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Alphabet is spending billions to become a force in health care

economist.com

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Re: Alphabet is spending billions to become a force in health care

#191

Post by randcraw »

dekhn wrote: post #171
randcraw wrote: post #129

Earlier quoted context omitted.

Google will succeed at healthcare only after medical decisions can be reduced to A/B tests. That is to say, never. After wasting many millions on failures like Calico, Google hasn't learned that healthcare is a service that's continuous, custom, and complex. And since the "customer's" health and life are at stake, maintaining health is a damned sight more important and difficult to do sufficiently well than Google's…

Why do you think Calico is a failure? I think the jury is still out on that one.

I have a little experience trying to work with Google in the R&D space at a large pharma. Google and other external R&D agents consistently underestimated the difficulty in getting access to sufficient data from us to employ large scale ML. That data often exists within a pharma's clinical trials, but it's acquired and stored in a way that makes it inaccessible to subsequent mining.

This is a problem for dataminers like me within pharmas too. Most of our clinical trial data is locked up contractually within contract research organizations (CROs) who are responsible for taking specific measurements of it as part of a trial. From what I've seen, dataminers within the company can gain access to only selective bits of that data (one or two features, perhaps) from all the patients in a trial, but never to all the data on each patient, and never data from the trial that spans multiple CROs.

This 'federation' of clinical trial data collection serves the needs of the trial design (and satisfies HIPPA regs), but it makes mining the data or asking new questions of it almost impossible. Too little data is available (and never longitudinal longer-term outcomes, since trial durations are short) to allow mining of more than short-term signals, like immediate response to treatment. Pharmas are unlikely to change that practice, in part because it's easier to federate the analyses and allow the raw data to remain in distributed silos. But federation is also a good way to discourage asking creative yet inessential questions that might later prove awkward or invite lawsuits, since litigation is an omnipresent worry in US healthcare.

How companies like Calico/Google hope to navigate such minefields is a question they have yet to answer successfully.

Re: Alphabet is spending billions to become a force in health care

#192

Post by lamontcg »

Gehlitio wrote: post #91
GoOnThenDoTell wrote: post #21

Please no. They have too much info on everyone already

Do you life with something chronic? Something were not a lot of people are doing research and we're there was no real discovery in the last 20 years? Because I do and you know how scattered the field of medicine is? There is one realistic way of getting more people with chronic issues new threatments and it's data. Lots and lots of it. IF someone can pull that of while protecting the individuals I believe it's alphab…

I'd expect that Google would be more likely to sell your data on your chronic condition and make you unemployable and uninsurable. They are highly unlikely to worry about protecting individuals.

Re: Alphabet is spending billions to become a force in health care

#193

Post by dekhn »

randcraw wrote: post #191
dekhn wrote: post #171

Earlier quoted context omitted.

Why do you think Calico is a failure? I think the jury is still out on that one.

I have a little experience trying to work with Google in the R&D space at a large pharma. Google and other external R&D agents consistently underestimated the difficulty in getting access to sufficient data from us to employ large scale ML. That data often exists within a pharma's clinical trials, but it's acquired and stored in a way that makes it inaccessible to subsequent mining. This is a problem for dataminers l…

You didn't answer the question of why Calico is a failure. They have very little to do with Google. Calico is its own independent institute that does exactly what Art and Larry wanted when they set it up- produce world-class research into longevity. I think you mean Verily, which works closely with Google on health care projects.

(note: I worked at google over a decade and work for pharma now. I helped establish Google's move into health care and even launched products intended for pharma users and set up the ethical guidelines to work with private data like clinical records. Unfortunately, Google's Research leadership chose to take their health efforts in a completely different direction so now I focus on stuff that will actually make a difference for pharma).

Re: Alphabet is spending billions to become a force in health care

#194

Post by xyzzyz »

lotsofpulp wrote: post #114
xyzzyz wrote: post #80

Earlier quoted context omitted.

Quoted post unavailable.

Education costs are peanuts compared to healthcare costs. Not to mention that educating children provides a significant economic return to the state in the form of labor when the children grow up. Whereas dialysis and heart surgeries and hip replacements for 70+ year olds is a complete loss. For examples, a single NICU baby or hemophiliac can easily cost $1M+ per year. Health insurers almost had to stop selling polic…

> All the premium increases people complained about due to ACA are a fraction of the tax increases that would have had to happen for universal healthcare.

So why would I ever want universal healthcare? I was being sold on it being cheaper and more efficient, but now you’re saying that it will also cost more. What’s the point, then?

Re: Alphabet is spending billions to become a force in health care

#195

Post by tptacek »

xyzzyz wrote: post #194
lotsofpulp wrote: post #114

Earlier quoted context omitted.

Education costs are peanuts compared to healthcare costs. Not to mention that educating children provides a significant economic return to the state in the form of labor when the children grow up. Whereas dialysis and heart surgeries and hip replacements for 70+ year olds is a complete loss. For examples, a single NICU baby or hemophiliac can easily cost $1M+ per year. Health insurers almost had to stop selling polic…

> All the premium increases people complained about due to ACA are a fraction of the tax increases that would have had to happen for universal healthcare. So why would I ever want universal healthcare? I was being sold on it being cheaper and more efficient, but now you’re saying that it will also cost more. What’s the point, then?

There's robust disagreement among reasonable people about whether single-payer health care is a good idea in the US or not. The comment you were responding to wasn't overtly advocating for it. There's less reasonable support for acalculiac xenophobia.

Re: Alphabet is spending billions to become a force in health care

#196

Post by cupofpython »

Dudeman112 wrote: post #151
cupofpython wrote: post #130

Earlier quoted context omitted.

you dont disappear. you become embedded. they are metaphorically assigning you a number and stripping you of an identity. It is dehumanizing. At the end of the day, it's just you by a different name. Instead of owning it and claiming "we have this information on Gehlitio" they say things like "We have these generalizations about anybody who happens to use HN, speaks in English, bought X Y and Z, subscribes to A, "

Have you lived with chronic pain, or expected to live the rest of your life disabled? Because privacy doesn't seem all that important once you actually are going through it. If you had to pick between being a cripple (say, with your arms or your legs useless) and forgoing your privacy are you really sure you'd give more value to privacy? Do actually consider what life is like under these circumstances before answerin…

I am not sure where I argued that privacy is more important than health. I am saying call it what it is. You are arguing privacy is worth trading for health. I actually agree with that. I dont agree with claims that what google is doing is preserving privacy.

My beliefs are quite the opposite of what you implied about me. I think we should move away from all this embedded bullshit and keep peoples identities intact because the generalizations will never be perfect and it might be useful to know who the actual people are that those generalizations are based on. Maybe that would facilitate human connections. Maybe that would make it easier to reward individuals for sacrificing their privacy in order to improve healthcare. Instead of just pretending they arent sacrificing privacy and are just a drop in the ocean of data providing results.

You are not a drop in the data ocean. Your data is important. There are not a lot of people like you. Google emphasizes generalization because it cheapens the value of your individual data point. Their policy creates an illusion I aim to dismantle.

Also, I do have chronic illness but that is not relevant here. Mine does not directly cause pain, though, full disclosure

Re: Alphabet is spending billions to become a force in health care

#197

Post by cupofpython »

Gehlitio wrote: post #177
cupofpython wrote: post #130

Earlier quoted context omitted.

you dont disappear. you become embedded. they are metaphorically assigning you a number and stripping you of an identity. It is dehumanizing. At the end of the day, it's just you by a different name. Instead of owning it and claiming "we have this information on Gehlitio" they say things like "We have these generalizations about anybody who happens to use HN, speaks in English, bought X Y and Z, subscribes to A, "

It sounds to me that you put a negative empathis on 'dehumanizing' but you only talk about an ad id. I disagree on this sentiment, I don't care if there is an dehumanizing number for me in a ad context. I would prefer it over a personal id. Anyway I still care much more for having a cure for my chronic pain. Good for you if you don't need this.

My post wasnt clear on this, but I support doing whatever we can to ease chronic pain.

I just disagree with the position that Google can do so while preserving privacy. If we are going to trade privacy for cures, let's at least do so openly.

Re: Alphabet is spending billions to become a force in health care

#198

Post by cupofpython »

jcranberry wrote: post #165
cupofpython wrote: post #130

Earlier quoted context omitted.

you dont disappear. you become embedded. they are metaphorically assigning you a number and stripping you of an identity. It is dehumanizing. At the end of the day, it's just you by a different name. Instead of owning it and claiming "we have this information on Gehlitio" they say things like "We have these generalizations about anybody who happens to use HN, speaks in English, bought X Y and Z, subscribes to A, "

All statistics are dehumanizing. I'm no data scientist but I'd imagine including the whole human when doing statistics would produce a pretty low signal to noise ratio.

Statistics are dehumanizing, you are correct. We do not judge individuals based on the statistics of their categorical groups for this reason. Doing so under the obfuscation of a ML model doesn't change that.

Health is very personal. Family history is usually pretty relevant. I am not sure what we gain by pretending we arent talking about actual people, or that by removing your name from all your specific health details it somehow means you cant still be personally targeted. I know Google gains the benefits of less regulations, though.

Re: Alphabet is spending billions to become a force in health care

#200

Post by lotsofpulp »

xyzzyz wrote: post #194
lotsofpulp wrote: post #114

Earlier quoted context omitted.

Education costs are peanuts compared to healthcare costs. Not to mention that educating children provides a significant economic return to the state in the form of labor when the children grow up. Whereas dialysis and heart surgeries and hip replacements for 70+ year olds is a complete loss. For examples, a single NICU baby or hemophiliac can easily cost $1M+ per year. Health insurers almost had to stop selling polic…

> All the premium increases people complained about due to ACA are a fraction of the tax increases that would have had to happen for universal healthcare. So why would I ever want universal healthcare? I was being sold on it being cheaper and more efficient, but now you’re saying that it will also cost more. What’s the point, then?

My intention was to point out an additional factor in universal taxpayer funded healthcare being a political football, which is

> The other option is pharmaceutical companies, hospitals, and doctors take a huge pay cut.

Bringing healthcare prices down is also out of the league of cities/counties/states. These things require federal action like increasing number of doctor residency funding or spots, reducing patent protection for medicines, or other measures to increase supply of healthcare.

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