4 ms·

IDEABOLT: Create a central repository of interesting cases and diagnoses, with a super intuitive UI, make it freely available to all MDs in the world to fill up

by Jun8 14y ago

IDEABOLT: Create a central repository of interesting cases and diagnoses, with a super intuitive UI, make it freely available to all MDs in the world to fill up and consult, sort of like the github for doctors. You can make money by being the intermediary to find subjects for experiments, e.g. "For a study we are looking for identical twins who cannot see from birth but now one has restored vision where the other does not". Does something that looks remotely similar exist?

Locke1689 14y ago
I looked into a related, more advanced version of this a couple years ago. It's basically impossible. You can't do it on patient records directly (HIPAA) and if you do it through case studies in PubMed, for example, the copyright holders (e.g., NEJM) will destroy you on licensing fees.
- Jun8 14y ago
  Can't you have doctors enter data into the system (without giving any patient identifying information), for example like the article here? Then, if you want more specific information, you can control the doctor perhaps.
  - Locke1689 14y ago
    No. Doctors can't give out patient information under HIPAA, even anonymized information.
    - Evbn 14y ago
      Then how does PubMed get it?
      - Locke1689 14y ago
        Sorry, I mean without specific releases. The patient has to agree to have their information published.
colomon 14y ago
I've been thinking about this for a while, in more general terms. Last year I had an issue with my eye. I bumped around from doctor to doctor (including one eye specialist) for nine months, for at least half of that period on two different antibiotics and a ten minute a day eye cleaning ritual. Finally when nothing seemed to be working I was bumped up to an eye doctor at a bigger hospital two hours away. Within a minute of seeing me, he had a diagnosis. It involved no medicine at all, cleared up the problem within 48 hours, and still seems to be working fine nearly ten months later. My thinking is that a properly programed medical diagnosis expert system probably could have figured out the issue by the second or third trip to the doctor. Further, my guess is that a nurse who has been properly trained to use such a system would be at least as accurate as your average doctor. Unfortunately, my next guess is that any such system would be opposed by the medical establishment and quickly sued into non-existence by patients it made mistakes on (even if the rate of such mistakes was significantly below that of normal doctors).
- rksprst 14y ago
  You're right physicians as a rule generally dislike software like that (partly because of their egos and distrust of software and partly because of job security). There are so many edge cases and so many examples physicians could give you of the AI/computer being wrong. A simple example is that any software will need input regarding the patient's history, his/her vitals. Right now heart rate data in ICUs is fed every second to storage systems. Let's say the this is a NICU and the baby's heart rate is suddenly elevated to extreme levels. The software would assume that something is wrong with the baby, when in reality a nurse is simply taking a blood sample and the baby started crying, being agitated by the nurse/needle. There are a lot of examples like this, it's a non-trivial problem to build use machine learning to take all of these factors into account to produce a diagnosis/treatment/intervention plan. I was recently at a medical/technology conference and the physicians in attendance were all actually in support of moving to using machine learning/AI (selection bias though, that was what the conference was about). They would rather have a machine with a 5% error rate than a human with 20% error rate. They believe that the role of physicians is going to change and become more of a management role as technology catches up.
sxp 14y ago
That's one of IBM's plans for Watson: http://www.wired.com/wiredenterprise/2012/03/ibm-watson/ http://www.wired.com/wiredenterprise/2012/03/ibm-watson/
johndavidback 14y ago
Yes. Dr. House, MD.
rwhitman 14y ago
There was something floating around on HN a few months ago. I've seen the topic come up a few times. I actually think doctors do have services like this, its just they are a walled garden supported by lots of expensive contracts and sales reps, as all things healthcare seem to be
rksprst 14y ago
Something similar does already exists, telemedicine. A lot of hospitals are starting to experiment with consulting via telemedicine (with robots for instance for video communication and bedside visits) for interesting/hard cases. It's not the same as what you're describing, but HIPAA regulations and how hospitals work would most likely rule out an "open" service like that.

by Jun8 14y ago

Locke1689 14y ago

I looked into a related, more advanced version of this a couple years ago. It's basically impossible. You can't do it on patient records directly (HIPAA) and if you do it through case studies in PubMed, for example, the copyright holders (e.g., NEJM) will destroy you on licensing fees.

Jun8 14y ago
Can't you have doctors enter data into the system (without giving any patient identifying information), for example like the article here? Then, if you want more specific information, you can control the doctor perhaps.
- Locke1689 14y ago
  No. Doctors can't give out patient information under HIPAA, even anonymized information.
  - Evbn 14y ago
    Then how does PubMed get it?
    - Locke1689 14y ago
      Sorry, I mean without specific releases. The patient has to agree to have their information published.

colomon 14y ago

I've been thinking about this for a while, in more general terms. Last year I had an issue with my eye. I bumped around from doctor to doctor (including one eye specialist) for nine months, for at least half of that period on two different antibiotics and a ten minute a day eye cleaning ritual. Finally when nothing seemed to be working I was bumped up to an eye doctor at a bigger hospital two hours away. Within a minute of seeing me, he had a diagnosis. It involved no medicine at all, cleared up the problem within 48 hours, and still seems to be working fine nearly ten months later. My thinking is that a properly programed medical diagnosis expert system probably could have figured out the issue by the second or third trip to the doctor. Further, my guess is that a nurse who has been properly trained to use such a system would be at least as accurate as your average doctor. Unfortunately, my next guess is that any such system would be opposed by the medical establishment and quickly sued into non-existence by patients it made mistakes on (even if the rate of such mistakes was significantly below that of normal doctors).

rksprst 14y ago
You're right physicians as a rule generally dislike software like that (partly because of their egos and distrust of software and partly because of job security). There are so many edge cases and so many examples physicians could give you of the AI/computer being wrong. A simple example is that any software will need input regarding the patient's history, his/her vitals. Right now heart rate data in ICUs is fed every second to storage systems. Let's say the this is a NICU and the baby's heart rate is suddenly elevated to extreme levels. The software would assume that something is wrong with the baby, when in reality a nurse is simply taking a blood sample and the baby started crying, being agitated by the nurse/needle. There are a lot of examples like this, it's a non-trivial problem to build use machine learning to take all of these factors into account to produce a diagnosis/treatment/intervention plan. I was recently at a medical/technology conference and the physicians in attendance were all actually in support of moving to using machine learning/AI (selection bias though, that was what the conference was about). They would rather have a machine with a 5% error rate than a human with 20% error rate. They believe that the role of physicians is going to change and become more of a management role as technology catches up.

sxp 14y ago

That's one of IBM's plans for Watson: http://www.wired.com/wiredenterprise/2012/03/ibm-watson/ http://www.wired.com/wiredenterprise/2012/03/ibm-watson/

johndavidback 14y ago

Yes. Dr. House, MD.

rwhitman 14y ago

There was something floating around on HN a few months ago. I've seen the topic come up a few times. I actually think doctors do have services like this, its just they are a walled garden supported by lots of expensive contracts and sales reps, as all things healthcare seem to be

rksprst 14y ago

Something similar does already exists, telemedicine. A lot of hospitals are starting to experiment with consulting via telemedicine (with robots for instance for video communication and bedside visits) for interesting/hard cases. It's not the same as what you're describing, but HIPAA regulations and how hospitals work would most likely rule out an "open" service like that.