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Startup Ideas

blog.ycombinator.com

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Re: Startup Ideas

#441

Post by vasilipupkin »

arkades wrote: post #421
vasilipupkin wrote: post #379

Earlier quoted context omitted.

To partners, sure. What sort of partners ? If I start a company and show up at the door, would they just give me the datasets ? Would those data sets be in useful formats ? if you are seriously telling me those data sets are easy to get, let's talk because I know what to do with them.

There’s usually a spot in every insurance company that considers itself the “innovation center.” Basically, if you incur no costs to them beyond getting you the data, and give them a free trial run on your product, you’ll get your data-sharing agreement. The data for insurers is in the form of Billings (which come with Diagnosis codes!), which follows a federally-standardized format (check out the Medicare website) a…

I am from outside the hc sector, but I know how to build models on large data sets. So if you seriously know how to get the data, I seriously know what to do with it.

Re: Startup Ideas

#442

Post by arkades »

aeorgnoieang wrote: post #434
arkades wrote: post #418

Earlier quoted context omitted.

Not really. We have a system for this: clinical trials. I, as a lone doc, am not equipped to make heads or tails of un-randomized un-controlled piles of data. A clinical trial -is-. That’s why we use them.

> I, as a lone doc, am not equipped to make heads or tails of un-randomized un-controlled piles of data. Isn't that a description of literally what every practicing doctors, that isn't involved in research, actually does? And clinical trials are extremely expensive. Surely there's some utility in gathering data between the extremes of doctor-patient and clinical trial.

No, it’s not.

We use properly conducted clinical science to give us a framework for interpreting the data we see, comparing data we have to studies with appropriate external validity to allow that comparison.

And no, there isn’t, if an RCT is at all feasible. There was a great paper a few years back that reviewed various case-control studies for conditions that were ultimately explored using RCTs (eg, knee arthroscopy, internal mammary artery ligation). What they found was that the retrospective study consensus was basically a coin-flip with respect to the RCT consensus. They just don’t provide useful data - too many confounders, known and unknown, go unaddressed.

Re: Startup Ideas

#443

Post by arkades »

aeorgnoieang wrote: post #435
arkades wrote: post #350

Earlier quoted context omitted.

Okay, I really don’t want the data. I don’t want the data because: (1) if I see something, I have to act on it, despite not actually having the knowledge of whether it means anything in this information-rich context. I just love things that -look- like information but that don’t actually tell me anything. (2) we have a LOT of data suggesting that we do more harm than good when we try to intervene or investigate every…

You've outlined a cogent rationale for refusing all medical treatment! And there is a lot of evidence that this is in fact not a terrible idea. A lot of medicine is, not just not-beneficial, but actively harmful. So as someone that would be liable to act on this data, I understand and sympathize that receiving this data would be an unfair burden on you. But what about the rest of us? We're being treated by people tha…

No, I haven’t. I’ve outlined a rationale for helping when there’s reasonable evidence that the benefit provided will outweigh the harm caused. Eg, antibiotics for the average upper respiratory infection vs antibiotics for sepsis. In the context of diagnostics: if the prior probability of disease is such that the outcome of the test doesn’t meaningfully change the likelihood, it’s bad for the patient to create a situation where for legal purposes I must now act as though the probability is much higher than it is.

And no, we aren’t actively refusing to learn if we are helping. We want the data collected in a meaningfully structured way that actually answers the question of whether it’s helping. Garbage In/Garbage Out doesn’t answer that question.

You say it’s unfair, but go reread my post. My concern is that my arm gets twisted into doing things that are -bad for you-, not bad for -me-. Whether you like the reasoning or it’s conclusion, nothing in it is about being unfair to you. It’s about trying to do my absolute best to live up to my ethical responsibility to optimize your health outcomes. The only part of it that’s defensive is the part where I don’t ignore test results, because it will get me sued out of medical practice in the rare occasion they’re true positives. And I would like for that not to be the case, but there we are.

Re: Startup Ideas

#444

Post by arkades »

vasilipupkin wrote: post #441
arkades wrote: post #421

Earlier quoted context omitted.

There’s usually a spot in every insurance company that considers itself the “innovation center.” Basically, if you incur no costs to them beyond getting you the data, and give them a free trial run on your product, you’ll get your data-sharing agreement. The data for insurers is in the form of Billings (which come with Diagnosis codes!), which follows a federally-standardized format (check out the Medicare website) a…

I am from outside the hc sector, but I know how to build models on large data sets. So if you seriously know how to get the data, I seriously know what to do with it.

j s at self driving medicine dot com

Reach out, we can talk about what you’re thinking.

Re: Startup Ideas

#445

Post by arkades »

chiefalchemist wrote: post #323
arkades wrote: post #302

Earlier quoted context omitted.

That is correct: the analysis of large data sets is opaque to patients, and application of the evidence base to specific patients happens in the heads of physicians. Patients are not part of the decision making process, and therefore not privy to the analysis, unless there is a decision to be made that requires their input (eg, two reasonable roads forward that depend on their preferences, or on their risk-tolerance.…

Yes. But at no point did I sense the options being offered were based on doppelganger type of data. Or even (the doctor saying) "here's the data...here's our interpretation...here are the recommendations and pros and cons..." Nothing like that. No continuity between docs or floors/wards. Just everyone kinda making it up as they go. It just struck me as another reason why outcomes aren't optimized, and costs, relative…

> "here's the data...here's our interpretation...here are the recommendations and pros and cons..."

I understand. That’s part of what is intentionally opaque. We don’t speak like that to anyone but other medical professionals. There’s a lot of Dunning-Kruger in what people think of their ability to parse hc information. As someone who grew up with serious chronic disease, I’ve been on both sides of this fence. It’s not something you really “get” until you’ve had to care for patients.

> costs inflating

Several Health Econ studies have shown that about 70% of hc costs are driven by new technologies (implants, procedures, patented meds.) It has nothing to do with how docs communicate with one another.

And how we communicate is also opaque to patients. Not intentionally, it’s just not a conversation for patients, any more than any two technicians in a software company talking/arguing technical details are having a convo meant for the ears of customers.

Re: Startup Ideas

#446

Post by obastani »

arkades wrote: post #442
aeorgnoieang wrote: post #434

Earlier quoted context omitted.

> I, as a lone doc, am not equipped to make heads or tails of un-randomized un-controlled piles of data. Isn't that a description of literally what every practicing doctors, that isn't involved in research, actually does? And clinical trials are extremely expensive. Surely there's some utility in gathering data between the extremes of doctor-patient and clinical trial.

No, it’s not. We use properly conducted clinical science to give us a framework for interpreting the data we see, comparing data we have to studies with appropriate external validity to allow that comparison. And no, there isn’t, if an RCT is at all feasible. There was a great paper a few years back that reviewed various case-control studies for conditions that were ultimately explored using RCTs (eg, knee arthroscop…

This sounds like a really interesting paper -- do you happen to have a link to the reference?

Re: Startup Ideas

#447

Post by a1exyz »

Tomis02 wrote: post #428

This is what happens when you'd like to save the world (and earn the big money and fame) but you unfortunately took the path of a CS degree (or worse, just software/business school) and are incapable of solving real hard problems, so you bet on the unlikely success of an useless startup. People have been sharing visions and ideas of the future for at least one hundred years, such as infinite lifespans, telepathy, art…

I think you're right but at least startups incentivize trying really really hard - as opposed to joining some big R&D firm. It challenges people to wrestle again and again with the ideas of value and what we want this world to be.

Trying and suffering leads to learning and progress.

Re: Startup Ideas

#448

Post by kromem »

zilian wrote: post #414
kromem wrote: post #168

Earlier quoted context omitted.

Kyle, I applaud the concept of sharing ideas for entrepreneurs to tackle. However, this list of ideas is dangerously bad, with nearly all of them suffering from either monetization challenges or huge execution issues. Anyone that sets out to solve these as-is will end up wasting a great deal of time, effort, and resources. It's generally bad form to approach a startup idea from the perspective of "wouldn't it be grea…

I agree and I've wanted to build a dashboard like this for a while. Matching problems & people looking for building business around real problems. I'm having issues about clarity and upvotes though : how do you favor people who know the domain ?

You let the comments themselves have upvotes.

Look at any of the technical subreddits - typically domain experts end up being near the top comments naturally, because they lay out substantive comments.

Reddit "flair" is a solution as well. Ideally a platform like this would be able to connect to a LinkedIn profile, and display some relevant info from said profile.

Re: Startup Ideas

#449

Post by taurath »

gnarbarian wrote: post #296
taurath wrote: post #236

Earlier quoted context omitted.

I am probably in the minority here, but it seems that the impetus of most of the problems on this list is what would possibly make the most money, written as if that is the measuring stick of the most societally useful startup. The top 5 problems in my city are more on the level of affordable housing, homelessness, drug use, over-incarceration and mental healthcare. I can't help but feel like we have enough gadgets a…

The whole point of venture capital is to make money.

Whatever happened to changing the world :)

Re: Startup Ideas

#450

Post by GordonS »

sdrothrock wrote: post #386
jogjayr wrote: post #171

Earlier quoted context omitted.

It's not so crazy if you apply it to babies. I'm sure a lot of new parents would very much appreciate knowing why their baby is crying now . What's that old quote about babies and the same error code for many different problems?

While not babies, a lot of parents have problems communicating with pre-verbal and basically non-verbal infants... but it's also been found that infants can actually learn and effectively use signs (not to be confused with ASL or a distinct sign language) to communicate. https://en.wikipedia.org/wiki/Baby_sign_language

We did this with both our kids. Our youngest, who is only 8 months old, can already sign in makaton for 'more', 'milk' and 'finished' - and we only started teaching him a few weeks ago!

It really is incredible what they are capable of at such a young age.

Other parents tell me all the time about how their kids are getting frustrated because the can't communicate verbally - I really don't know why signing for babies isn't more popular.

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