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Grail wrongly told hundreds of people they might have cancer
- userbinator 3y agoMore than half the erroneous letters were sent to customers who hadn't had their blood drawn yet for the Galleri test, the spokeswoman added. That would probably invoke an "I'm being phished" reaction if I were in that situation, but I do wonder if the average person would realise the impossibility of the situation.
- etiennebausson 3y agoIf this is a company I just bought a product from, I wouldn't got to the phishing explanation first. I would think the company is running a scam and sending random replies, astrology style, and that I got through a crack in their system.
- ClosedPistachio 3y agoI read the title quickly as Gmail and was very concerned and confused...
- wpietri 3y agoMore and more I think "software" and "developer" are over-broad terms. "Move fast and break things" can be fine for projects where errors don't cause significant harm. But it seems dangerous to me to think that job's the same as one where it becomes "move fast and break people".
- jmcgough 3y agoDid you read the article? It doesn't seem like they did anything wrong beyond giving too much power to a 3rd party vendor.
- deleted 3y ago[deleted]
- SkyPuncher 3y ago“Third party” is not an excuse for “first party” First party is fully responsible for what vendors they choose to use. As a customer, I have little insight into that.
- wpietri 3y agoDid you? I have seen people get told they have cancer. That Grail can blame some other company is surely little consolation to people who spent 36 hours or more thinking they might be dead soon.
- heisenbit 3y agoCareful selection and monitoring remains their responsibility and accountability typically remains with them. Delegation is not risk free although plenty of managers pretend otherwise.
- cycomanic 3y agoI read the article, in my book the option of sending out a mass email of "you have cancer" should have been impossible. If a test showed that there is potential for cancer the email should have always been written by a real human. Instead it seems the "you have cancer" template sits in the same system with all the other "customer engagement" emails. If that's not a "sign of moving fast and break things" then I don't know. These different topics should have been compartmentalised into totally different departments that don't have anything to do with each other.
- Al-Khwarizmi 3y agoIf you're sending thousands of emails with essentially identical content, it seems pointless to me to have them written by a human. Can you imagine the job of a human writing different wordings for "you have cancer" hundreds of times per day? Is that what we should be using humans for?
- wpietri 3y agoThey have already explained the point. It's reducing the number of people who are incorrectly told they may soon die a horrible death. If there are better ways to prevent that than a human-in-the-loop approach, feel free to propose it. But having watched it happen a couple of times, I'll note that actual doctors deliver cancer diagnoses in person, so it's not unreasonable to think that should continue to be the case.
- aaron695 3y ago[dead]
- DoreenMichele 3y agoThere should be more emphasis on taking things slow and doing it right in the healthcare industry. I've also seen stuff that suggests overworked healthcare providers make more mistakes.
- nradov 3y agoI would certainly agree with that for developing new diagnostic assays. But unfortunately clinicians doing direct patient care seldom have the luxury of taking things slow. Demand is growing every year and we aren't adding new providers at the same rate. Taking things slow with one patient means another patient has to wait in line.
- DoreenMichele 3y agoIf you don't have time to do it right, when are you going to find time to do it over?
- nradov 3y agoThat's easy to say when you don't have patients backed up and waiting.
- DoreenMichele 3y agoThat's extremely easy to say as someone with a serious medical condition who desperately wishes the TV show House were reality. I've read plenty of similar stories to mine. I came to hate the 15 minute appointment with a passion.
- 9991 3y ago15 minutes? Why so long?
- AlotOfReading 3y agoOn a system level, a false positive like this usually generates many, many follow-ups and additional tests just to be safe. That additional patient is now waiting significantly longer for the system to clear the backlog of high priority false alarms. We can't ethically deny people care they actually need, so the most important tool we have to optimize healthcare resources is to avoid doing unnecessary things, even if it may seem slower upfront.
- mo_42 3y agoWhat would be the harm? It’s a blood test for a broad spectrum of cancers. So any doctor and patient should know that there is a non-zero false positive rate. So the harm could be CT scans, biopsies, colonoscopies, … Also some kind of psychological trauma about the positive test result. I would have liked to see the real error rates and how many tests they're selling. It seems like this is not part of the false positive rate of the medical test itself. But it is part of the overall false positive rate of the organization.
- eska 3y agoThe problem is the same as what destroyed the diagnosis through expert systems the first time around in the 80s/90s.. the software adds an asterisk behind every diagnosis, whether positive or negative, and says “..but talk to your doctor to be sure”. The consequence is that patients flood doctors, and you might as well remove the software from the equation.
- mo_42 3y agoEvery test has some failure rate aka asterisk. A priori a we cannot dismiss a test for a high failure rate. It depends on how severe the condition is. So for really nasty cancers, we accept higher false positive rates because of the severe consequences. I don’t know about these expert systems. Might very well be that they were overall useless. Another scenario where it’s plausible is skin cancer. Let’s say there’s an app with a false positive rate of 10%. Now worried patients flood dermatologists. They quickly double check and send them home or treat them. Don’t nail me down on numbers here. But it seems like an acceptable situation given that more and more people are dying of skin cancer.
- eska 3y agoI think you may be underestimating the importance of this. Say you have a test that detects skin cancer 60% of the time. ..flipping a coin would do it 50% of the time. Such a test is pretty useless. Remember that you’re applying this diagnosis to the broad population, not somebody who came to your practice with an initial suspicion.
- mmoll 3y agoHow can you wrongly tell someone they might have cancer?
- adaml_623 3y agoYou might have cancer. Just as an example of how you might wrongly tell someone they might have cancer
- sebzim4500 3y agoBut it's true that he might have cancer? A decent portion of the population does, after all.
- krisoft 3y agoLet me show you a more clear example: "sebzim4500, we have analysed your blood sample taken on the 2nd of June, 2023. The GM2345 general immuno-assay test indicates the presence of anti-globulins which tells us that you possibly have Hodgkin's lymphoma. We recommend that you start chemotherapy immediately. Please contact our office to arrange your treatment." While it is true that you might have cancer (as you say a decent portion of the population does) but we know the above message is false. I do not have your blood sample, I did not run any tests, the name and description of the test is made up. All of these make the statement wrong. And in everyday vernacular someone might describe the above interaction as "sebzim4500 was wrongly told that he might have cancer."
- elif 3y agoThe grail test is very transparent that it is not a replacement for traditional cancer screening, but is a supplement to it. Even further, cancer screening is not a replacement for cancer diagnosis.
- bloak 3y ago"You might have cancer" is an example of a sentence whose meaning can't easily be analysed in terms of "truth conditions" (https://en.wikipedia.org/wiki/Truth_condition https://en.wikipedia.org/wiki/Truth_condition). When used appropriately, the speaker has information which they believe the listener does not already have and which, in the opinion of the speaker, should cause the listener to increase their estimate of the probabiliy of them having cancer ... or something like that. So the appropriateness of the statement depends rather crucially on the context and on prior knowledge. That's why sentences with the word "might" tend to become infuriatingly meaningless when quoted out of context by journalists.
- ramraj07 3y agoBill Burr put it correctly: "why would you send your saliva into the internet?" Don't. You don't have any guarantees that these dubious companies will do right by your DNA. I'm surprised when people who wouldn't keep Alexa in their homes would send their DNA to ancestry.com. Like do you realise DNA is forever? You AND your entire bloodline is now forsaken genetic privacy for all eternity! A single leak and your genetic data is out in the internet for perpetuity! I've even stopped giving blood samples to random pathology services and restrict to just one (no guarantees that they'll not fork me over either but at least minimise my exposure).
- elif 3y agoThis has absolutely nothing to do with DNA. The galleri test analyzes blood samples for certain forms of protein.
- blackbear_ 3y agoEvery time mistakes in cancer tests come up, I have to bring up this textbook counter-intuitive probabilistic result that happens when one tries to detect an a priori very rare condition. It follows from a straightforward application of Bayes formula: - Suppose a person has 1% chance of getting cancer, so p(cancer) = 0.01 - Suppose that the test has 99% sensitivity and specificity, i.e., p(positive | cancer) = p(negative | no cancer) = 0.99 (no test is perfect in the real world, in this case the test is wrong only one time every 100). - To use Bayes we first need the probability of a positive result regardless of disease status, i.e. p(positive) = p(positive | cancer) * p(cancer) + p(positive | no cancer) * p(no cancer) = 0.99 * 0.01 + 0.01 * 0.99 = 0.0198 - Then by Bayes we have p(cancer | positive) = p(positive | cancer) * p(cancer) / p(positive) = 0.99 * 0.01 / 0.0198 = 0.5 And things get worse the rarer the condition is. For example, when p(cancer) = 0.001 then p(cancer | positive) = 0.09, while for p(cancer) = 0.5 the computations above give p(cancer | positive) = 0.99. In other words, the rarer the condition, the more precise tests have to be to have confidence in its results.
- red0point 3y agoThe article is about a simple misconfiguration on their email campaign, nothing to do with their actual tests. It‘s a misleading title for sure.
- blackbear_ 3y agoYes, I know. The point that I was trying to make is that this is bound to happen again, even if everything is set-up correctly.
- Dylan16807 3y agoIf it's "set up correctly", then they'll only do a test like that if they have a reasonable follow-up test. In which case they will probably send a good and valid email and "this" is not what will happen.
- veltas 3y agoIn a sense this comment is still relevant, because from the grand perspective this email error could be considered a random failure on the part of the test in its full practical context. And it's not impossible it will happen again (in fact I expect it to). But it's certainly not characteristic of the test itself in theory, but is nevertheless characteristic of any such test that might involve bad IT. It's almost like test false-positive background radiation.
- disillusioned 3y agoEssentially, this was a misconfigured transactional email campaign, and not the result of an erroneous test or false positive, which is an important, if a bit buried, lede here.
- xnorswap 3y agoWhy is "You might have cancer" even an email at all? Shouldn't that be done face to face? When I was diagnosed with the cancer the nurses wouldn't even tell me I had cancer until I was sitting down with the haematologist, even so far as going to tell me when they asked me to come in to discuss my blood test that, "Don't worry that your appointment is in <St. Cancer wing>, that's just where our department is based". ( I didn't believe them, I was feeling incredibly rough at the time, cancer made sense. )
- deleted 3y ago[deleted]
- dieselgate 3y agoI remember very distinctly when my mom got the word over fax, not sure what communications were had before that. Wishing you good health
- PunchTornado 3y agoThe letter didn't said "You have cancer, tell bye to your loved ones" with big bold letters. It said something like you should come to the hospital for further checks. Which in the internal procedure is done only for those that the test detected with cancer. (Source I'm in the pilot)
- xnorswap 3y ago[flagged]
- deleted 3y ago[deleted]
- Someone 3y ago> Why is "You might have cancer" even an email at all? Shouldn't that be done face to face? Not necessarily, but you’d have to phrase it as “we need to take a closer look”. If you’re doing population screening, you often have so many false positives that the probability that you have cancer, given that you had a positive test result, still is fairly low (for example, if 1:10,000 people have cancer, and the test is 100% reliable for those having cancer, and 99% for qthose who don’t, ≈1:100 people will be false positives, so in the group who tested positive, ≈99:100 would be false positives)
- andy_ppp 3y agoDoctors can misdiagnose and misunderstand or even just plain confuse patients too. Grail (as I understand it) has the potential to completely revolutionise cancer treatment and while we shouldn’t go easy on them for a tech mistake like this we should get this technology rolled out and it might well save millions of lives. I bet the people who have now been told they don’t have cancer feel a great sense of relief and maybe a new desire to look after their health. Are we sure overall this sort of placebo shock won’t end up being a net positive for those involved?
- saiya-jin 3y agoDoctors have licenses, which are hard to obtain and can and are revoked for life for serious missteps. They need to have expensive insurance because patients sue them if they mess up, sometimes even if they don't. Doctors can end up in jail. Even outside of US I can imagine it would be very easy to sue for emotional distress caused. Imagine somebody may quit their job on spot, do some financial decisions which they wouldn't do otherwise, or even commit suicide if already on the edge.
- stef25 3y agoWithout wanting to downplay the effects of being told you have cancer, one has to wonder if the doctor or lab should be responsible for whatever an unstable person does upon receiving this news. The examples you mention would be just as bad even if the news was true. Not sure if there's any valid logic there on my part. > Even outside of US I can imagine it would be very easy to sue for emotional distress caused Living in the EU, I'm guessing it would have to be REALLY bad for you to be able to take someone to court over this. It would have to be "fake news" that persisted for a pretty long time, not just a phone call or email. Put an innocent person in jail for X years, compensate them for it. Tell a person they're going to jail and tell them the next day that they aren't, that's a different story.
- ndsipa_pomu 3y ago> one has to wonder if the doctor or lab should be responsible for whatever an unstable person does upon receiving this news. If the doctor/lab has been negligent with their work, then yes they should be held partly responsible. Obviously mistakes happen, but you expect that a serious diagnosis would be taken seriously and double checked.
- veave 3y ago[flagged]
- philip1209 3y ago400 false positives. How big was the denominator, though? While this is unfortunate, false positives do happen.
- elif 3y agoThese are not false positives. Read the article it was an email bug.
- blueflow 3y agoSoftware issue. Can't do anything about it. </s>