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Man saves wife’s sight by 3D printing her brain tumor

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Re: Man saves wife’s sight by 3D printing her brain tumor

#71

Post by Florin_Andrei »

pjungwir wrote: post #53
mcmancini wrote: post #19

I coauthored a paper a few years ago on the intra-observer variability of measurements of brain tumors when using the bidimensional product. An increase of 25% in the BP is taken as an indicator of brain tumor progression. We found that the intra-observer variability is so high, you can get that 25% increase purely by chance. The first recommendation of the medical team, to wait and see, is understandable.

Having been to three ultrasounds for my children, I'm amazed how casually they use a 2D length to estimate the baby's age, and therefore delivery date, and therefore when it is overdue and calls for a cesarean, etc. Your results seem like they confirm my suspicions that this can't possibly be very accurate.

Or maybe you're seeing just a slice of a procedure with a more complex theory behind it that you're not aware of.

Remember, being good at computers does not imply being good at medicine. This should be self-evident, but just a quick perusal of some comments here shows the contrary.

Re: Man saves wife’s sight by 3D printing her brain tumor

#72

Post by SilasX »

zeidrich wrote: post #64
_almosnow wrote: post #22

What's alarming is that a guy in his spare time can come up with a better diagnose than a 'certified professional'...

He had spare time, the doctor didn't.

The doctor had work time, and ostensibly an entire eduction specifically for this job. The doctor was still at an (extreme) advantage.

Re: Man saves wife’s sight by 3D printing her brain tumor

#74

Post by ashark »

Nagyman wrote: post #68
jkokenge wrote: post #40

Earlier quoted context omitted.

It seems that health care professionals don't have a nuanced problem solving attitude. They make a diagnosis, see how this diagnosis fits into a preconceived treatment bin, then just solve from that position without understanding what's different, what's unique to each case. And, in their defense, they probably just don't have the time for that extra work. That's where I see technology as most useful....how to automa…

I agree with you and also believe this extends to the majority of professions. Even within software development, there are a significant number of people that will only solve the immediate problem in front of them in a stepwise manner, rather than using lateral thinking to evaluate if the problem should be solved in the way that's most familiar to them, or to look at it from a different perspective and solve another…

A lot of school administrators have PhDs, but get one to tell you how they learned about some really cool experimental results at some conference (probably publicized by someone trying to sell them something, incidentally, but that's another problem) and are trying to reproduce them at their school(s).

You'll be in for a treat.

A "treat".

Fun bonus anecdote:

One of my wife's principals was convinced the prayer jar she provided for the staff was effective because over half of the prayers the prior year had been answered. When she told me that story it damn near broke my brain.

Re: Man saves wife’s sight by 3D printing her brain tumor

#75

Post by jpmattia »

gmarx wrote: post #51
VikingCoder wrote: post #42

Earlier quoted context omitted.

There are multiple problems. The biggest problem in my mind is that outcomes are not tracked well. That means that there's no medical feedback loop to measure the long-term effectiveness of... anything. And no good way to do retrospective studies to prove new measurement techniques. And also the laws for patient protection makes it incredibly difficult to get even anonymized data for researchers to use. The next bigg…

Medicine has a data problem. It is multifaceted and far more difficult to fix than it should be. I've worked on these problems for years and it is immensely frustrating. Incentives just aren't set properly to solve them. For example with outcomes tracking, even if you had a good software system for it, you won't get reimbursed for it.

> For example with outcomes tracking, even if you had a good software system for it, you won't get reimbursed for it.

It's worse than that: It would be sued out of existence by those people who rank badly (ie, exactly those bad practitioners that need to have their asses kicked.)

In a related example: A friend wrote a book about first-hand experience in dealing with a nursing home for her aging parent. There were many instances of problems, but one in particular was that a doc had prescribed the wrong drug.

The publisher loved the book, and made the publication offer contingent on a number of changes. One of those changes: You can't implicate a person or his institution because of the liability. It doesn't matter how good your proof is, the jury system is so broken that the publisher just can't accept the risk.

Now just imagine if there were a searchable database of outcomes tied to individual practitioners or institutions.

Re: Man saves wife’s sight by 3D printing her brain tumor

#76

Post by tapp »

smacktoward wrote: post #63
DMac87 wrote: post #54

Earlier quoted context omitted.

Even if true, I don't know what to make of such a statement - needless interventions for ALL diseases/causes may kill a lot more than any ONE single, narrowly defined disease/cause - that says more about the classification/definition system than interventions... it's only if interventions on any ONE disease kill a significant proportion vs the disease itself that that intervention / interventions are truly dangerous.…

The problem is that it's not just "needless interventions" that can backfire. Even in situations where an intervention could unquestionably help, there's still plenty of ways for it to go wrong. The most obvious is human error -- a well-intentioned intervention that's disastrously mis-executed -- but that's just the beginning of the list, not the end. What you have to remember is that for the vast majority of human h…

> Today doctors obviously do understand the role of germs in spreading disease better

And yet study after study of hospital acquired infections show that simple hand washing between patient examinations is abysmally irregular (between 10 and 50%.)

Re: Man saves wife’s sight by 3D printing her brain tumor

#77

Post by Karunamon »

stefantalpalaru wrote: post #32

Alternate title: Man encourages his wife to go through unnecessary surgery for a benign and symptomless meningioma after she had an unnecessarily complicated thyroid removal in order to avoid a 4cm scar on her neck. Oh, he also made a shitty 3D model of her skull in the process.

Did we read the same article?

The neurosurgeon discovered that the tumor was starting to entangle her optic nerves, and told her that if she had waited six months, she would have had severe, and possibly permanent, degradation of her sight.

Because I'd really like to think you're being this insensitive out of ignorance, rather than malice.

Re: Man saves wife’s sight by 3D printing her brain tumor

#78

Post by VikingCoder »

jpmattia wrote: post #75
gmarx wrote: post #51

Earlier quoted context omitted.

Medicine has a data problem. It is multifaceted and far more difficult to fix than it should be. I've worked on these problems for years and it is immensely frustrating. Incentives just aren't set properly to solve them. For example with outcomes tracking, even if you had a good software system for it, you won't get reimbursed for it.

> For example with outcomes tracking, even if you had a good software system for it, you won't get reimbursed for it. It's worse than that: It would be sued out of existence by those people who rank badly (ie, exactly those bad practitioners that need to have their asses kicked.) In a related example: A friend wrote a book about first-hand experience in dealing with a nursing home for her aging parent. There were man…

You're not going quite far enough -

Medical Practitioners and Medical Institutions should be required by law to document outcomes, provide information about disputed outcomes, and update the information on a periodic basis.

And tampering with the information should carry heavy punishment, including jail time for the practitioner and officers of the institution.

Actions like the recent cover-ups in the VA hospitals about wait times leading to deaths should be nearly impossible to hide from the public eye.

Re: Man saves wife’s sight by 3D printing her brain tumor

#79

Post by pjungwir »

Florin_Andrei wrote: post #71
pjungwir wrote: post #53

Earlier quoted context omitted.

Having been to three ultrasounds for my children, I'm amazed how casually they use a 2D length to estimate the baby's age, and therefore delivery date, and therefore when it is overdue and calls for a cesarean, etc. Your results seem like they confirm my suspicions that this can't possibly be very accurate.

Or maybe you're seeing just a slice of a procedure with a more complex theory behind it that you're not aware of. Remember, being good at computers does not imply being good at medicine. This should be self-evident, but just a quick perusal of some comments here shows the contrary.

Yes, I completely agree. It's not like I'd take action on my doubts. I'm sorry if my original comment sounded critical---that wasn't my point. But it is crude, isn't it? I believe even doctors concede that these estimates are not very accurate (especially when taken mid/late in the pregnancy), and it is sort of alarming to watch a nurse snap lines across the skull cross-section freehand and use those.

I find that in general with medicine my intuition battles against what my intellect knows must be the case. It's not like anything in the body is far away. Cancer isn't even very small. Isn't it weird that it's so hard to treat? Obviously it must be, but it feels like it should be easy. The patient is a foot away. We are inscrutably powerless.

When every day you command computers and they obey, when you can summon distant people and their image appears before you, when you can instantly consult more lore than in the greatest library, when you see people casually toting radiant tablets of spellbinding powers, progress in medicine feels so slow, so analog---so carnal. I know it's wrong, and we live in a world of medical miracles, with vaccines and antibiotics and DNA and everything else, but sometimes I can't help but feel that nothing has happened since Galen. It's not an argument, it's a feeling, but one with pathos that I'm sure many share.

Re: Man saves wife’s sight by 3D printing her brain tumor

#80

Post by djokkataja »

emcrazyone wrote: post #6
jepper wrote: post #4

Interesting article, glad the operation was successful. The most interesting part of the article is not the advance in technology (nothing new, we've been using 3d prints as models for complicated fractures / bone tumours or even custom prostheses for years (academic centre)) but the low use rate of this technology by most hospitals. The trick with overlaying follow-up scans is called image fusion and is easy and can…

@jepper I agree with your comments and to add to what you said, what really stuck out for me was how receptive the doctors were to his analysis. I didn't pick up any kind of resistance by the medical professionals to this guy's analysis. Also, I have a chronic condition and this comment from the article is just so true. "Scott’s recent thyroid surgery had taught them that getting the best care requires being proactiv…

The article did mention that he contacted a number of doctors around the country, and it didn't sound like he had a horde of them competing over who would have the opportunity to perform the operation, just the one guy at UPMC.

Plus since he had done a lot of research and "shopping around" for the thyroid procedure previously, he probably had a good idea of how to navigate the medical system to do this sort of thing.

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