Slashdot Mirror
Computers Shown To Be Better Than Docs At Diagnosing, Prescribing Treatment
Lucas123 writes "Applying the same technology used for voice recognition and credit card fraud detection to medical treatments could cut healthcare costs and improve patient outcomes by almost 50%, according to new research. Scientists at Indiana University found that using patient data with machine-learning algorithms can drastically improve both the cost and quality of healthcare through simulation modeling.The artificial intelligence models used for diagnosing and treating patients obtained a 30% to 35% increase in positive patient outcomes, the research found. This is not the first time AI has been used to diagnose and suggest treatments. Last year, IBM announced that its Watson supercomputer would be used in evaluating evidence-based cancer treatment options for physicians, driving the decision-making process down to a matter of seconds."
An expected outcome. First machines become good and cheap at performing manual labor, then it's lowly qualified jobs such as sorting stuff or basic accounting.
In a few years, liberal professions will fall. Our salaries (I'm a doctor) have been diving as more and more people around the world can afford a career and achieve a good enough level to perform as a doctor or an engineer.
Creative and risk-taking careers will resist for a longer time.
We can hope for a future of working machines and humans enjoying themselves. The other option will be cheap-ass humans with no way of earning a living whatsoever.
I'm sure this is not what diagnosticians would like to consider, but I think the simple truth is that computers will negate our need for human diagnosis in the very near future. I'm sure we'll hear the same "The computers will be great *assistance* to actual doctors" but I don't think that's actually true. I know the computer is likely doing a better job, there should possibly be a few overseers but the vast majority of doctors shouldn't be needed, and frankly I wouldn't want them second guessing what's likely to be a much more accurate and unbiased diagnosis given by the machine.
I find this interesting, I was wondering when we'd reach the point where the accumulation of knowledge available in any given field exceeded the ability of the human mind to completely grasp in a useful manner. It's going to reach a situation where multiple experts on a given subject with a fair idea about related subjects are going to be the only unit capable of actually doing anything sooner rather than later - apparently in medicine at least computers have come to the rescue.
I suppose with the many specialisations in every area we're already there, the question is can we repeat the improved returns in areas like physics and chemistry.
In the early 1970s, Mycin achieved 69% accuracy of prescribing a "correct" treatment for a patient's condition, which was deemed better than human specialists.
The linked articles don't seem to include the absolute accuracy that it achieves, just the relative accuracy against doctors. I wonder if we've come any further than the basic expert system rules allowed 40 years ago.
An expert system is only as good as the information it is fed. Until we get machines that can quickly scan a human body and tell us everything there is to know about it, we will still need doctors to talk to patients, vet what they say, observe what didn't mention and ask followup questions.
I don't care what this article says, this is nothing new. My in-home psychiatrist in the 1990s was great at diagnosing my issues. Perhaps you were a patient of his, too? His name was Dr. Sbaitso.
"This one goes in your mouth, this one goes in your butt."
-JWR
The problem with doctors is their ego. Being a nurse for quite some time Ive seen countless doctors come through the hospital that do not treat a patient properly, ignore patient complaints, dont treat problems aggresively enough, are too passive, and so on and the vast majority of them refuse to do otherwise because of their ego. They are doctors, no one should question them and they hate it when you do and when you do they dig their heels in and dont budge. Doctors are also human so they get tired of their job, they get lazy, they stop caring after awhile, they worry more about what they will do later than the problem at hand, they stay up too late.
Ive also seen countless times people who swear by these doctors and will accuse of them of fault simply because the doctor has been nice to them. A doctor who is friendly can do no wrong in a patients eyes. Or a patient has some common problem that even a moron could treat, then when the doctor fixes them suddenly they become godlike.
Personally I would trust the diagnosis of a machine that has more information programmed into it than a thousand doctors do collectively from allover the world.
A machine can be a doctor because thats how doctors are trained, they are trained to be machines. They treat the problem, they do not treat the person. Treating the person is a nurses job. And treating the problem is simply nothing more than deduction. If patient has multiple problems then you take those numbers and it will lead you to the correct answer. Thats all being a doctor is, you look at the signs and symptoms, then you add them alltogether and you get the answer as to what the cause is. Its all a forumla and nothing more, there is no great mystery to it.
Apart from doctors who will understandably not want to be rendered obsolete (and they won't be -- the computer can only prescribe a treatment, not administer it!), the main objection that would be raised to this is "What if the computer makes a mistake?" For some reason, people are really bad at understanding that even though the computer might make a mistake, it will make mistakes at a lower rate than a human. This is the same problem with computer-driven automobiles. Yes, the computer might screw something up and kill somebody, but this should happen at a much lower rate than caused by human drivers -- however, because the rate isn't EXACTLY ZERO it is seen as completely unacceptable, even though this is an irrational position to maintain.
This sort of thing is just what big pharma wants, no human interaction and careful consideration, just a pill dispenser...symptom a + symptom B == Pill 2...
How much you wanna bet this thing always prescribes expensive non generic drugs and never tries the 50-70 year old known treatments that are usually the first steps in treatment before new expensive drugs are prescribed.
Also, anyone notice the change in medical advertising and communications, they never say "ask your doctor" any more, its ask your prescriber, or ask your provider...like they want to dis-intermediate doctors and are getting the public ready.
And will the system consider the patients age/cost to treat/insurance level/likelihood of patient paying future insurance premiums to make up for expenses?
It will if you program it to. Things like this are tools. As a relatively young doctor (resident) I welcome things like this. Every doctor I know uses reference material, some are printed on dead trees and some are electronic. Today, there's not much difference. But the point it is that there's too much medical knowledge for one person to keep it all in their head at one time. If something like this were to come to market it wouldn't be replacing doctors, it would be augmenting them. Machines do what we tell them to, always have and (hopefully) always will. False rivalries like this completely miss the point. I would love to have a computer algorithm that could correctly diagnose 99% of the time even if it were flagrently wrong the other 1%. That's why humans are in the loop.
... is that the computer doesn't have, literally, hands-on experience.
For example... you have stomach pain. Okay. Where? Does this hurt? Does it hurt if I poke this? Do you have a fever? How high? ("Oh, I don't know, maybe XX" ...)...
In other words, you still need someone who *knows* what to do to help diagnose simply to *get* the information. You need someone trained to know where to poke, where to tap, where to see if something hurts. And then, of course, to try to wheedle the real information out rather than the confusing answers patients (note that I am not a doctor, I am a patient) give. :)
As a diagnostic tool, I think it would be a huge benefit. An individual simply can't keep up to date on everything, don't know everything, and can't research everything. Having a diagnostic tool that *does* do all that would be a huge benefit. There would be options and diagnoses that perhaps the doctor had not thought about. Additionally, the diagnostic tool - I hope! - would not just say "Oh, it's this" but would perhaps say "Well, it could be this, and you need to find out this information first ... or it could be this, and for that you need to do these tests..."
The idea that a patient, combined with a non-trained non-doctor, can somehow come up with all the right answers/information and a machine can simply diagnose it on the spot seems like a very simplistic view. Perhaps that works with colds, the flu, or warts... but for more complex things... it seems diagnoses tend to work on a "it could be this; let's do more specific tests to find out if it is" type of investigation.
In my experience, most doctors don't really think about problems, but just look at historical remedies and prescribe those particular drugs. They just regurgitate what is in the books. If you have something new or multiple problems (I've been dealing with this for a year now, with no relief in sight), I think I'd rather listen to watson. These guys have cost me thousands of dollars and all of my vacation time and I'm worse than when the problems started.
The big difference here is in technologies.
Mycin used a bunch of rules to arrive at medical decisions. These had to be manually entered by medical experts which is time consuming, difficult, and outdated by the time it is completed. It was a narrowly focused, brittle system that strived to emulate the logic of it's designers.
The newer approaches (like the kind from this article) build their own probabilistic models of medical diagnosis and treatment based on statistical analysis of data. Lots and lots of data. Data that would have taken hundreds of years to process in the 1970s. From this, they learn what works and what doesn't and under what circumstances independent of the knowledge of its designers. In effect, it can be better than its creators.
My God can beat up your God. Just kidding...don't take offense. I know there's no God.
Cars with human drivers are the only ones that suddenly swerves from the opposing traffic lane in front of you. And at least 1/4 of the time, those human drivers are drunk too! And quickly getting more than 1/4 of them distracted on their cell phones, as if one can read phone texts and type while they drive!
I'd take my chances with a computer controlling a car any day over the current system of allowing human drivers who daily make mistakes and kill 40,000+ Americans PER YEAR on the highways and streets!
Probably because its a summary of a press release, rather than the actual paper. This was a computer simulation exercise - a model. No patients were actually treated. There was no prescribing. There were no superior outcomes. Its all hypothetical.
Could an AI outperform an MD? Sure, could happen and probably will eventually. But this model doesn't show that. It just shows that its easier to model health care in silicon than the real world. Remember we can cure cancer in mice - models aren't the same thing as reality.
+--------------------- You idiot! I told you we were facing the wrong way!
WTF does your comment have to do with airports?
Watson screwed up the Final Jepoardy problem in the first match, which was (category: US Cities): "Its largest airport was named for a World War II hero; its second largest, for a World War II battle."
Meh. You can be replaced by sufficiently advanced algorithms. I'm mathematician, FFS. There are already automated theorem provers which can solve undergrad-level problems. As computers evolve, they'll be just as good as people and loads cheaper than people at everything we do, up to and including the creation of art. If we progress to the point where all of our jobs can be done by computers... what should we do? At the point where artificial intelligence becomes genuine intelligence, it will rapidly outpace human intelligence. This is evolution. We are breeding our replacements.
Hmmm...what if there is an irreducibly non-algorithmic component to human intelligence? That would invalidate the Church-Turing thesis that your assertion seems to be relying on. Roger Penrose thinks it would at least, and he makes a pretty good argument for that position, and against the Strong AI you are hypothesizing. He also defends his argument pretty well, too..
I call bullshit. There is no such diagnostic software.
Here are the names of some companies producing the "non existing software":
DiagnosisPro
Isabel Health Care
Here's a recent article on the New York times about the subject, Isabel Health Care has been around since at least 2006, when we recommended the software to a local hospital.
There is no complete database of every possible disease with typical and atypical presentations.
Complete in that it contains every disease known, and no you do not need agreement about the symptoms to enter them in a database. The reasoning process handles that part, you simply enter "some reports say these are symptoms, some other reports these other symptoms, and moreover it is always possible that a few symptoms maybe absent".
From the NYT article, here is one example of a "non such database":
Since the 1980s, Massachusetts General Hospital has been developing and refining DXplain, a program that provides a ranked list of clinical diagnoses from a set of symptoms and laboratory data.