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The Fall of Babylon is a warning to AI unicorns

wired.com

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Re: The Fall of Babylon is a warning to AI unicorns

#41

Post by vidarh »

ewzimm wrote: post #40
vidarh wrote: post #23

Earlier quoted context omitted.

It's such a shame. From a user point of view they were great. I'm registered with them. The UK GP practice has been taken over by someone else (eMed) The app was great. I got appointments fast until very recently. The triage was basic, though, but to an end-user it wouldn't have been obvious to what extent their business plan relied on that for the shot at future profitability. I used to work for a VC, and we investe…

This comment is so much more informative than the article. They made a medical UX that people actually wanted to use but oversold the AI. I wonder why nobody tried to merge the front-end with a different AI, or did that fail too?

I think the big issue here is that from a user point of view the "AI" is mostly uninteresting unless it is really amazing and as long as it's not really bad.

As a user I want to resolve my medical issue.

If the AI is really bad, it would become a nuisance and force me to go through annoying and poorly thought through questions to get an appointment, and/or make me answer "wrong" to get to where I want to be. Babylons "AI" had few enough questions it didn't feel like a barrier, so at most it was a minor nuisance.

Had it been really good, maybe I'd have cared, but what does "really good" look like here? If what I have is ambiguous, or need tests, I still need an appointment. From a user point of view there is no happy case there, even if they get it a point where it saves them money, because it doesn't save me money, and I can't tell if it's saved me time, e.g. by routing me to a person better able to help.

So the AI was sold to investors as a means to cut costs by being able to take on more patients per expensive human resource, be it doctors or nurses or others. But you need to make really good decisions so that you don't end up with extra referrals down the line to compensate before you save enough doctors time to fund the software developers and project managers etc. to build that AI.

And it seems like they basically got drunk on the valuations mentioning AI got them, took all they money they could get, and then failed to exercise any reasonable cost control when they should have realised that even if they had something really good, the proportion of revenue per patient they could shunt towards development on a per patient basis is small.

E.g. in the UK, the NHS pays an average of around 160 pounds / $195 per patient per year to GPs to cover everything. The margin you can extract from that after paying doctors and general practice costs doesn't fund a very large development operation until you get to a very significant scale.

Re: The Fall of Babylon is a warning to AI unicorns

#43

Post by choeger »

I've yet to see a convincing new business model for LLMs. They are impressive, don't get me wrong, but right now they only seem to augment many already existing businesses or workflows in one way or another.

Unless that changes, "A.I." will be a commodity that you purchase like you already do with storage. Hardly exciting, tbh.

Re: The Fall of Babylon is a warning to AI unicorns

#44

Post by lowbloodsugar »

Balooga wrote: post #37
opo wrote: post #35

Earlier quoted context omitted.

I don't know if IBM created anything in this area back then, but the MYCIN expert system was developed in the 1970s at Stanford. MYCIN was shown to outperform infectious disease experts by 1979 in a blind testing: >... Eight independent evaluators with special expertise in the management of meningitis compared MYCIN's choice of antimicrobials with the choices of nine human prescribers for ten test cases of meningitis…

I wish I had the link to the YouTube video where a researcher described one of the main reasons why MYCIN failed. Because when you optimize for number of patients per doctor, it is a lot more cost effective to prescribe a broad spectrum antibiotic that kills all pathogens and move on to the next patient than it is to spend time with one patient and MYCIN to narrow down to the exact pathogen.

And that worked out well! When you optimize for reducing costs, not outcomes, the outcome you get is antibiotic resistant bacteria!

Seriously though, if we take a "maximize outcomes" approach, then doctors don't actually need to spend any time with a patient - the computer can do it. Maybe this isn't optimal for wealthy first-worlders, but it will be better than what poor first-worlders and everybody else have now. Many people in the US simply do not go to the doctor, unless it's an unavoidable ER trip.

Re: The Fall of Babylon is a warning to AI unicorns

#45

Post by shrimpx »

riku_iki wrote: post #10
icyberbullyu wrote: post #7

There's a difference between a company that overextends itself and fails to live up to its own promises, and the current explosion of LLMs. Are there some snake-oily VC pitches that over-promise what LLMs can do? For sure. The big distinction is that LLMs already have a whole bunch of things they're great at while Babylon was never really able to perform even one of it's promised features very well.

> The big distinction is that LLMs already have a whole bunch of things they're great at I would say mediocre not great, and it is up to market to decide if quality threshold is crossed. So far there is no reliable data that some LLM startup started making good money and clients didn't leave after 1 year of mediocre results.

I feel like LLMs won't find their success in this "here's a LLM product!" kind of way but more by being leveraged internally by companies to increase velocity, do more with fewer employees, etc. I've certainly gained a lot from LLMs just by getting help on my own projects.

Re: The Fall of Babylon is a warning to AI unicorns

#46

Post by DonHopkins »

prewett wrote: post #20

I was hoping they were going to somehow draw parallels from ancient (Mesopotamian) Babylon. Sadly, it's some apparently overhyped health startup, which isn't nearly as interesting, although probably a more relevant comparison.

Why aren't there any unicorns named after Sodom and Gomorrah?

Re: The Fall of Babylon is a warning to AI unicorns

#47

Post by DonHopkins »

vessenes wrote: post #8

I'd like a word for what is now the ritualized 'weirdo CEO anecdote' as a hook into why a company failed trope. Make no mistake: if Babylon were currently worth $20bn, Antigua standups and calling employees Babylonians would be the subject of business-school case studies. That said, this is a puff piece in Wired for so many reasons, not least of which is the question of whether or not app-based diagnosis and triage i…

What -- are you telling me that WIRED MAGAZINE does PUFF PIECES??!

You've Got Smell!

https://www.wired.com/1999/11/digiscent/

>But the orange peel is just the beginning, a humble hors d'oeuvre. Marc Canter, sometimes known as the father of multimedia, joins us to serve the multiscented main course.

With Marc Canter as boastful spokesman, biggest weirdo, proud maître d', and influencer under the influence of the munchies, it's more of a Puff Puff Pass piece.

>"You know, I don't think the transition from wood smoke to bananas worked very well." -Marc Canter

https://news.ycombinator.com/item?id=29225777

Re: The Fall of Babylon is a warning to AI unicorns

#48

Post by DonHopkins »

lowbloodsugar wrote: post #15
vessenes wrote: post #8

I'd like a word for what is now the ritualized 'weirdo CEO anecdote' as a hook into why a company failed trope. Make no mistake: if Babylon were currently worth $20bn, Antigua standups and calling employees Babylonians would be the subject of business-school case studies. That said, this is a puff piece in Wired for so many reasons, not least of which is the question of whether or not app-based diagnosis and triage i…

I think it was IBM that demonstrated in the 80s that a decision tree out performed doctors at diagnosis.

My Apple ][ came with a BONE TUMOR DIAGNOSIS program written in Applesoft on the contributed software floppies from Apple, "COPYRIGHT 1978 APPLE COMPUTER, INC." You might consider it Apple's earliest AI Powered Health App! You can run it in an emulator here:

https://archive.org/details/a2_Biology_19xx_

    Text found in Biology_19xx__.do/BONE TUMOR DIAGNOSIS.bas:

    0 TEXT : GOTO 2000
    19 DIM PB(9,19)
    20 FOR I = 1 TO 9: FOR J = 0 TO 18: READ PB(I,J): NEXT : NEXT
    25 DATA 15,20,35,45,20,80,99,1,100,20,40,60,1,0,15 ,35,50,0,0
    26 DATA 5,75,20,5,20,80,100,50,75,0,90,10,0 ,30,50,35,15,0,0
    27 DATA 3,50,35,15,30,70,30,20,100,25,85,15,0 ,2,85,15,1,0,0
    28 DATA 17,25,25,50,35,65,40,1,85,65,20,80,5,65,15,20,25,25,15
    29 DATA 10,20,20,60,5,95,55,0 ,90,65,20,80,25,2,0 ,10,40,30,20
    30 DATA 25,65,25,10,10,90,30,05,95,75,15,85,98,05,0, 0,10,30,60
    31 DATA 5,20,35,45,0,100,30,1,100,50,25,75,100,5,15,25,55,5,0
    32 DATA 15,70,25,5,35,65,20,5,85,90,15,85,0,0,0,5,10,20,65
    33 DATA 5,10,25,65,20,80,50,1,85,80,15,85,0,0,0,0,20,30,50
    49 FOR I = 1 TO 10: READ Z$(I): NEXT I
    50 DATA I-A,I-B,I-C,II,III,"95-100%","40-95%","25-60%","15-35%","4-15%"
    55 IF NOT Q THEN NEW
    60 DATA GIANT CELL TUMOR,CHONDROBLASTOMA,CHONDROMYXOID FIBROMA,CHONDROSARCOMA
    62 DATA FIBROSARCOMA,OSTEOSARCOMA,PAROSTEAL SARCOMA ,EWING'S TUMOR,RETICULUM CELL
    70 FOR I = 1 TO 9: READ DIAGNOSIS$(I): NEXT
    80 FOR I = 1 TO 9:PB(I,19) = 1: NEXT
    90 HOME : PRINT " THIS PROGRAM USES A PRIOR PROBABILITY"
    92 PRINT "MATRIX PUBLISHED BY G.S.LODWICK M.D. IN"
    94 PRINT "THE RADIOLOGIC CLINICS OF NORTH AMERICA"
    96 PRINT "IN 1963."
    98 PRINT : PRINT "THE PROBABILITY OF THE DIAGNOSIS IS"
    99 PRINT "CALCULATED USING BAYES' RULE FOR THE"
    100 PRINT "PROBABILITY OF CAUSES"
    102 PRINT : PRINT "NINE DIAGNOSES ARE CONSIDERED"
    105 FOR I = 1 TO 9: PRINT I; TAB( 4);DIAGNOSIS$(I): NEXT
    106 PRINT : PRINT "THIS PROGRAM MAY NOT GIVE THE CORRECT DIAGNOSIS. FINAL DIAGNOSIS CAN BE OBTAINED ONLY BY BIOPSY"
    110 PRINT " HIT ANY KEY TO CONTINUE";: POKE -16368,0: GET A$
[...]

    2000 HOME : VTAB 5: PRINT " COPYRIGHT 1978 APPLE COMPUTER, INC."
    2010 FOR K = 1 TO 2500: NEXT K
    2050 VTAB 12
    2060 PRINT "THIS PROGRAM IS FOR PHYSICIANS ONLY!"
    2065 PRINT : PRINT
    2070 PRINT "IT IS DESIGNED TO BE USED AS A SINGLE"
    2080 PRINT "TOOL WHICH, ALONG WITH MANY, MANY":Q = 1
    2090 PRINT "OTHERS, CAN LEAD A QUALIFIED PHYSICIAN"
    2100 PRINT "TO A PROPER DIAGNOSIS."
    2105 PRINT
    2110 PRINT "ANY USE BY A NON-QUALIFIED PERSON TO"
    2120 PRINT "DIAGNOSE ANY CONDITION WOULD BE"
    2130 PRINT "GROSSLY MIS-LEADING AND DANGEROUS."
    2150 FOR K = 1 TO 18000: NEXT K
    2160 GOTO 19
    3000 REM BASED ON A PROGRAM BY JEFFREY DACH M.D.
    3010 REM 909 ROSCOE CHICAGO,ILL.60657
    3020 REM COPYRIGHT 1978 APPLE COMPUTER, INC.

Re: The Fall of Babylon is a warning to AI unicorns

#49

Post by Phrenzy »

DonHopkins wrote: post #46
prewett wrote: post #20

I was hoping they were going to somehow draw parallels from ancient (Mesopotamian) Babylon. Sadly, it's some apparently overhyped health startup, which isn't nearly as interesting, although probably a more relevant comparison.

Why aren't there any unicorns named after Sodom and Gomorrah?

Mostly because the similarity is implied.
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