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A journey into the shaken baby syndrome/abusive head trauma controversy

cambridgeblog.org

471–480 of 639 posts

Re: A journey into the shaken baby syndrome/abusive head trauma controversy

#471

This doesn’t surprise me. We have massive systemic issues in medical science and care delivery. - Medical science handles variation by simply assuming that large enough samples will average out variation. This loses a ton of information as the “average person” is a construct that almost certainly doesn’t exist. - news media on medical science glosses over all uncertainties in the name of clickbaity sensationalism. -…

Basically, you want to replace statistics ("large enough samples will average out variation") with AI. I'm afraid that's cargo cult instead of science. AI can lie. It means a "truely personalized medicine" would sometimes poison its patients. See for instance Donald Knuth experiment with Chat GPT, starting with "Answer #3 is fouled up beautifully!" with some totally wrong AI answers https://www-cs-faculty.stanford.ed…

> Basically, you want to replace statistics ("large enough samples will average out variation") with AI

No. This is misunderstanding due to my lack of clarity. Apologizes.

The biggest problems with Medical data is that 1) incredibly small scale data is collected to make assertions, 2) the data is horrendously de-normalized

In Radiology, a common validation approach is have radiologists review cases on the order of 250 studies to make assessments about a radiology product. This is considered the gold standard for FDA. Look into it more, vaccines, treatments. The sample sizes are fucking tiny.

The statistical assertion is that these relatively small samples capture the variation sufficiently to demonstrate efficacy across devices, treatments. These are then extrapolated to the US and wider populations. Do you believe that this is rigorously true?

The rationale underpinning this is simply practicality. You cannot get thousands (or hundreds of thousands) of patients/doctors/etc to get a strong signal and confidence. For drugs, it's super hard, but for devices and software interventions, it way easier to get data.

That brings us to the second big problem: the data structure is completely highly varied and denormalized.

1) From a pure structure point of view, it's basically free text fields that doctors sporadically fill.

2) From a underlying truth point of view, each hospital across the world has different protocols for care delivery. A histopathological FNA procedure might have a completely different meaning in CA, NY, or EU. This might simply be because of workflow, timeline, or just people using the words wrong.

What I mean with AI+Sensors:

AI doesn't need to solve the problem of intuition around medical problems. The biggest impact will likely come from the relatively mundane task of simply structuring and normalizing the data. Sensors simply help to generate more data

To be more concrete, you don't want (and shouldn't trust) this:

Prompt: "Please diagnose this person"

You want this:

Prompt: "Here is 100 TB of data from 100 different hospitals each with different workflows and patients for histopathology. For each patient, synthesize a CSV with the following schema "AnonPatientID, AnonCaseID, Pathology Result, Pathology stage, Incidenctal findings, ..."

Then I can do the analysis myself.

Hope this makes more sense.

(I work in healthtech and med device and I promise you: Demoralization at the state of medicine is a rite of passage after which you can begin to address practical problems)

Re: A journey into the shaken baby syndrome/abusive head trauma controversy

#472
post #174

Amazing that bit about child welfare organisations fighting against the science, when clearly taking children away based on false accusations is clearly far worse for the child’s welfare, not to mention the parents’! It’s just incredible the injustice that can be done in the name of protecting children. I really do wonder if it’s cultural or some kind of innate psychological irrarionality that seems stronger in some…

> Amazing that bit about child welfare organisations fighting against the science, when clearly taking children away based on false accusations is clearly far worse for the child’s welfare, not to mention the parents’! This is just speculation, but I bet those groups (or their members) aren't always calmly and coolly trying to find the best policies protect the welfare of children. Instead they feel themselves on a k…

This is true, but not for the reasons you might expect. Well, 10% of the time this is the case, but 90% ...

Mostly they are operating on priors. The prior probability of a separation being the right thing to do is very high, because they have a _long list of mitigation before they actually can take a kid away. In the case of a doctor-approved immediate physical danger, they are regulated into acting on behalf of the immediate safety of the child while the investigation is ongoing but even that is considered temporary.

The goal of any foster care situation is to get the kids back with the biological parents, so time is on their side, provided they are not living in a circumstance that disallows the kind of attendance and involvement that the state would require to clear a caseworker to re-unite the family. Sadly, many are.

Source: Foster parent.

Re: A journey into the shaken baby syndrome/abusive head trauma controversy

#473
post #76
post #70

Earlier quoted context omitted.

Possession is nine tenths of the law. It's not someone else's child if it's in your house and you need a genetic test to deny responsibility. This idea that bloodlines are relevant is anachronistic superstition. Several of my friends are not genetically related to their children. It's simply not relevant.

Adopting is no big deal. Being cuckolded is generally considered one of the biggest betrayals in the human experience. It's incredibly relevant to know if your spouse is faithful to you!

You are conflating infidelity with lack of knowledge of a child's paternity.

They are not remotely the same.

Re: A journey into the shaken baby syndrome/abusive head trauma controversy

#474

Oh the good old, violent Easter European bias mixed into crap science.

It also because north Europe has one of the most toxic social services in the world, kidnapping kids 24/7. That's basically their job.

Seen complaints/protests like this in my country. Then the adult children of the lady leading these protests spoke out against her and pointed out she was just doing it to get a house and embezzling a load of GoFundMe money.

This wasn't SBS though, she just kept adopting out her kids to devote more time to her drug habits.

Re: A journey into the shaken baby syndrome/abusive head trauma controversy

#475
post #243

Earlier quoted context omitted.

There's another factor in this, which makes it hard to change: For the people in child welfare organizations, for social workers, for doctors, for police, for judges to change their mind about current and future decisions requires them to change their mind about past decisions. The necessary implication is that many of the people they have persecuted in the past were, in fact, innocent. It requires them to admit that…

This is spot on. This psychological barrier is probably the number one obstacle to a wider recognition of the existence and extent of this problem. People like me who challenge the science behind the diagnoses of SBS face an absolutely unprecedented and unreasonable pushback, like I've never seen in any other area. Basically everyone who has worked on this side has faced threats, insults, personal attacks, cancellati…

It's the sunk cost fallacy.

This is why Max Planch (German physicist) has quipped that science advances one funeral at a time.

Re: A journey into the shaken baby syndrome/abusive head trauma controversy

#476
post #365

Earlier quoted context omitted.

> Oh the good old, violent Easter European bias mixed into crap science. Honest question, trying to parse your statement (and bear in mind I don't live in Europe, so I'm surely missing the obvious): do you mean that in Denmark there is a bias against Eastern Europeans, such as Romanians? Edit: excellent, got a downvote for asking an honest question and clarifying why I wrote it. Is this an example of the fine discour…

For your edit: 'honest questions' (which are in fact anything but: the person asking has no interest in the answer, and the question itself is often leading) are a common disruptive tactic used by people (normally pushing extreme right-wing ideologies) to derail a conversation. I'm sure that you're not doing that here, but unfortunately people with genuinely honest questions have become collateral damage caused by di…

this "are a common tactic" gets a bit old, good way to gatekeep certain topics.

If the same "tactic" is used, why not come up with a good counter? A point stands whether it's being asked disingenuously or not.

Re: A journey into the shaken baby syndrome/abusive head trauma controversy

#477

Earlier quoted context omitted.

Implying ripping children out of their families willy-nilly is "more developed."

Its tongue in cheek. Germany is developed, but you will get arrested if you try to homeschool your children.

b/c it's seen as a basic right, and issue of equality to have access to the same level of state education. The concept of "your" children is something of the problem.

Re: A journey into the shaken baby syndrome/abusive head trauma controversy

#479
post #140

> It is the perfect combination of crap. I think that's being way too charitable. In a world where people are incarcerated on a scale unprecedented in all of human history, and where prosecutorial success is measured by number of scalps taken, the assumption that this is plain malice designed to let the state rob a few more individuals of their freedom makes much more sense than it all being just a big pile of incomp…

We detached this subthread from https://news.ycombinator.com/item?id=37667150.

Re: A journey into the shaken baby syndrome/abusive head trauma controversy

#480

>> how many people are in jail or lost their kids due to something that didn't actually happen. Thousands upon thousands. By some estimates upwards of 10% of incarcerated individuals. The situation is just accepted. The general consensus is always that locking up too many people is better than than too few. It is on defense attorneys to check on the system.

We detached this subthread from https://news.ycombinator.com/item?id=37667150.
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