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Why are cancer guidelines stuck in PDFs?

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Re: Why are cancer guidelines stuck in PDFs?

#141

Post by jampekka »

prepend wrote: post #132
ethbr1 wrote: post #102

Earlier quoted context omitted.

As an analogy, imagine if the consequence of Oracle doing Oracle-as-usual things was worse medical outcomes. But they did them anyway for profit. That's basically medical information system vendors. The fact that the US hasn't pushed open source EMRs through CMS is insane. It's literally the perfect problem for an open solution.

I love open source EMRs, but has any major country adopted open source EMRs? I know OpenMRS exists but is mainly used within developing nations. The US has Vista, made by VA, and it is a beast and no one really wants to use it.

If I understand correctly, Estonia made their own EMR/EHR from scratch. The government produced (and commissioned?) software is all open source. https://koodivaramu.eesti.ee/explore

EMR software seems like something that shouldn't be that hard. It's fundamentally a CRUD. Sure, there's a lot of legacy to interface with, but medical software seems like a deeply dysfunctional and probably corrupt industry.

Re: Why are cancer guidelines stuck in PDFs?

#142

Post by londons_explore »

epcoa wrote: post #106
londons_explore wrote: post #81

Earlier quoted context omitted.

but we have well established ways to deal with those... test/validation sets, n-fold validation, etc. Even if there was some overfitting or data contamination that was undetected, the result would most probably still be better than a hand-made decision tree over the same data...

Ok, until you can sue the AI you need to find a doctor ok putting their license behind saying “I have no idea how this shiny thing works”. There are indeed some that will, but not a consensus.

Great. Lets have the few that are willing to put their license behind that do so, and then a study showing that those people get better cure rates than those who do not...

And then the decision tree can be rewritten as "Do ${New_method}".

Re: Why are cancer guidelines stuck in PDFs?

#143

Post by jampekka »

hyhconito wrote: post #140
shiroiushi wrote: post #133

Earlier quoted context omitted.

>Because JSON is fucking horrible for humans? It's better than XML at least.

JSON has never been better than XML. People are just terrible at XML and don't want to learn.

"People are just terrible at C++ and don't want to learn."

Re: Why are cancer guidelines stuck in PDFs?

#144

Post by HPsquared »

resource_waste wrote: post #111
pcrh wrote: post #3

The fundamental idea here is that doctors find it difficult to ensure that their recommendations are actually up-to-date with the latest clinical research. Further, that by virtue of being at the centre of action in research, doctors in prestige medical centres have an advantage that could be available to all doctors. It's a pretty important point, sometimes referred to as the dissemination of knowledge problem. Curr…

It amazes me that AI isnt a borderline requirement for being a doctor. Think of how much info is outdated or just wrong.

There's a lot of outdated and wrong info coming from AI tools as well. It's the natural outcome of training on a large historical dataset.

Re: Why are cancer guidelines stuck in PDFs?

#145

Post by HPsquared »

grumbel wrote: post #62

Same reason why datasheets are still PDFs. It's a reliable, long lasting and portable format. And while it's kind of ridiculous that we are basically emulating paper, no other format fills that niche. It's the niche HTML should be able to fill, since that was its original purpose, but isn't, since all focus over the last 20 or so years has been on everything else, but making HTML a better format for information excha…

I really wish there was a standard way to package html with JavaScript for offline viewing, basically to treat it like a pdf but with fancy things like interactive controls.

Re: Why are cancer guidelines stuck in PDFs?

#146

Post by harvey9 »

ethbr1 wrote: post #102
righthand wrote: post #46

Earlier quoted context omitted.

Medical information system vendors only care about making a profit, not implementing actual solutions. The discrepancies between systems can lead to bad information which can cost people their life.

As an analogy, imagine if the consequence of Oracle doing Oracle-as-usual things was worse medical outcomes. But they did them anyway for profit. That's basically medical information system vendors. The fact that the US hasn't pushed open source EMRs through CMS is insane. It's literally the perfect problem for an open solution.

Since Oracle bought Cerner a few years ago, no imagination needed. Sadly, since Cerner has lots of good people who want to make good products.

Re: Why are cancer guidelines stuck in PDFs?

#148

Post by triska »

upghost wrote: post #5

It's so much worse than you could possibly imagine. I worked for a healthcare startup working on patient enrollment for clinical oncology trials. The challenges are amazing. Quite frankly it wouldn't matter if the data were in plaintext. The diagnostic codes vary between providers, the semantic understanding of the diagnostic information has different meanings between providers, electronic health records are a mess,…

David has since also made extensive progress with his category-theoretic approach, available in a new repository:

https://github.com/Precisfice/DEDUCTION

Re: Why are cancer guidelines stuck in PDFs?

#149

Post by refurb »

liontwist wrote: post #60
refurb wrote: post #43

Earlier quoted context omitted.

I worked with oncologists and this isn’t true. Oncology has a rapidly changing treatment landscape and it’s common for oncologists to be discussing the latest paper that has come out. If you’re an oncologist and not keeping up with the literature you’re going to be out of date in your decisions in about 6 months from graduation.

Funny enough that last paragraph is also said of software engineers too. Neither are true.

Unlike oncologists, people won't die if you don't keep up on the latest programming techniques.

Re: Why are cancer guidelines stuck in PDFs?

#150

Post by delfinom »

ethbr1 wrote: post #102
righthand wrote: post #46

Earlier quoted context omitted.

Medical information system vendors only care about making a profit, not implementing actual solutions. The discrepancies between systems can lead to bad information which can cost people their life.

As an analogy, imagine if the consequence of Oracle doing Oracle-as-usual things was worse medical outcomes. But they did them anyway for profit. That's basically medical information system vendors. The fact that the US hasn't pushed open source EMRs through CMS is insane. It's literally the perfect problem for an open solution.

>The fact that the US hasn't pushed open source EMRs through CMS is insane. It's literally the perfect problem for an open solution.

It's not insane, it's because the US is an oligarchy. And it's about to go even more oligarchy on steroids in the next year.

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