Slashdot Mirror

← Back to Stories (view on slashdot.org)

Fighting the Number-One Killer In the US With Data

Posted by samzenpus on from the checking-the-chart dept.

mattydread23 writes "Often, the signs of eventual heart failure are there, but they consist of a lot of weak signals over a long period of time, and doctors are not trained to look for these patterns. IBM and a couple heathcare providers, Sutter Health and Geisinger Health System, just got a $2 million grant from NIH to figure out how better data analysis can help prevent heart attack. But the trick is that doctors will have to use electronic records — it also means a lot more tests. Andy Patrizio writes, 'What this means is doctors are going to have to expand the tests they do and the amount of data they keep. Otherwise, the data isn't so Big.'"

9 of 121 comments (clear)

  1. Great use of govt money! by kqs · · Score: 3, Interesting

    This is the perfect use of government money: projects which are promising (though they may not pan out in the end), which will help many people, and which will not be subsidized by industry because they will not make money in the next three quarters. I don't expect any real results from this study for many years, but I think it's a very important study to do.

    1. Re:Great use of govt money! by ColdWetDog · · Score: 4, Interesting

      It's also the perfect segue into Total Informational Awareness. It's basically data mining. You find a couple of soft indicators - the patient starts complaining of shortness of breath perhaps, has hypertension, is overweight. Then he moves. Starts over again. Doc asks the same question, patient puts down different dates (because they don't remember the doc visit five years ago), rinse lather repeat. If you could track this sort of stuff over time the 'computer' could start making some pretty easy correlations.

      IF you had the data. And only IF you had the data. Which means linked EHRs. Which is an interesting concept and would likely help, except, given the current state of our Panopticon Plus government, you have to wonder exactly who they are trying to help.

      Comrade.

      Oh, AND IT'S HEART FAILURE NOT HEART ATTACK. THEY'RE DIFFERENT. If you're the editor at least glance at TFA. /pedant /normal blood pressure mode

      --
      Faster! Faster! Faster would be better!
    2. Re:Great use of govt money! by Albanach · · Score: 4, Insightful

      Great. Then you pay for it. I don't share your enthusiasm, so why should I have to share your bill?

      Because every day you benefit from projects that were funded using taxpayer dollars/pounds/euros on the basis of long-term aspirations. The massive investment in road networks, rail networks and telecommunications were all taxpayer funded or subsidized. The technology spin-offs from the space program are benefits that again may never have seen the light of day without aspirational projects.

      You benefit from those who walked before you. In return in makes sense to pave the way for those who will walk after you.

    3. Re:Great use of govt money! by JoshuaZ · · Score: 4, Insightful

      Because you can say that for every government thing, fire departments, police departments, military defense. These all benefit everyone in a society, so there's no easy way to prevent you from benefiting. This is related to what economists call a "public good." And the only way to make sure public goods get funded is for everyone to pay a tiny amount. If you don't think something is a public good that justifies such a situation, then you should talk to your congressmen. Of course, if you think that you shouldn't pay for any of them, then that's your problem.

    4. Re:Great use of govt money! by mfwitten · · Score: 3, Interesting

      Somalia is the result of a failed state, what was formerly known as the Somali Democratic Republic, which was governed under a single-party, Socialist rule. The resulting mayhem has nothing to do with libertarian or anarchist principles, particularly the Non-Aggresion Principle.

      In any case, what actually gives you a functional civilization is a large number of individuals trading voluntarily amongst themselves to better their own situations; profit is not merely the transfer of wealth, but rather the creation of wealth.

      How much is "my share", anway? Only the price mechanism of a free market can figure that out consistently, adapting to the reality at hand rather than the fantasies of a "noble" bureaucrat.

      So, what is "Government", anyway? Any organization—any organization at all—that confiscates resources by threat of strike-first violence is a "governmental" organization. When one such organization becomes a monopoly, we call that organization "Government".

      Government is simply a bad company that doesn't go out of business because it is able to confiscate your resources by threat of violence; it doesn't give you the goods and services for which you personally think you are paying, but you have to pay them anyway—it's totally absurd and unconscionable.

      It is not a modern value to coerce resources from people by threat of violence. So, in fact, governments are actually the last barbaric vestige of a pre-modern civilization.

  2. Waste of money by katz · · Score: 3, Interesting

    If you want to prevent heart disease, stop eating saturted fat and cholesterol and stick with a low-fat whole-plant-based diet. This knowledge is not new; this stuff has been known for almost a hundred years now, yet we're still spending money dancing around the fact that eating animals and their byproducts leads to heart disease.

    Source: http://www.plantpositive.com/

    1. Re:Waste of money by rubycodez · · Score: 5, Interesting

      Utter rubbish. The French eat meat and have a high fat diet, but have a very low incidence of heart problems

      Your link is to a fad-diet site.

    2. Re:Waste of money by fahrbot-bot · · Score: 3, Informative

      Utter rubbish. The French eat meat and have a high fat diet, but have a very low incidence of heart problems

      Your link is to a fad-diet site.

      I think they consume far less sugar and soda and more fiber, which may explain things. You might find these two (long) talks interesting. The first is research/study based, the second is more anecdotal, but with some research. I thought they were both excellent and interesting.

      • Sugar: The Bitter Truth (1h30m) by Dr. Robert H. Lustig, MD, UCSF Professor of Pediatrics in the Division of Endocrinology, explores the damage caused by sugary foods. He argues that fructose (too much) and fiber (not enough) appear to be cornerstones of the obesity epidemic through their effects on insulin. Series: UCSF Mini Medical School for the Public.
      • How Bad Science and Big Business Created the Obesity Epidemic (1h) by David Diamond, Ph.D., of the University of South Florida College of Arts and Sciences shares his personal story about his battle with obesity. Diamond shows how he lost weight and reduced his triglycerides by eating red meat, eggs and butter.
      --
      It must have been something you assimilated. . . .
  3. Don't believe the salesman's hype by nbauman · · Score: 4, Informative

    It is a hypothesis that collecting more data will find a pattern that will predict heart failure earlier, and that will lead to earlier interventions.

    They haven't demonstrated that it works.

    In order to demonstrate it, they have to do a controlled trial. They have to use these data collection systems in a group of 5,000 patients, and use the usual methods in another 5,000 similar patients, and see if there's any difference in a meaningful outcome. Do the patients live any longer? Are they any less likely to get strokes?

    Sometimes it works, sometimes it doesn't. The New England Journal of Medicine just published a report on the use of a high-tech surgical intervention -- implanting cardiac resynchronizing devices in a new subset of heart failure patients. http://www.nejm.org/doi/full/10.1056/NEJMoa1306687 It turned out the resynchronization patients had more deaths than the control group, and they stopped the study early. You don't know until you've done the randomized, controlled trial. That's the method of science, the experimental method. You take your brilliant ideas and put them to a test.

    That's science. Everything else is bullshit.

    There was a study of using an electronic medical record in a pediatric intensive care unit. The patients with the EMR had a higher death rate than the control patients. The doctors said that when they needed to write a prescription in a hurry, they would just take out their Rx pad and write it. When they needed to write it with the EMR, they had to sign in, go through screens, and find what they were looking for.

    EMR replaced a simple, effective system -- paper and pen -- with a more difficult system. What's the point?

    Read what doctors are actually saying about electronic medical records, http://www.kevinmd.com/blog/ http://www.nejm.org/

    There are systems that actually make it easier to treat patients. As I understand it, the Veterans Affairs and Kaiser Permanente have systems that actually collect useful data. The Scandinavians have great useful databases. http://www.bmj.com/content/347/bmj.f5906 But a lot of the new systems, particularly the ones that are merely being installed because they're required and subsidized under new federal regulations, are driving doctors crazy. They complain that they have to log in, go through screens, fill out checklist after checklist, and wind up with records that go on for hundreds of pages that nobody ever looks at again. Traditionally, on paper, they were forced to write a concise narrative for their colleagues and themselves, of useful information that got to the point and helped them make a decision about what to do next. These poorly-designed EMRs stopped forcing doctors to think. It simply forced them to collect a lot of data. Data isn't information. Useless data is noise.

    And maybe most of all, they complain that instead of looking at their patients, they're looking at a computer screen. If you have to tell somebody that he's going to die in 6 months if he doesn't stop smoking, you shouldn't be looking at your computer screen. Maybe there's an element of human communication that computer nerds don't appreciate.

    In any computerized records, there's a tradeoff between how much data you collect, and how much time you have to spend entering data. You can spend an extra hour a day just entering more data. Is this pill a tablet or a capsule?

    And more important than time, when you write a medical record, you should be filtering information for just the important information. Otherwise you're just adding noise to the record, and making it harder for the humans to spot patterns.

    If you want to prevent heart failure, the basic job is to stop smoking, lose weight, and exercise. When patients get outside of certain well-understood parameters, you can give the