Live data from Hacker News

AI used for skin cancer checks at London hospital

bbc.com

41–50 of 91 posts

Re: AI used for skin cancer checks at London hospital

#41
post #35

This doesn't seem like nothing new? I remember a talk about this being done some 12+ years ago. Just without the AI label to generate hype.

There has been talk about this pretty much since CNNs got good at object recognition ~2012.

But healthcare is a rather conservative industry (for good reason) so it has taken a while to build confidence in the technology and get regulatory approval.

Re: AI used for skin cancer checks at London hospital

#42

Anecdotally, when I had a potential skin cancer checked at a London hospital they were completely ill-prepared. When I came back to Australia, it was checked and immediately removed as an obvious melanoma. Perhaps the idea of Comparative Advantage also applies to healthcare between countries with natural variances to types of disease?

It's even more granular than that.

My neighbour who is a doctor moved to another city because that's where he managed to get a spot to train for his field.

It appears that he's learning much more there than he would back home because in this country some procedures are rare outside of his current location.

Re: AI used for skin cancer checks at London hospital

#43

Earlier quoted context omitted.

Do all cases in the UK start with a GP? No ability to go straight to a dermatologist? And are all dermatologists based out of hospitals? In the US, we'd just go straight to a dermatologist, who would either remove it on the spot, or for a location that's liable to scar badly, refer to a specialist surgeon. For somebody fair skinned with lots of sun damage like myself, it's an annual "ritual".

Most UK health stuff starts with a GP appointment. Even for private health care, you usually see a GP first (could be a private GP or NHS, in-person or video) and they then refer you to the next thing whatever that may be. ( N.B. that a NHS GP can give you a referral that you use for private treatment) There are some things you can just straight up book an appointment for yourself without a referral from a GP, but 95…

I wonder what % of GP skin consults result in a referral? If it’s even remotely close to a majority, seems like it would be better just going straight to the dermatologist.

Sample of one, but every spot (5+ over the past decade) I’ve asked my dermatologist about has resulted in a biopsy and of those several were cancer.

Re: AI used for skin cancer checks at London hospital

#44

Anecdotally, when I had a potential skin cancer checked at a London hospital they were completely ill-prepared. When I came back to Australia, it was checked and immediately removed as an obvious melanoma. Perhaps the idea of Comparative Advantage also applies to healthcare between countries with natural variances to types of disease?

Speaking with some 70 year olds, their opinion on the "best doctor in town for skincare" was basically a doctor who'd simply cut out whatever you like and send it for a biopsy.

At most you had to deal with a stitch or two but often only a bandaid. Nowadays the hydrocolloid bandages seem magic.

Re: AI used for skin cancer checks at London hospital

#45
post #35

This doesn't seem like nothing new? I remember a talk about this being done some 12+ years ago. Just without the AI label to generate hype.

Yeah - I don't recall which company (maybe johnson & johnson) it was but my aunt worked for one that produced a portable machine that used a camera to check moles and used some sort of algorithm to give a predicted score. This was 20ish years ago. I remember she brought it to my grandparents and we had fun checking everyones moles for the day.

Re: AI used for skin cancer checks at London hospital

#46
post #7

99% accuracy in diagnosing benign case This is meaningless. The only thing that matters in this kind of application is false negative rate at some acceptable false positive rate. I assume whoever is working on this knows that, so this is mostly a criticism of the article. That said, this is a horrible use of AI.

It’s really all about the protocol. AI tends to spot things that doctors don’t, and vice versa. Dermatology is also an area being pillaged by private equity and access is poor for many people. I lost my wife to melanoma. She noticed a lesion within days of it appearing, and a doctor saw it within 48 hours and felt it was benign. My wife didn’t accept it and had a plastic surgeon remove it and biopsy, then had a margi…

Dude that sucks mate. I had a melanoma taken off last year. It was dormant (stage 0) but had been there for 10ish years. But reading shit like this reminds me that even though I'm probably fine, all I can do is just live my best life. Hang out with my family. Enjoy the things I enjoy and not think about it too much. (and get my skin checks every 6 months :D)

Re: AI used for skin cancer checks at London hospital

#47

Anecdotally, when I had a potential skin cancer checked at a London hospital they were completely ill-prepared. When I came back to Australia, it was checked and immediately removed as an obvious melanoma. Perhaps the idea of Comparative Advantage also applies to healthcare between countries with natural variances to types of disease?

Australia has high skin cancer so it's not suprised that doctors there are best in this area.

Re: AI used for skin cancer checks at London hospital

#48
post #25
post #7

99% accuracy in diagnosing benign case This is meaningless. The only thing that matters in this kind of application is false negative rate at some acceptable false positive rate. I assume whoever is working on this knows that, so this is mostly a criticism of the article. That said, this is a horrible use of AI.

Not really. It allows you to order your cases from most-likely to least-likely, and get human eyeballs on the most-likely cases first.

This is how most ML in healthcare is used. It's a fantasy to think we can give all patients equal attention, so it often makes sense to prioritize those most at risk. Of course no model is perfect, but ML can be very beneficial when used in the right context (i.e. not like United Healthcare).

Re: AI used for skin cancer checks at London hospital

#49
post #24

Anecdotally, when I had a potential skin cancer checked at a London hospital they were completely ill-prepared. When I came back to Australia, it was checked and immediately removed as an obvious melanoma. Perhaps the idea of Comparative Advantage also applies to healthcare between countries with natural variances to types of disease?

Sadly, a friend of mine died from this type of problem. He traveled from Ghana to Jordan and fell ill in Jordan, the Jordanian doctors didn't diagnose it as malaria in time to save him because Jordan doesn't have malaria. I'm sure it would have been obvious to a Ghanaian doctor.

When I first heard the clinical idiom "When you hear hoof-beats, think horses not zebras" I thought it was a precautionary saying about the bias toward assuming the familiar. But it's meant to be instructive!

Re: AI used for skin cancer checks at London hospital

#50
post #7

99% accuracy in diagnosing benign case This is meaningless. The only thing that matters in this kind of application is false negative rate at some acceptable false positive rate. I assume whoever is working on this knows that, so this is mostly a criticism of the article. That said, this is a horrible use of AI.

It's trendy to say "it's horrible to use AI for this" without giving specific reasons. Some reasons it could be good to use AI here:

- this can prioritize urgent patients for the severely overworked doctors

- medical error is a leading cause of death, this serves as a second-opinion (97% true-positive rate and 79% true-negative rate)

- it can be used as evidence by a nurse or physician advocating for a patient's treatment

Post reply on HN