Live data from Hacker News

Google AI has access to huge haul of NHS patient data

newscientist.com

71–80 of 83 posts

Re: Google AI has access to huge haul of NHS patient data

#71
post #10
post #7

Terrible reporting. Improving health outcomes by AI analysis of patient data is a much bigger prize - morally and commercially - than anything which could be achieved through ad targeting. Google is far too smart to squander such an opportunity by abusing patients' trust.

The big problem is the precedent it sets for data access. What are the criteria for who gets access? What are the constraints of that access? This story covers the latter being blown apart, the constraints were poorly defined and implemented and thus even if the criteria is well defined access to far more data was made possible. I'm sure that few patients desire an end to research, or would argue that such access isn…

Nope. To set a precedent it would have to precede. Giving de-identified medical records to researchers is a long-standing, well-established and regulated process. The only interesting thing here is that it's Google and not some PhD's university lab.

Here's HHS on what HIPAA has to say about this: [0]

[0] http://www.hhs.gov/hipaa/for-professionals/privacy/special-t...

Re: Google AI has access to huge haul of NHS patient data

#72

I think this situation nicely juxtaposes positive externality with private rights. As an individual, you may wish to hoard all of your personal medical information. Doing so may provide marginal benefit or protection against some theoretical harms. However, much of medical science relies on large population studies. Is knee surgery worth it? Are breast exams? Do COX-2 inhibitors increase heart attacks? Enormous amoun…

> Whenever I visit the doctor and I am given a form asking if my data can be sent to some group to participate in a study, I always answer yes. Never once have I had any negative repercussions from doing so, and it is my hope that the data was used to publish scientific papers that added to net knowledge of humanity. I've grown cynical. My first thought on seeing this kind of form is that a third party will be making…

You--as an individual--receive zero benefits from your medical data when it's kept private. You can't consume it, you can't use it, and you can't trade it. It has no inherent value on its own. Were researchers forced to pay you for access to your de-identified data, it'd be a number so infinitesimal as to be all but meaningless.

You aren't giving up something of value to you. There's zero opportunity cost involved. The value is added after your data is collected, collated, analyzed, and used by researchers. Individually, it's meaningless. Together, it's priceless.

Will someone eventually profit? Sure, but they'll do so because society benefits from the work they've done. And eventually, the cost will decrease. Would you rather have drug treatments that exist in the first place even if someone profits from them or nothing? Those are pretty much your options. For all of its flaws, the current research model at least works. The only other option, besides doing nothing and letting people die from diseases we could eventually treat, is some sort of public financing and that comes with a host of problems. Would anyone really be so foolish as to want to subject medical research to the congressional budget process, even if there's an abstraction layer between congress and the researchers? That means tradeoffs, and lots of them: for instance, Drug option A would be pursued, and option B ignored because we're already funding A even if B might be more promising later on.

We already see it with federal applied research when critical work is jeopardized for the sake of political grandstanding. Every so often, someone will trot out a cherry-picked grant they don't like and wave it around like a red flag in front of a bull. Drug companies might be bad enough, but the politicians would be worse.

Re: Google AI has access to huge haul of NHS patient data

#73

Earlier quoted context omitted.

It's going to sound like I'm telling you how to live your life and how to feel and I really don't mean it that way but I don't know any other way to express my viewpoint so I'll just power through it: The idea that someone, somewhere is making a profit on something you provided should make you happy, not sad. To make a profit, they had to be paid, and to be paid they normally have to have provided something that some…

> The idea that someone, somewhere is making a profit on something you provided [for free] should make you happy, not sad. This seems like a double standard. Why should I be happy when corporations will regularly go to court to make sure that nothing they create returns to the public domain within my lifetime? The norm seems to be capturing this kind value wherever (and for a long as) possible, not distributing it fr…

Ok, so what? Even if a company fights to maintain control over their product, there's still a societal benefit even if that benefit has been artificially limited due to price. And while they can delay things to an extent, eventually, they'll lose control over their product as IP protections run out. There are still games that can be played at that point when everything is lined up just right, but those are games that can be addressed through legislation and the courts.

I'd rather hideously expensive treatments exist, even if I can't afford them, than live in a world where they're never even an option. Price can and does change over time, and those treatments become more accessible to more people. But if the treatments are never developed in the first place, then that's an even greater tragedy because then there's literally nothing that can be done to make them accessible.

Re: Google AI has access to huge haul of NHS patient data

#74
post #7

Terrible reporting. Improving health outcomes by AI analysis of patient data is a much bigger prize - morally and commercially - than anything which could be achieved through ad targeting. Google is far too smart to squander such an opportunity by abusing patients' trust.

That seems incredibly naive. They utilize every other bit of information they collect, why wouldn't they utilize this data? Google is a corporation. It can't have good intentions of its own. It's the thousands of employees who will potentially be working with and handling the data that you need to worry about.

Google places the most comprehensive controls on PII of any place I've seen, including hospital environments subject to HIPAA. (Mostly because, unlike the hospitals, they have the technical clue how to enforce it properly. The hospitals... are still learning about computer security, and it's not their forte: http://arstechnica.com/security/2016/03/two-more-healthcare-... )

Getting access to private information in Google is hard - my experience as a researcher here is that there's a strong incentive to find an open-source or non-PII dataset before touching user data. I'll go through my year here without ever touching even the most innocuous PII data.

It's very unlikely to me that thousands of people will have access to this data. It's much more likely that a small handful will, and that they'll be supported by others with no access whatsoever. From the article, in fact:

"The agreement clearly states that Google cannot use the data in any other part of its business. The data itself will be stored in the UK by a third party contracted by Google, not in DeepMind’s offices. DeepMind is also obliged to delete its copy of the data when the agreement expires at the end of September 2017."

From an incentive perspective, the potential value-add of abusing the data is tiny compared to the potential costs and loss of user trust. Google's very aware of how important it is to maintain user trust -- http://www.techradar.com/us/news/internet/google-we-have-a-c...

Corporations don't have brains, but they have cultures, and Google's culture -- composed of those thousands of engineers -- is quite fanatical about protecting user privacy. It's one of the non-technical things that's impressed me most during my time here.

The risk with a company like Google is if the economic winds and culture changes, but that's a long-term process, and is also the reason for legally-binding contracts to do things like delete the data (see above).

tl;dr: Google has the technical means to protect the confidential data better than almost any other agency, including from its own employees. The most important question to ask is whether the NHS structured the data sharing in a way that provides for long-term protection, and (IANAL!) it sounds like it from the article.

Source: I'm a professor who deals with our IRB occasionally, have colleagues doing joint CS-medical research, pushed patients around a hospital in a younger life, and am on sabbatical for the year at Google.

Re: Google AI has access to huge haul of NHS patient data

#75
post #55

Earlier quoted context omitted.

No politician was involved in this decision.

http://www.bbc.com/news/uk-16021240 > "All necessary safeguards would be in place to ensure protection of patients' details - the data will be anonymised and the process will be carefully and robustly regulated. > "Proper regulation and essential safeguards need to be in place when it comes to patients data," he said. "It cannot be done in a way where essential rules are threatened." The legality of these data sharin…

You've linked to a page about care.data

This Google thing has fuck all to do with care.data - they're totally separate.

I understand "the" NHS is complex, but it's pretty frustrating talking to someone who has very strong opinions and who clearly doesn't know what they're talking about.

It's really weird to link to a document that talks about the severe legal penalties for anyone who attempts to de-anonymise the data, and then use that to say "look how flimsy these agreements are!", especially when the document you link to has a BOLD lead saying that things are even stricter in the newer document.

> The politician provides the initial promises

Again, not a politician. Chief data officer at NHS England, and a real doctor. http://www.nuffieldtrust.org.uk/about/our-people/dr-geraint-...

> The problem with psuedonymous data is the NHS basically admits it can be used to identify people given sufficient effort.

It's trivially easy for Google to do this already without the NHS data, and they don't face prison time for doing it. See all the pregnant teens outed by supermarket loyalty cards for other examples.

Re: Google AI has access to huge haul of NHS patient data

#76

Earlier quoted context omitted.

True, but I think you can mitigate these issues. Especially for the NHS dataset, since you will either see the patient in there or in a death index (unlike, say, US where they may have just gone to another hospital). Also, the scope here is more like a longitudinal vaccine study than a clinical trial. 50M people will provide a lot of robustness that you wouldn't see in a 1000 patient trial.

> you will either see the patient in there or in a death index Or you won't see any new information for the patient, because the patient is lost to followup. Or - worse - you'll see new information, but it'll be invisibly erroneous, because random GPs don't work to the standard that physicians administering examinations in clinical studies do. > 50M people will provide a lot of robustness that you wouldn't see in a 1…

>> Or - worse - you'll see new information, but it'll be invisibly erroneous, because random GPs don't work to the standard that physicians administering examinations in clinical studies do.

So you will take this into account and emphasize the more reliable types of tests, like blood tests. Or you'll find ways of learning which doctors who do the tests more accurately(or train doctors to do so) and which people are more consistent/reliable with their relationship with their docs. Or maybe you'll get a few hypotheses which are relatively likely and that would incentivize the researchers/google to do small clinical trials on them.

It's worth a try at least.

Re: Google AI has access to huge haul of NHS patient data

#77

Earlier quoted context omitted.

not sure if you saw my comment downstream? would encourage you to read original piece for a more nuanced presentation of the information - https://www.newscientist.com/article/2086454-revealed-google... happy to address criticism

Hi Hal I thought the article should have compared and contrasted with other government run large data sharing programs such as CMS qualified entity or AHRQ HCUP.

thanks for the comment. This would be interesting, but not sure it would have made sense to pack it into one article that is already heavy with data terminology for a lay reader.

Will definitely be looking into healthcare data more, as this story has resulted in some interesting leads

Re: Google AI has access to huge haul of NHS patient data

#78
post #69
post #22

Earlier quoted context omitted.

It so happens Google has the perfect means at its disposal for de-anonymizing large swaths of such data: trillions of user location records, calendar appointments, emails, and texts. It's not too hard to put all that together to match a specific encounter record, for example.

which would both violate their contract and also be illegal.

I do not trust Google and I am not being given a choice.

Re: Google AI has access to huge haul of NHS patient data

#79
post #69
post #22

Earlier quoted context omitted.

It so happens Google has the perfect means at its disposal for de-anonymizing large swaths of such data: trillions of user location records, calendar appointments, emails, and texts. It's not too hard to put all that together to match a specific encounter record, for example.

which would both violate their contract and also be illegal.

And Google would never break the law or breach a contract. Especially a contract they signed with the UK Government.

I mean, other than that time just a few years ago[0] where Google broke the law and then breached the contract they signed with the UK Government.

[0] http://www.bbc.com/news/technology-19014206

Post reply on HN