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I wasted $40k on a fantastic startup idea

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Re: I wasted $40k on a fantastic startup idea

#361

Post by marcinzm »

conductr wrote: post #252
marcinzm wrote: post #198

Earlier quoted context omitted.

I mean, there's a reason pharmaceutical companies in the US spend $20 billion a year marketing to physicians and it's not because it doesn't work. Doctors in the end are human and as capable of being influenced and biased and taking shortcuts as any other person. That doesn't mean they're evil, just human.

A big chunk of that $20B is on high cost ads to the general public, which doesn’t occur in many other parts of the world. It’s a backwards system when a patient is told to ask their doctor for a prescription to a medication by the company that manufactures said medication.

No, that $20 billion is ONLY for doctor marketing. There's an additional $10 billion on top of that spent on patient advertising/marketing.

edit: There's a whole industry around providing pharma companies better tools to influence doctors. I believe the industry name for this part of pharma companies is Medical Affairs so feel free to google the tooling being offered.

Re: I wasted $40k on a fantastic startup idea

#363

Post by dkarl »

fastball wrote: post #143
dkarl wrote: post #109

I'm kind of concerned that people read this as satire but miss the most important part, namely the absence of concern about the safety and validity of the results. You know, the part where he stuck some statistical software in front of a database populated by a "motley crew" of contractors and wanted doctors to use it as a shortcut for making patient care decisions. The part where he implicitly compares the HTML spit…

But... this is peer-reviewed work by professional researchers[1]. He just tabulated them / made them searchable. [1] Given the reproducibility crisis, I'm not sure we should trust these much either, but that's a discussion for another time.

They're already searchable. He's claiming to extract usable information from them in a way that can be instantly used by doctors, so that they don't have to read the studies or find an up-to-date summary of the literature by a skilled professional.

He even called what his software did a meta-analysis. My understanding is limited, but a meta-analysis is difficult and laborious to do correctly. You have to design the standards you use to include and exclude studies and examine each study to decide whether including it will improve or harm the quality of your results. For example, maybe a method to evaluate outcomes that used to be common has been discredited. Maybe a study was done under a principal researcher who has been caught fabricating results in other studies. Maybe a study claims to be double-blind, but when you read it carefully, it turns out that it isn't. Maybe a study is well-designed in every way, but it was designed for a slightly different purpose, so the data can't be used the way you want to.

Factors like these result in the exclusion of a lot of studies from a meta-analysis, after painstaking examination by researchers who have the expertise to design and run the studies they're reading. It's scientifically difficult and important work. The author is bragging about not doing this work:

> On July 2, 2018, GlacierMD powered the world's largest depression meta-analysis, using data from 846 trials, beating Cipriani's previous record of 522.

Re: I wasted $40k on a fantastic startup idea

#365

Post by ayewo »

AzzieElbab wrote: post #359

Hey MS, Google, Amazon, Oracle, and countless others invested billions into health-it and made no observable impact. 40k for one of the most popular pharmaceutical site really is a wonder to behold, sorry about the 40k

I'm guessing that several of these attempts do not properly account for the negative externalities that are peculiar to the health industry.

Apple is taking a much much different approach in how they hope to gain a foothold in the health industry, starting with HealthKit and slowly chipping away at the problem with the Apple Watch getting FDA and related certifications.

Tim Cook is on record saying that if Apple is to be remembered for something with a lasting impact, it would be in health [0].

Unlike their peers, Apple's strategy in health is anchored on a very very long-term horizon. Would be interesting to see how their strategy unfolds. Fingers crossed.

0: https://www.cnbc.com/2019/01/08/tim-cook-teases-new-apple-se...

Re: I wasted $40k on a fantastic startup idea

#366

Post by aejnsn »

_xnmw wrote: post #364

Fantastic idea? This is AI snake-oil. If this guy literally thought he could build an auto-meta-analyses that could magically prescribe the right OTC to fix your pain based on a few button clicks, he's trying to play God.

It’s another one of the AI use cases where the problem is built around a solution.

Re: I wasted $40k on a fantastic startup idea

#367

Post by aaron695 »

f6v wrote: post #275
sillysaurusx wrote: post #255

Earlier quoted context omitted.

With all the negative pushback this is getting, it’s making me think he was onto something. The exact same criticisms would apply to Airbnb, for example. “They have not the slightest idea how the hotel industry works. This is a very professional industry with a lot of legal hurdles...”

Well, Airbnb and Uber aren’t the best examples, are they? Their growth and “success” is fueled by either operating in a legal gray zone, or defying the local regulations all together. Many people all over the world think their lives were made much worse since Airbnb is negatively affecting the long-term rental market. Point is, the effect of the company on the society can’t just be measured by market cap. Back to the…

> Their growth and “success” is fueled by either operating in a legal gray zone, or defying the local regulations all together.

We just got an impossible vaccine in under a year, I'm happy for all of medicine to spend a bit of time in a "legal gray zone" to see what might happen.

> Many people all over the world think their lives were made much worse since Airbnb is negatively affecting the long-term rental market.

Absolutely, just like the Luddites (Although they would be well off Luddites) their world is worse. But humanity has been made far better.

Re: I wasted $40k on a fantastic startup idea

#368

Post by hn_throwaway_99 »

sillysaurusx wrote: post #255
Gatsky wrote: post #212

Earlier quoted context omitted.

This article was posted before several years ago. The whole premise is bumptious - "I can copy data out of a bunch of papers [which I am in no position to screen for quality or relevance], run a canned 'gold standard' analysis in R [the idea that there is one true way to generate valid data is ridiculous], and then go tell the professionals what they are doing wrong." He even brags that his meta-analysis for depressi…

With all the negative pushback this is getting, it’s making me think he was onto something. The exact same criticisms would apply to Airbnb, for example. “They have not the slightest idea how the hotel industry works. This is a very professional industry with a lot of legal hurdles...”

Just because people think an idea is bad is doesn't mean it's a billion dollar startup idea. Indeed, most ideas people think are bad are actually bad - it's only the few outliers that are actually successful. Even then I think there is a ton of mythologizing around this idea that the founders were able to see something nobody else did, usually to make the founders look like some sort of diamond-in-the-rough geniuses, when in reality what they built was just a natural evolution of tech that existed at the time (successful founders usually just execute better and faster than others).

I mean, despite all stuff I've heard on HN about how a lot of big VCs passed on AirBnB, when I first heard of it it seemed like a very natural evolution from sites like Couch Surfing and VRBO that had existed for years.

Re: I wasted $40k on a fantastic startup idea

#369

Post by abecedarius »

nickjj wrote: post #352
johnisgood wrote: post #210

Earlier quoted context omitted.

Note: psychologists cannot prescribe anything here (Eastern Europe), psychiatrists can. I do not see any issues telling doctors that they are prescribing the wrong medication because you may know it better than them. I personally learnt a lot about pharmacology due to my illness, and I know what kind of medications are should not be supposed to be prescribed which the doctor working at the ER at that moment may not.…

> I do not see any issues telling doctors that they are prescribing the wrong medication because you may know it better than them. If you're not comfortable with a medication's potential side effects I do think it's worth bringing it up (I'm not a doctor, just an occasional patient) but it really comes down to how it's phrased. There's a very big difference between: "Actually propranolol won't work for me because aft…

You're offering reasonable practical advice, I think. But imagine if this were about consulting an auto mechanic. It's like "You can't just question them, you have to suck up!" It reminds me of a small Apple developer's open letter to Apple a while back, clearly very carefully worded, full of protestations about what a big longtime fan they were of Apple.

The difference in both cases is the gatekeeping.

Re: I wasted $40k on a fantastic startup idea

#370

Post by driverdan »

xiphias2 wrote: post #187
dkarl wrote: post #109

I'm kind of concerned that people read this as satire but miss the most important part, namely the absence of concern about the safety and validity of the results. You know, the part where he stuck some statistical software in front of a database populated by a "motley crew" of contractors and wanted doctors to use it as a shortcut for making patient care decisions. The part where he implicitly compares the HTML spit…

You are on point. For common diseases there are guidelines manually created and periodically updated by 40 doctors. Doctors should just use the last updated protocol for easy decisions. Even though for headache this is the recommended first line medication: Ibuprofen 400 mg, ASA 1000 mg, naproxen sodium 500–550 mg, acetaminophen 1000 mg https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4541429/#!po=0....

That's for migraines, not general headaches.
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