4 ms·

> are tested as to if they work, not how they work Should they be doing both? I can't imagine shipping code that I don't know how it works, but it passes tests

> are tested as to if they work, not how they work Should they be doing both? I can't imagine shipping code that I don't know how it works, but it passes tests... Otherwise, you'll get pseudoscience - just mix random chemicals and see how patient reacts, rinse and repeat until something works...

boesboes 4y ago
> shipping code that I don't know how it works, but it passes tests We call that machine learning
- rmbyrro 4y ago
  What isn't machine learning is sometimes called "tested code"
fragcula 4y ago
The psychiatrists themselves don't need to do both, as doctors practicing EBM they are interested in proven results. The decision to recommend a treatment (and to accept it) is based on the pros and cons only. What people really care about is side effects. That's one of the reasons modern pharmas are so fixated in testing old drugs for new disorders (the other reason is they might be able to get a new patent case in point when Eli Lilly made pink fluoxetine for girls with a new indication for PMS [0]). Similarly, the best way to identify side effects is by looking at the molecule and guessing (static analysis), testing with cells, animals or other non-human biological systems (I guess this is alpha testing as we rarely think of the testers as human...), and then in human studies (early access). Even then we roll out incrementally (phase 2), before widely testing in phase 3 and collecting feedback. [0] https://money.cnn.com/2000/07/06/companies/lilly/ https://money.cnn.com/2000/07/06/companies/lilly/
vkou 4y ago
> Should they be doing both? I can't imagine shipping code that I don't know how it works, but it passes tests... If that were the criteria, then we would not have medicine at all, because biological systems are so incredibly complicated, nobody understands even a tiny fraction of how a particular chemical will affect them.
- harshreality 4y ago
  I don't think that's quite accurate. We know first-order biochemical effects for a lot of drugs. There are always side effects, but they're side-effects, and those are largely understood as well. Psych drugs have difficulties because they aren't used for their biochemical effects, they're used for their psychological effects, and psychological effects of biochemical processes are poorly understood.
  - fragcula 4y ago
    An extra foible is that many medications have psychiatric side effects. So even if you're prescribed a statin for the biochemical effect on cholesterol you might get some of the purported psychiatric effects.
kurikuri 4y ago
>Should they be doing both? Yes, but with different aims. The learning about ‘how a treatment works’ is useful for developing new potential treatments and new hypotheses, but the mechanism itself is not necessary nor sufficient in its potential treatment efficacy.
workingon 4y ago
Welcome to modern medicine.

boesboes 4y ago

> shipping code that I don't know how it works, but it passes tests We call that machine learning

rmbyrro 4y ago
What isn't machine learning is sometimes called "tested code"

fragcula 4y ago

The psychiatrists themselves don't need to do both, as doctors practicing EBM they are interested in proven results. The decision to recommend a treatment (and to accept it) is based on the pros and cons only. What people really care about is side effects. That's one of the reasons modern pharmas are so fixated in testing old drugs for new disorders (the other reason is they might be able to get a new patent case in point when Eli Lilly made pink fluoxetine for girls with a new indication for PMS [0]). Similarly, the best way to identify side effects is by looking at the molecule and guessing (static analysis), testing with cells, animals or other non-human biological systems (I guess this is alpha testing as we rarely think of the testers as human...), and then in human studies (early access). Even then we roll out incrementally (phase 2), before widely testing in phase 3 and collecting feedback. [0] https://money.cnn.com/2000/07/06/companies/lilly/ https://money.cnn.com/2000/07/06/companies/lilly/

vkou 4y ago

> Should they be doing both? I can't imagine shipping code that I don't know how it works, but it passes tests... If that were the criteria, then we would not have medicine at all, because biological systems are so incredibly complicated, nobody understands even a tiny fraction of how a particular chemical will affect them.

harshreality 4y ago
I don't think that's quite accurate. We know first-order biochemical effects for a lot of drugs. There are always side effects, but they're side-effects, and those are largely understood as well. Psych drugs have difficulties because they aren't used for their biochemical effects, they're used for their psychological effects, and psychological effects of biochemical processes are poorly understood.
- fragcula 4y ago
  An extra foible is that many medications have psychiatric side effects. So even if you're prescribed a statin for the biochemical effect on cholesterol you might get some of the purported psychiatric effects.

kurikuri 4y ago

>Should they be doing both? Yes, but with different aims. The learning about ‘how a treatment works’ is useful for developing new potential treatments and new hypotheses, but the mechanism itself is not necessary nor sufficient in its potential treatment efficacy.

workingon 4y ago

Welcome to modern medicine.