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Google Is Training Machines to Predict When a Patient Will Die

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Re: Google Is Training Machines to Predict When a Patient Will Die

#11

Post by newsbinator »

jand wrote: post #4

I would feel quite unconfortable if every action taken (or not taken) by medic staff has to be second-guessed simply because there are financial incentives derived from this research. Customer A does not receive full medical support because "he's dying anyway"? Is there a way to ensure that such cruel use of the research is prohibited?

More data is good.

It's better if this becomes an ethical/moral problem about when to care for patients and to what degree, rather than a guessing game problem while anybody's guess is as good as anybody else's.

Re: Google Is Training Machines to Predict When a Patient Will Die

#12

Post by digitalzombie »

Why did they just use a logistic model instead of survival/time-to-event model?

https://www.ncbi.nlm.nih.gov/pubmed/21478775

Uses cox regression model which is a survival regression model.

Also the base model aka previous model they're comparing it to is a logistic regression and the link leads to a pdf about how to increase hospital efficiency it seems like. This sounds stupid and heartless.

In statistic we got survival analysis, a whole branch that is focus on patient and their survival rate for the medical field. Google chose to compare to a paper and algorithm that focus on what seems like making hospital more money instead.

I've seen a lot of data science people goes into different field and just telling people they can make money for them. It's great but with healthcare I don't think people should be treated as dollar signs.

If anybody up and coming wants to use data science in bio, I would encourage them to look into statistic and biostatistic. We have tons of stuff already and then branch out to ML later. But at least know what's out there and there are establish organization, nonprofit out there too that all they do is biostat and build model. My friend works at a nonprofit child oncology.

I just want to point out there are people that's building model to help patient with terrible sickness out there to survive. We're not diddling our thumbs trying to make other people richer.

Re: Google Is Training Machines to Predict When a Patient Will Die

#13

Post by kypro »

coldseattle wrote: post #3

This will help with self-driving cars faced with a "trolley problem." You can choose the victim most likely to die anyway.

The trolley problem here already exists regardless. Just because making difficult decisions is uncomfortable doesn't mean the most moral outcome is to leave it to chance.

Re: Google Is Training Machines to Predict When a Patient Will Die

#14

Post by dapearce »

jand wrote: post #4

I would feel quite unconfortable if every action taken (or not taken) by medic staff has to be second-guessed simply because there are financial incentives derived from this research. Customer A does not receive full medical support because "he's dying anyway"? Is there a way to ensure that such cruel use of the research is prohibited?

>Customer A does not receive full medical support because "he's dying anyway"?

Unless the patient consents to stop or reduce care, this would be medical negligence, which is illegal (in the US). Medical providers are required by law to provide medical treatment with all the knowledge and skill they possess.

Re: Google Is Training Machines to Predict When a Patient Will Die

#15

Post by joshgel »

baxtr wrote: post #10
pavel_lishin wrote: post #8

Earlier quoted context omitted.

I'm sorry to hear about your loss, but can you elaborate on what data was discarded after her passing?

Thank you. Well, the way I understand it: her treatment history won’t be considered by any other doctor than her own. The reason for that is that she wasn’t part of a proper medical study. However, I believe there is value in her data. The last days she was treated with an experimental drug. If there was an open database on all cases with treatment history I could have looked into that and get a feeling what to expec…

This is partially true. Her data can't be used willy nilly (sp?). Hospitals and doctors offices can use this data for their internal operations, to improve efficiency, quality, etc and (honestly) profit. They can also use this data in research, but only with IRB approval for exemption from consent. Her data should be protected!

Also, I would add that the data collected for routine patient care is often of significantly lesser quality than that collected as part of organized research studies. This is because in a research study, all patients get the same studies and tests whereas in clinical care, they only get what they need, so there is significant amounts of 'missing' data.

Re: Google Is Training Machines to Predict When a Patient Will Die

#16

Post by dragonwriter »

dapearce wrote: post #14
jand wrote: post #4

I would feel quite unconfortable if every action taken (or not taken) by medic staff has to be second-guessed simply because there are financial incentives derived from this research. Customer A does not receive full medical support because "he's dying anyway"? Is there a way to ensure that such cruel use of the research is prohibited?

>Customer A does not receive full medical support because "he's dying anyway"? Unless the patient consents to stop or reduce care, this would be medical negligence, which is illegal (in the US). Medical providers are required by law to provide medical treatment with all the knowledge and skill they possess.

> Medical providers are required by law to provide medical treatment with all the knowledge and skill they possess.

No, to avoid liability for malpractice, they need to meet the “professional standard of care”, which is assessed by general practice in the medical community, not “all the knowledge and skill” the individual provider possesses.

Re: Google Is Training Machines to Predict When a Patient Will Die

#17

Post by bane »

baxtr wrote: post #7

A very close relative of mine passed away 2 weeks ago. She had cancer for 2 years and when she was first diagnosed the doctors would give her 8-10 “good years”. Well... When she died, I was shocked to learn that very few data points of her sichkness and treatment history would be preserved for later analysis. Doctors work almost entirely on their gut feeling and probably some clinical studies with n being very small.…

I get the impression that much of medicine is one of those strange practices that looks kinda like science, but really isn't. Medical practice appears to work more like a highly evolved guild system than any other kind of recognizable scientific activity. It's probably far beyond the point where its necessary to bring in actual scientific practices, so I can't say it's on the cusp of a sweeping change.

One of the problems that really prevents the change is that analysis of patient data is so highly protected that it's virtually impossible to do proper studies. We assume that people with such access are performing them, but I know from second-hand experience that actual time spent on real treatment studies is very small and most of the time is spent dealing with policy and patient privacy issues.

Large insurance and government-based (VA, CMS, etc.) providers have the most data, but either what they're looking for isn't exactly aligned with what patients need, or the organizations are so fubar (e.g. the VA) that real studies are unlikely to happen.

There really needs to be some kind of research exception/feedback loop on massive scale data analytics that allows some group of objective researchers to mine patient data and put in place actionable recommendations that work their way into medicine rapidly -- perhaps with some penalizing stick insurance providers can leverage against practitioners to make sure they adopt newer better practices.

Re: Google Is Training Machines to Predict When a Patient Will Die

#18

Post by corporateslaver »

digitalzombie wrote: post #12

Why did they just use a logistic model instead of survival/time-to-event model? https://www.ncbi.nlm.nih.gov/pubmed/21478775 Uses cox regression model which is a survival regression model. Also the base model aka previous model they're comparing it to is a logistic regression and the link leads to a pdf about how to increase hospital efficiency it seems like. This sounds stupid and heartless. In statistic we got surv…

Maybe they tried cox regression and it didn’t work. I’ve used that model and went with logistic regression before

Re: Google Is Training Machines to Predict When a Patient Will Die

#19

Post by waydowntogo »

I'm programmer and I'm always saying (something like this) - the program / AI can be able to do things the best way how it can be done the best way by its programmer(s)

My point is - this is completely nonsense. IT world and Real world are two difference worlds.

It's look like Google needs wake up call.

Re: Google Is Training Machines to Predict When a Patient Will Die

#20

Post by neurobashing »

I'm sure it's an interesting technical challenge with huge amounts of complex, nuanced debate involved, and it could have a huge impact on health care.

That said, my wife is an oncology nurse, and I will bet everything that no machine will ever get better at predicting than an experienced, skilled nurse. Humans are built to read humans.

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