4 ms·

That’s completely true but doctors also miss things, or make errors, that would have been trivially caught by a deterministic rule-based system. Just look at h

That’s completely true but doctors also miss things, or make errors, that would have been trivially caught by a deterministic rule-based system. Just look at how successful checklists have been in surgery (or air transport), that’s a very simple rule-based system that has saved countless lives. Helping doctors to diagnose effectively requires someone to ask them the right questions. All too often the job of asking questions is left to the patient.

Retric 4y ago
Checklists are great for surgery or routine care because the goal is well understood. Diagnosis is more complicated though I agree a deterministic rule-based system can be useful for first responders and emergency rooms. Prescreening questions asked by a nurse and fed into a rule based system might be helpful in general medicine. The issue is when you have access to someone’s medical history that extremely useful information doesn’t fit well with rule based diagnosis. Similarly a comprehensive and deterministic system would need to include questions for an insane number of edge cases making it difficult to use. Do you really add an option for actually blue skin because of these people: https://en.wikipedia.org/wiki/Blue_Fugates https://en.wikipedia.org/wiki/Blue_Fugates I could see an AI that that recommends medical tests or diagnosis could be useful, rule based systems just seem overly limited.
- mindslight 4y ago
  From my programmer perspective, the point of automating deterministic rule-based systems is so that the humans involved can/will move on to applying non-deterministic intuition-based reasoning - what I would call "intelligence". It feels like most doctors I've met informally run the deterministic rules in their head (as they've been doing for N decades), and then mostly consider themselves having done their job. This makes for a nice and easy job for the common cases, but ends up dropping the uncommon cases on the floor.
  - DigDugDude 4y ago
    As I said above, there is widespread use of clinical decision support systems already. They do things like flag patients that the program determines might have sepsis in the hospital. The issue is, even these relatively simple programs generate large numbers of false positives and negatives. Now, let's say someone has an uncommon cause of epigrastric pain. Epigastric pain is a very non-specific symptom to begin with. So, the amount of rule based work up you can do on that information alone even for common causes is very small. Nevermind the uncommon causes. Accurately diagnosing and following up on each patient that walks through your door over the course of an entire 80 year medical history is infinitely more complex than getting a plane from point A to point B. And, the problem of people giving up after having worked through algorithms isn't necessarily solved by more and more formal algorithms. Airline safety is actually a perfect example of why that is the case. Plenty of cases of pilots getting fixated on what the auto pilot is telling them.

Retric 4y ago

Checklists are great for surgery or routine care because the goal is well understood. Diagnosis is more complicated though I agree a deterministic rule-based system can be useful for first responders and emergency rooms. Prescreening questions asked by a nurse and fed into a rule based system might be helpful in general medicine. The issue is when you have access to someone’s medical history that extremely useful information doesn’t fit well with rule based diagnosis. Similarly a comprehensive and deterministic system would need to include questions for an insane number of edge cases making it difficult to use. Do you really add an option for actually blue skin because of these people: https://en.wikipedia.org/wiki/Blue_Fugates https://en.wikipedia.org/wiki/Blue_Fugates I could see an AI that that recommends medical tests or diagnosis could be useful, rule based systems just seem overly limited.

mindslight 4y ago
From my programmer perspective, the point of automating deterministic rule-based systems is so that the humans involved can/will move on to applying non-deterministic intuition-based reasoning - what I would call "intelligence". It feels like most doctors I've met informally run the deterministic rules in their head (as they've been doing for N decades), and then mostly consider themselves having done their job. This makes for a nice and easy job for the common cases, but ends up dropping the uncommon cases on the floor.
- DigDugDude 4y ago
  As I said above, there is widespread use of clinical decision support systems already. They do things like flag patients that the program determines might have sepsis in the hospital. The issue is, even these relatively simple programs generate large numbers of false positives and negatives. Now, let's say someone has an uncommon cause of epigrastric pain. Epigastric pain is a very non-specific symptom to begin with. So, the amount of rule based work up you can do on that information alone even for common causes is very small. Nevermind the uncommon causes. Accurately diagnosing and following up on each patient that walks through your door over the course of an entire 80 year medical history is infinitely more complex than getting a plane from point A to point B. And, the problem of people giving up after having worked through algorithms isn't necessarily solved by more and more formal algorithms. Airline safety is actually a perfect example of why that is the case. Plenty of cases of pilots getting fixated on what the auto pilot is telling them.