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Demand for human radiologists is at an all-time high

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Re: Demand for human radiologists is at an all-time high

#71

When Tesla demoed (via video) self-driving in 2016 with a claim "The person in the driver’s seat is only there for legal reasons. He is not doing anything. The car is driving itself" and then when they unveiled Semi in 2017 - I tweeted out and honestly thought that trucking industry is changed forever and it doesn't make sense to be starting in trucking industry. It's almost end of 2025 and either nothing out of it o…

No it’s just machine learning was always awesome for the 98% of the cases. We got fooled that we can easily deal with the remaining 2%.

It is the usual complexity rule of software: solving 80% of the problem is usually pretty easy at only takes about 50% of the estimated effort, it is the remaining 20% that takes up the remaining 90% of estimated effort (thus the usual schedule overruns).

The interesting thing is that there are problems for which this rule applies recursively. Of the remaining 20%, most of it is easier than the remaining 20% of what is left.

Most software ships without dealing with that remaining 20%, and largely that is OK; it is not OK for safety critical systems though.

Re: Demand for human radiologists is at an all-time high

#72

> Three things explain this. First,... Second, attempts to give models more tasks have run into legal hurdles: regulators and medical insurers so far are reluctant to approve or cover fully autonomous radiology models. Third, even when they do diagnose accurately, models replace only a small share of a radiologist’s job. Human radiologists spend a minority of their time on diagnostics and the majority on other activi…

As a patient I don't think I've ever even talked to any radiologist that actually analyzed my imaging. Most of the times my family or I have had imaging done the imaging is handled by a tech who just knows how to operate the machines while the actual diagnostic work gets farmed out to remote radiologists who type up an analysis. I don't even think the other doctors I actually see ever directly talk to those radiologi…

It really depends on the specifics of the clinical situation; for a lot of outpatient radiology scenarios the patient and radiologist don't directly interact, but things can be different in an inpatient setting and then of course there are surgical and interventional radiology scenarios.

Re: Demand for human radiologists is at an all-time high

#73
post #40
post #29

Earlier quoted context omitted.

People love to bring this up, and it was a silly thing to say -- particularly since he didn't seem to understand that radiologists only spend a small part of their time reading scans. But he said it in the context of a Q&A session that happened to be recorded. Unless you're a skilled politician who can give answers without actually saying anything, you're going to say silly things once in a while in unscripted settin…

Many of us have changed opinions after seeing how the tech does not scale. At the time? I would say he was a AI evangelist.

The tech scales, but accessing the training data is a real problem. It's not like scraping the whole internet. And most of it is unlabeled.

Re: Demand for human radiologists is at an all-time high

#74

When Tesla demoed (via video) self-driving in 2016 with a claim "The person in the driver’s seat is only there for legal reasons. He is not doing anything. The car is driving itself" and then when they unveiled Semi in 2017 - I tweeted out and honestly thought that trucking industry is changed forever and it doesn't make sense to be starting in trucking industry. It's almost end of 2025 and either nothing out of it o…

Look at Waymo, not Robotaxi. Waymo is essentially the self driving vision I had as a kid, and ridership is growing exponentially as they expand. It's also very safe if you believe their statistics[0]. I think there's a saying about overestimating stuff in the short term and underestimating stuff in the long term that seems to apply here, though the radiologist narrative was definitely wrong. [0] https://waymo.com/saf…

I agree with both comments here. I wonder what the plausibility of fully autonomous trucking is in the next 10-30 years...

Is there any saying that exists about overestimating stuff in the near term and long term but underestimating stuff in the midterm? Ie flying car dreams in the 50s etc.

Re: Demand for human radiologists is at an all-time high

#75

When Tesla demoed (via video) self-driving in 2016 with a claim "The person in the driver’s seat is only there for legal reasons. He is not doing anything. The car is driving itself" and then when they unveiled Semi in 2017 - I tweeted out and honestly thought that trucking industry is changed forever and it doesn't make sense to be starting in trucking industry. It's almost end of 2025 and either nothing out of it o…

well part of the reason why you may have felt mislead by that video is because it was staged so i wouldn't feel that bad. https://www.reuters.com/technology/tesla-video-promoting-sel... for me i have been riding in waymos the last year and have been very pleased with the results. i think we WANT this technology to move faster but the some of the challenges at the edges take a lot of time and resources to solve, but n…

Waymo is a 21 year old company that only operates on a small part of the US after $10 billions of funding.

Re: Demand for human radiologists is at an all-time high

#76
post #29
post #5

In 2016, Geoffrey Hinton – computer scientist and Turing Award winner – declared that ‘people should stop training radiologists now’. If we had followed every AI evengelist sugestion the world would have collapsed.

People love to bring this up, and it was a silly thing to say -- particularly since he didn't seem to understand that radiologists only spend a small part of their time reading scans. But he said it in the context of a Q&A session that happened to be recorded. Unless you're a skilled politician who can give answers without actually saying anything, you're going to say silly things once in a while in unscripted settin…

Radiologists, here, mostly sit at home, read scan and dictate reports. They rarely talk to other doctors and talking to a patient is beyond them. They are some of the specialists with the best salary.

With interventional radiologists and radio-oncologists it's different but were talking about radiologists here...

Re: Demand for human radiologists is at an all-time high

#77
post #7

Earlier quoted context omitted.

Let's assume the last person that entered their radiologist training started then and the training lasts 5 years. At the end of their training the year is 2021 and they are around 31. So that means they will practice medicine for cca 30 years which would put the calendar at around 2051. I'd wager in 25 years we'd get there so I think his opinion still has a large percentage of being correct.

Radiologists can retrain to do something else adjacent surely? Not like they'll suddenly be like an 18 year old with no degree trying to find a job.

Why do we assume that radiologists would have literally 0% involvement in the radiology workflow?

I could see the assumption that one radiologist supervises a group of automated radiology machines (like a worker in an automated factory). Maybe assume that they'd be delegated to an auditing role. But that they'd go completely extinct? There's no evidence of, even historically, a service being consumed that has zero human intervention.

Re: Demand for human radiologists is at an all-time high

#78
post #40

Earlier quoted context omitted.

Many of us have changed opinions after seeing how the tech does not scale. At the time? I would say he was a AI evangelist.

The tech scales, but accessing the training data is a real problem. It's not like scraping the whole internet. And most of it is unlabeled.

If you need more data to scale, and there is no data, it literally can't scale.

Scale is not always about trougput. You can be constrained by many things, in this case, data.

Re: Demand for human radiologists is at an all-time high

#79
>"they struggle to replicate this performance in hospital conditions"

Are there systematic reasons why radiologists in hospitals are inaccurately assessing the AI's output? If the AI models are better than humans in testing novel data then, well, the thing that has changed in a hospital situation compared to the AI-Human testing environment is not the AI, it is the human, under less controlled constraints, additional pressures, workloads, etc. Perhaps the AI's aren't performing as poorly as thought. Perhaps this is why they performed better to begin with. Otherwise, production ML systems are generally not as highly regarded as these models when they perform as significantly below test data sets in production. Some is expected, but "struggle to replicate" implies more.

>"Most tools can only diagnose abnormalities that are common in training data"

Well yes, training on novel examples is one thing. Training on something categorically different is another thing all together. Also there are thresholds of detection. Detecting nothing, or with a a lower confidence, or unknown anomaly, false positive, etc. How much of the inaccuracy isn't wrong, but simply something that is amended or expanded upon when reviewed? Some details here would be useful.

I'm highly skeptical when generalized statements exclude directly relevant information to which an is referring. The few sources provided don't at all cover model accuracy, and the primary factor cited as problematic with AI review, lack of diversity in study composition for women, ethnic variation, children, links to a a meta study that was not at all related to the composition of models and their training data sets.

The article begins as what appears to be a criticism of AI accuracy with the thinness outlined above but then quickly moves on to a "but that's not what radiologists do anyway", and provides a categorical % breakdown of time spent where Personal/Meetings/Meals and some mixture of the others combine to form at least a third that could be categorized as "Time where the human isn't necessary if graphs are being interpreted by models."

I'm not saying there aren't points here, but overall, it simply sounds like the hand-wavy meandering of someone trying to gatekeep a profession whose services could be massively more utilized with more automation, and sure-- perhaps at even higher quality with more radiologists to boot-- but perfect is the enemy of the good etc. on that score, with enormous costs and delays in service in the meantime.

Re: Demand for human radiologists is at an all-time high

#80
post #41

Earlier quoted context omitted.

If they had absolute perfect performance at zero cost, you would not need a radiologist. The current "workflow" is primary care physician (or specialist) -> radiology tech that actually does the measurement thing -> radiologist for interpretation/diagnosis -> primary care physician (or specialist) for treatment. If you have perfect diagnosis, it could be primary care physician (or specialist) -> radiology tech -> ML…

Nope. To understand why, you would really need to take a good read of the average PCP's malpractice policy. The policy for a specialist would be even more strict. You would need to change insurance policies before your workflow was even possible from a liability perspective. Basically, the insurer wants, "a throat to choke", so to speak. Handing up a model to them isn't going to cut it anymore than handing up Hitachi…

In that scenario, the "throat to choke" would be the primary care physician. We won't think of it as an "ML radiologist", just as getting some kind of physical test done and bringing it to the doctor for interpretation.

If you're getting a blood test, the pipeline might be primary care physician -> lab with a nurse to draw blood and machines to measure blood stuff -> primary care physician to interpret the test results. There is no blood-test-ologist (hematologist?) step, unlike radiology.

Anyway, "there's going to be radiologists around for insurance reasons only but they don't bring anything else to patient care" is a very different proposition from "there's going to be radiologists around for insurance reasons _and_ because the job is mostly talking to patients and fellow clinicians".

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