A.I. vs. M.D. • Hacker News Board

Re: A.I. vs. M.D.

#31

Post by bilbo0s » Mon, Apr 03, 2017, 12:22 PM UTC

TuringNYC wrote: post #11

digitalzombie wrote: post #10

Hopefully more companies are doing this. My research thesis is in this area, hoping for a nice career doing modelling to predict illness. I'd like to have a nice paying job doing something that actually help people instead of just only making somebody more richer. Also it doesn't matter if the AI gets wrong, the algorithm gives say 80% accuracy and it tells you base on your genetic make up if you should take the surg…

I am doing this, full-time for almost three years soon. The company is at http://dochuddle.com/ So here is the warning: Medical startups are hard, really hard. - It is difficult to apply research on 32x32 cat icons on 15megapixel xrays. - It is difficult to get data without year-long contract efforts - It is very difficult/expensive, if not impossible, to use cloud resources due to HIPAA and localization rules so you…

Keep in mind that TuringNYC did not even MENTION the main issue that trips up most startups...

ie - they are unfamiliar with how to secure, (and KEEP), FDA approval for their products. It actually comes as a surprise to many of them that they even NEED FDA Approval. Then they are further shocked by how invasive the process is, and how long it can take. And don't even get me started about the look on their faces when they realize that, despite all of that, you're still held CRIMINALLY accountable for any bugs in your software. (Stay away from anything that might injure anyone if you are unsure of the ability of your process to reliably prevent bugs. Things like RTP are no-go areas for all but the most meticulous medical software developers.)

Don't get into medical software unless you have an extremely long, and very well funded, runway. This is not an industry where 2 guys in a garage can innovate and side-step the regulations. And whatever you do, stay away from anything that could actually harm the patient if it is wrong.

Re: A.I. vs. M.D.

#32

Post by wnkrshm » Mon, Apr 03, 2017, 12:43 PM UTC

Nadya wrote: post #5

shiven wrote: post #4

A few decades from now, 30 - 50 years at most, doctors and patients, will look back at us and wonder, why we were not using algorithms to assist with diagnosis already.

As with many things - fear that the AI will be wrong (no matter how less frequently this happens than with doctors) and a desire for a human to blame if there is a mistake. If a doctor makes a misdiagnosis and kills the patient as a result it is less bad than if an AI makes a misdiagnosis and kills the patient as a result. It's the one thing I don't understand about most of society. Same with self driving cars. Self…

Maybe it's not so much that a human isn't to blame in the case of an algorithm classifying something incorrectly, but that an algorithm might make mistakes that a human wouldn't.

I've read a very interesting article [0] about autonomous driving recently, a discussion about the ethics and social obstacles in the way of adopting autonomous cars. The author makes the case that while algorithms might perform a task safer than humans in total but they will inevitably make mistakes. And those mistakes may well be mistakes that are trivial for a human to prevent.

Algorithms making lethal mistakes that a human professional will be extremely unlikely to make, will be the hardest part to swallow if we adopt automation in critical roles - even if the total amount of deaths can be reduced that way.

Even if they are safe across the board, statistically proving to people that autonomous machines perform correctly and aren't prone to obvious mistakes would take decades and billions of hours of operation to be able to make a statement about their safety relative to human performance - since lethal accidents due to human error are relatively rare events. So we are faced with a hen and egg problem in that regard.

[0] http://spectrum.ieee.org/cars-that-think/transportation/self...

Re: A.I. vs. M.D.

#33

Post by mhb » Mon, Apr 03, 2017, 12:57 PM UTC

bilbo0s wrote: post #31

TuringNYC wrote: post #11

Earlier quoted context omitted.

I am doing this, full-time for almost three years soon. The company is at http://dochuddle.com/ So here is the warning: Medical startups are hard, really hard. - It is difficult to apply research on 32x32 cat icons on 15megapixel xrays. - It is difficult to get data without year-long contract efforts - It is very difficult/expensive, if not impossible, to use cloud resources due to HIPAA and localization rules so you…

Keep in mind that TuringNYC did not even MENTION the main issue that trips up most startups... ie - they are unfamiliar with how to secure, (and KEEP), FDA approval for their products. It actually comes as a surprise to many of them that they even NEED FDA Approval. Then they are further shocked by how invasive the process is, and how long it can take. And don't even get me started about the look on their faces when…

China Creates Special Economic Zone for Medical Tourism: https://news.ycombinator.com/item?id=14022383

Re: A.I. vs. M.D.

#34

Post by TuringNYC » Mon, Apr 03, 2017, 1:29 PM UTC

bilbo0s wrote: post #31

TuringNYC wrote: post #11

Earlier quoted context omitted.

I am doing this, full-time for almost three years soon. The company is at http://dochuddle.com/ So here is the warning: Medical startups are hard, really hard. - It is difficult to apply research on 32x32 cat icons on 15megapixel xrays. - It is difficult to get data without year-long contract efforts - It is very difficult/expensive, if not impossible, to use cloud resources due to HIPAA and localization rules so you…

Keep in mind that TuringNYC did not even MENTION the main issue that trips up most startups... ie - they are unfamiliar with how to secure, (and KEEP), FDA approval for their products. It actually comes as a surprise to many of them that they even NEED FDA Approval. Then they are further shocked by how invasive the process is, and how long it can take. And don't even get me started about the look on their faces when…

Very good point @bilbo0s and thank you for bringing this up. I didn't mention it as we focused on a non-clinical diagnostic (thus not subject to FDA), decided to entirely avoid the US market (focus on more less risk averse economies open to innovation and aligned via ACO-style systems.)

FDA is definitely the biggest hurdle of them all. I'd shudder if we had to deal with that 600 pound gorilla.

Re: A.I. vs. M.D.

#35

Post by TuringNYC » Mon, Apr 03, 2017, 1:32 PM UTC

drchiu wrote: post #29

TuringNYC wrote: post #11

Earlier quoted context omitted.

I am doing this, full-time for almost three years soon. The company is at http://dochuddle.com/ So here is the warning: Medical startups are hard, really hard. - It is difficult to apply research on 32x32 cat icons on 15megapixel xrays. - It is difficult to get data without year-long contract efforts - It is very difficult/expensive, if not impossible, to use cloud resources due to HIPAA and localization rules so you…

This is probably one of the most accurate portrayals of medical systems i countries with highly developed and sophisticated legal system. It's sad but one of those things that is only apparent once you're neck deep in it. The people who want to truly help patients are swept aside by those who are in positions to benefit themselves or their friends at the expense of others, including patients. Think administrators, bu…

@drchiu, it is uncertain how the system will evolve, but one way to solve the fall-guy problem might be to purchase insurance on these systems and have them bonded. It is all new territory, so no one really knows.

Self Driving Cars will face the same challenge w/r/t liability insurance when there isn't a driver. It might be a insured & bonded set of algos and systems.

Re: A.I. vs. M.D.

#36

Post by vonnik » Mon, Apr 03, 2017, 2:36 PM UTC

Automating diagnosis goes too far. Deep learning will largely be used for decision support; i.e. surfacing and indicating possible diagnoses for a medical professional to choose from.

Most machine-learning companies have misunderstood the role of radiologists. Their first job is not diagnosis. It is to find the right domain, the right view of the data, from which to formulate a diagnosis. So the problem is to map from one set of parameters, say, how an X-ray is taken, to another more promising set of parameters for the same X-ray, to get the view they need. It's not just see an image, find a tumor.

Re: A.I. vs. M.D.

#37

Post by HillaryBriss » Mon, Apr 03, 2017, 2:37 PM UTC

ubernostrum wrote: post #15

a_imho wrote: post #13

Earlier quoted context omitted.

Apples and oranges. We do have driving assistance, fully autonomous vehicles are entirely different. Low hanging fruits are being picked, not wanting a software to call the shots every time is a valid stand imo.

I think aviation is a good analogy. Most of the automation in a modern airliner, for example, isn't there to make the plane "fly itself" from point A to point B -- it's there to do things machines are good at in order to reduce the workload of the human crew, so they have more time/energy to focus on the things humans are good at. Flight plans, for example, are still decided on by humans, even if a programmed compute…

> automation, in aviation, is a partnership between humans and machines

as a lay person who's visited too many people in hospitals, this sounds like a reasonable description of the modern hospital room as well.

* bp and pulse monitors do a job which doctors and nurses used to do manually

* non invasive oxygen saturation level monitors do a job which could not be done easily in the past

* automated IV drip monitors do a job nurses used to have to do manually

* wrist bands with bar codes and an accompanying scanner coupled to a database serve as a "second opinion" or double check on the medication a patient is being given

etc

Re: A.I. vs. M.D.

#38

Post by dr_zoidberg » Mon, Apr 03, 2017, 2:48 PM UTC

sosa2k wrote: post #3

I read the book Complications by Atul Gawande a while back and it touched on this issue. He mentioned how a computer was more accurate at detecting heart attacks than an experience doctor. He also talked about how if the computer is better than the doctor at reading things like these, it really doesn't make much sense for the doctor to have to evaluate/approve the results. Kind of reminds me of James Simons' thought…

> Sorry about the lack of technical knowledge into the CS stuff, first post here and I haven't really put in the time to learn about CS and AI yet.

No need to apologize, you made an interesting and relevant comment. The fact that you feel the need to apologize is more telling of the culture you perceive in this site than of your lack of knowledge in any area.

Re: A.I. vs. M.D.

#39

Post by StJuice » Mon, Apr 03, 2017, 8:46 PM UTC

if you give a flying (sic) about solving medical issues, and actually know a thing or 7 about curing disease, check out Kaggle's competitions. The cervical cancer competition is of particular interest.

If you happen to disagree, step away from your doubt for a sec and listen: we can, and will cure these diseases with AI. That's the whole point. We imbue our intelligence into a machine and voila, the machine does what we ask it to do with greater expediency and more acumen than an individual can do alone. We don't garden with machines and say" wow, this took fifteen thousand people to build, should we use it so we can do other stuff instead?".

Nope. We say, thank you John Deere, I'll take 2. While we are at it, let's look a little deeper and think about how civilization functions in general. Is that not what we do? We connect, we decide to work together, and next thing you know, we improve our quality of life: otherwise known as a corporation (or conglomerate if you wannanother version, ya heard?).

So, is AI good for medicine, yes: it is.

Here's a free thought to prove my point. Using my intellect today I deduced that anxiety is absurdity masked as truth. Imbue that into some AI, you'll heal the minds of the world, ok?

Peas in the ground, head in the air, thoughts with the 1. -Love

Re: A.I. vs. M.D.

#40

Post by sosa2k » Tue, Apr 04, 2017, 1:06 AM UTC

dr_zoidberg wrote: post #38

sosa2k wrote: post #3

I read the book Complications by Atul Gawande a while back and it touched on this issue. He mentioned how a computer was more accurate at detecting heart attacks than an experience doctor. He also talked about how if the computer is better than the doctor at reading things like these, it really doesn't make much sense for the doctor to have to evaluate/approve the results. Kind of reminds me of James Simons' thought…

> Sorry about the lack of technical knowledge into the CS stuff, first post here and I haven't really put in the time to learn about CS and AI yet. No need to apologize, you made an interesting and relevant comment. The fact that you feel the need to apologize is more telling of the culture you perceive in this site than of your lack of knowledge in any area.

I posted this comment about 15 minutes after I discovered Hacker News. Wasn't sure on the culture here compared to places like reddit. It seems to be similar to the more specialized subreddits.