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In the context of the US medical system medical advice is highly regulated. Specifically this seems problematic: > This is an open-source project with a missio

In the context of the US medical system medical advice is highly regulated. Specifically this seems problematic: > This is an open-source project with a mission to provide everyone their own private doctor. Doctors are not just capable of passing the licensing exam, they’re also required to attend school, do a residency, and many other things. They are also personally liable. Medical devices and software that provides some level of care also have extremely rigorous regulatory controls. Providing a medical service that non compliant is a crime.

TuringNYC 3y ago
>> Doctors are not just capable of passing the licensing exam, they’re also required to attend school, do a residency, and many other things. They are also personally liable. >> Medical devices and software that provides some level of care also have extremely rigorous regulatory controls. Providing a medical service that non compliant is a crime. The author is not starting a medical practice, they are showing a proof of concept -- without asking for money -- which is sharing knowledge and know-how in a desperately needed area where the world needs to progress. My guess is that billions of people around the world die early from lack of medical care. This project will NOT solve that, but it will help nudge us in the long route to better, cheaper, and more accessible medical care in the long term. Lets not knock someone down, this is a hacker forum, so lets hack and learn.
- fnordpiglet 3y ago
  Yes but providing medical advice doesn’t require a business relationship, it requires providing medical advice and asserting some level of medical authority. I have no intention of tearing down anything. But they should be very careful in how they describe what they’re offering, even if - perhaps especially if - it’s a free proof of concept in the open. Opening yourself up to personal liability an standing in non compliance with medical regulatory requirements is just a bad idea. All they need to do is rigorously disclaim their work. Your appeal to the dire need of the world for better medical technology doesn’t withstand the need for strong medical regulations - history is full of dangerous quackery, these rules exist for a very carefully considered reason, even if they can be frustrating, and even if they’re overly broad now and need reform. The point isn’t they are doing something wrong, it’s that they need to be very careful of how they describe their stuff. I 1000% agree democratizing medical data and services via open platforms is laudable. But just don’t set yourself up for legal trouble in that pursuit.
  - TuringNYC 3y ago
    Great point! Totally agree. I also think -- in the spirit of learning -- most of the folks on HN would probably like to know more details about the fine-tuning cost, procedures, trade-offs, etc. as well as about evaluation frameworks.
    - fnordpiglet 3y ago
      I agree, I’m always interested in the fine tuning mechanics. Unfortunately most of the guides posted these days are selling a SaaS that simplifies the processes whereas I’m not interested in the glossed over process but the brutal details. My grandfather was a relatively renowned medical researcher who eschewed funding to publish his research in the open. As a result he published a huge corpus of research across a vast array of medical topics, but those old papers aren’t indexed anywhere and without a corporate sponsor his work was largely forgotten. We compiled all his papers in his final years and bound them in a multi volume set. I plan to unbind them and have a company OCR them and so I can fine tune a model with them, and provide them and their references and citing papers in a vector db. I’m curious what of his mind I can recapture, as his every moment even in personal life he spoke about and like his language in papers. His only hobby outside research was shotput and trying to cure some beagle he rescued from a shelter that had some unknown chronic skin disease. I’m busy at the moment but have been passingly following and reading papers on the LLM work happening in the open to prepare to do that side project. I’ve been kind of disappointed with the quality of guides out there and the rapid commercialization of the space.
tansan 3y ago
Thank you for explaining
oneTbrain23 3y ago
Highly regulated means 1. It is based in USA (USA in world economies and influence has drop to around 20% of the world). If I used it in Bahamas or even Ukraine, not a single AG in ENTIRE USA can do anything about it. 2. Had to go thru court and judge pass a judgement. Every court cases in USA can be grinded via a Jury. Every judges can be bribed or threatened (as shown during the 2020 elections). Assuming it passes that, you still have to go thru all the way to SC. And even that like Roe vs Roe, it still can get reverse. 3. AG needs to bring this case to court first. Same as #2. In fact go research how many very questionable AG deaths in USA in the last 5 years. 4. Just put a disclaimer EULA. And put it in a out of USA jurisdiction while on borderless Internet (sci-hub set a good precendence). 5. USA medical regulation today arent on par with vast majority westetnised world standard. Some ASEAN and Eastern Asia standard would make vast majority of FDA boardmembers look like quacks.

TuringNYC 3y ago

>> Doctors are not just capable of passing the licensing exam, they’re also required to attend school, do a residency, and many other things. They are also personally liable. >> Medical devices and software that provides some level of care also have extremely rigorous regulatory controls. Providing a medical service that non compliant is a crime. The author is not starting a medical practice, they are showing a proof of concept -- without asking for money -- which is sharing knowledge and know-how in a desperately needed area where the world needs to progress. My guess is that billions of people around the world die early from lack of medical care. This project will NOT solve that, but it will help nudge us in the long route to better, cheaper, and more accessible medical care in the long term. Lets not knock someone down, this is a hacker forum, so lets hack and learn.

fnordpiglet 3y ago
Yes but providing medical advice doesn’t require a business relationship, it requires providing medical advice and asserting some level of medical authority. I have no intention of tearing down anything. But they should be very careful in how they describe what they’re offering, even if - perhaps especially if - it’s a free proof of concept in the open. Opening yourself up to personal liability an standing in non compliance with medical regulatory requirements is just a bad idea. All they need to do is rigorously disclaim their work. Your appeal to the dire need of the world for better medical technology doesn’t withstand the need for strong medical regulations - history is full of dangerous quackery, these rules exist for a very carefully considered reason, even if they can be frustrating, and even if they’re overly broad now and need reform. The point isn’t they are doing something wrong, it’s that they need to be very careful of how they describe their stuff. I 1000% agree democratizing medical data and services via open platforms is laudable. But just don’t set yourself up for legal trouble in that pursuit.
- TuringNYC 3y ago
  Great point! Totally agree. I also think -- in the spirit of learning -- most of the folks on HN would probably like to know more details about the fine-tuning cost, procedures, trade-offs, etc. as well as about evaluation frameworks.
  - fnordpiglet 3y ago
    I agree, I’m always interested in the fine tuning mechanics. Unfortunately most of the guides posted these days are selling a SaaS that simplifies the processes whereas I’m not interested in the glossed over process but the brutal details. My grandfather was a relatively renowned medical researcher who eschewed funding to publish his research in the open. As a result he published a huge corpus of research across a vast array of medical topics, but those old papers aren’t indexed anywhere and without a corporate sponsor his work was largely forgotten. We compiled all his papers in his final years and bound them in a multi volume set. I plan to unbind them and have a company OCR them and so I can fine tune a model with them, and provide them and their references and citing papers in a vector db. I’m curious what of his mind I can recapture, as his every moment even in personal life he spoke about and like his language in papers. His only hobby outside research was shotput and trying to cure some beagle he rescued from a shelter that had some unknown chronic skin disease. I’m busy at the moment but have been passingly following and reading papers on the LLM work happening in the open to prepare to do that side project. I’ve been kind of disappointed with the quality of guides out there and the rapid commercialization of the space.

tansan 3y ago

Thank you for explaining

oneTbrain23 3y ago

Highly regulated means 1. It is based in USA (USA in world economies and influence has drop to around 20% of the world). If I used it in Bahamas or even Ukraine, not a single AG in ENTIRE USA can do anything about it. 2. Had to go thru court and judge pass a judgement. Every court cases in USA can be grinded via a Jury. Every judges can be bribed or threatened (as shown during the 2020 elections). Assuming it passes that, you still have to go thru all the way to SC. And even that like Roe vs Roe, it still can get reverse. 3. AG needs to bring this case to court first. Same as #2. In fact go research how many very questionable AG deaths in USA in the last 5 years. 4. Just put a disclaimer EULA. And put it in a out of USA jurisdiction while on borderless Internet (sci-hub set a good precendence). 5. USA medical regulation today arent on par with vast majority westetnised world standard. Some ASEAN and Eastern Asia standard would make vast majority of FDA boardmembers look like quacks.