
- Enginerrrd 5y agoThe potential harm runs deeper than this even. Once a structural abnormality is found, the nocebo effect can come into play and essentially cause symptoms in asymptomatic people, which is a terrible result.
- inglor_cz 5y agoAlso, one thing that is found does not preclude existence of other things to be found. The first discovered problem may attract so much attention that potential others are neglected. Tl;dr: the first diagnosis tends to stick with the patient.
- exporectomy 5y agoI know that can be an issue but like you say, there's a balance and I don't think we know where that balance is for the non-existent AI technology with unknown error rates. Newborn babies undergo a whole lot of simple and inaccurate screenings. I guess those are cases where the harm due to inappropriate treatments is lower than that due to leaving diseases undetected. Either way, I'd rather the technology exist and then people work out how best to use it, rather than the decision being forced on us by it not existing.
- hdhjebebeb 5y agoI had an abdominal ultrasound recently - the actual process of placing the probe and annotating the images seems like a pretty specific technical skill. I don't think any old person (or even a doctor) off the street can just rub the wand on you and find your kidneys for instance.
- azalemeth 5y agoIndeed. US is a highly technical, specific skill. Even within a specific use case -- e.g. echocardiography -- there's a specific series of qualifications that cardiologists need to get in order to be deemed competent. The rotation of your hand in a specific position in transthoracic echocardiography can change the resulting ejection fraction of the heart -- the main functional outcome. It's a simple thing to see done; quite another for you to do yourself and make safe decisions.
- exporectomy 5y agoThat's the idea of using AI. So the operator doesn't have to be skilled at identifying things.
- sjg007 5y agoI have had an abnormal ultrasound and then a CT negative. If AI can cut down the CTs it's a win.