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88% Of Medical 'Second Opinions' Give A Different Diagnosis - And So Do Some AI (mayoclinic.org)
First, "A new study finds that nearly 9 in 10 people who go for a second opinion after seeing a doctor are likely to leave with a refined or new diagnosis from what they were first told," according to an article shared by Slashdot reader schwit1:
Researchers at the Mayo Clinic examined 286 patient records of individuals who had decided to consult a second opinion, hoping to determine whether being referred to a second specialist impacted one's likelihood of receiving an accurate diagnosis. The study, conducted using records of patients referred to the Mayo Clinic's General Internal Medicine Division over a two-year period, ultimately found that when consulting a second opinion, the physician only confirmed the original diagnosis 12 percent of the time. Among those with updated diagnoses, 66% received a refined or redefined diagnosis, while 21% were diagnosed with something completely different than what their first physician concluded.
But in a related story, Slashdot reader sciencehabit writes that four machine-learning algorithms all performed better than currently-used algorithm of the American College of Cardiology, according to newly-published research, which concludes that "machine-learning significantly improves accuracy of cardiovascular risk prediction, increasing the number of patients identified who could benefit from preventive treatment, while avoiding unnecessary treatment of others."
"I can't stress enough how important it is," one Stanford vascular surgeon told Science magazine, "and how much I really hope that doctors start to embrace the use of artificial intelligence to assist us in care of patients."
But in a related story, Slashdot reader sciencehabit writes that four machine-learning algorithms all performed better than currently-used algorithm of the American College of Cardiology, according to newly-published research, which concludes that "machine-learning significantly improves accuracy of cardiovascular risk prediction, increasing the number of patients identified who could benefit from preventive treatment, while avoiding unnecessary treatment of others."
"I can't stress enough how important it is," one Stanford vascular surgeon told Science magazine, "and how much I really hope that doctors start to embrace the use of artificial intelligence to assist us in care of patients."
So what the study finds is that doctors as well as technology disagree. There's nothing indicating that the second or third opinion is correct.
To Terminate, or not to Terminate, that's the question - SCSIROB
So, WebMD really is the better option... ;)
I would expect that many people who ask for a second opinion have a reason to ask for a second opinion: in fact, the article even mentions the situation where the first doctor recommended they do so. What would be more telling would be if they did a large study and gave EVERYONE second opinions, and then told us how many differed.
This smells like another case of "lies, damned lies, and statistics", which is designed to make the Mayo Clinic look good.
"So Do Some Al"
Point 1: Who is Al?
Point 2: Read this aloud. It sounds like a Vietnamese speaking.
I'm not supposed that to doctors will give different diagnoses, but they also have to work with what they're given. A patient may give different details, especially if they've just spoken to a GP - they're likely to preempt questions that had to be asked previously.
This goes with every profession. A colleague of mine was being investigated by HMRC (tax) and was complaining that his accountant was still telling him it was ok to claim fuel, but the tax man wasn't. The problem was he didn't understand that by lying to the accountant (consciously or otherwise) she couldn't give him the correct info.
There is no guarantee you will be better off because of it.
I saw 4 doctors for a handful of ailments. They were always quick to prescribe me things. They were all wrong. I ended up resolving my ailments on my own. Several thousand dollars, wasted.
If only 12% of the time second opinions confirm the original diagnosis and 21% of the time they find something completely different, then we should obviously skip the initial diagnosis and just go for the second opinion.
I'm an American. I love this country and the freedoms that we used to have.
Another thing to keep in mind is that a chart is not some purely dispassionate recording of standardized metrics. Even before you get to the diagnosis, you are already looking at pre-processed information, and not raw data.
Although there are some parameters recorded for most patients regardless of the issues at hand (such as vital signs, or maybe listening to the patient's heart/lungs), other history and data is selected -- much of the history, review of systems, and physical exam is performed as a way of supporting or excluding items in a differential that the physician is already thinking about. The list of things that I could observe and write down about a human in a chart is practically unlimited, including a long and useless lists of things that patient doesn't have -- and if I choose to specifically mention what findings are absent, it is because I am making a case for one condition or another..
The other thing to consider is that part of the evidence that is used to support or refute a diagnosis is time. Often I ask a patient to follow-up over the next few days, weeks or months as a way to see if things change (or don't change) the way I expect it too. When a patient follows up with me, I may be making a "second opinion" each time, and the ability to follow someone over time is a valuable tool that gets discarded when someone bounces from doctor-to-doctor searching for answers, without ever looping back to previously visited doctors for follow-up. Sometimes there is a list of rare "zebra" diagnosis that I usually don't write down, because I would usually get laughed at by colleagues for jumping at shadows (but I may keep them in mind if things start not making sense in the future). In any case, a doctor who is asked for a second opinion gets the luxury of having both the first doctor's records (hopefully), as well as a data point occurring later in time.
Anyway, can the thought process for making a final analysis of the case a doctor has made from examining a patient be improved? Certainly, but keep in mind Garbage-In, Garbage-Out, if you feed the AI medical records from someone with excellent vs poor clinical diagnosis skills, the quality of your results will vary greatly. Presumably the best results would be obtained when applied to a doctor with good intuition and observation skills, but poorly organized decision making.
It seems to me that a person wants to hear a different opinion because they didn't like the first. So they would tend to refine their answers to questions about the symptoms to obtain that different opinion.
i.e. this doesn't actually tell you what it claims to, it tells you that the self selected disatisfied group seek out a different diagnosis.
concludes that "machine-learning significantly improves accuracy of cardiovascular risk prediction
Computer: Subject has 728% increase in cardiovascular heart disease risk due to obesity, sedentary lifestyle, nuggets, and left-handed masturbation to furry Dragon Ball drawings.
Impressed Doctor: God damn.
(-1: Post disagrees with my already-settled worldview) is not a valid mod option.
One doctor saying you have cancer while another says it is the flu is definitely 'different'. If both say you have lung cancer, but the second says it is a slight variation of the cancer diagnosed by the first doctor, does that meet the definition of 'different' for this study?
Maybe the people who went for a 2nd diagnosis had reasons to do so.
I used to work at a hospital and I think I can explain the basis for this. Doctors are clueless, refuse to use technology, they rush everything, and they're incredibly lazy. I don't mean some of them either. 100% of them.
The moto of modern medicine
It should be read as: of people who were UNSATISFIED with their first doctor to the point they got a second opinion, were correct in their belief.
Not that 88% of doctors visits are wrongly identified. 99.999% of people who get a cold, and get some antibiotics, and feel better in a couple of days, aren't seeking a second doctor.
Is it sad that a robot can diagnosis better then a real doctor? Kinda says these doctors are not very good, if the robot was correct.
I honestly haven't seen evidence in my life that the practice of medicine is any less of a soft science than psychology. Yes, our understanding at the research level is starting to get there, but to apply that knowledge to the diagnosis of "a" problem in something as complex as the human system that always has many problems and many right ways of working is still an art.
One thing that would have been interesting that I didn't see in the article is what percentage of the time the change in diagnosis affected treatment. To plug the gaps in diagnosis, we have developed many blanket treatments that are effective across classes of disorders.
When these scientist can't seem to make up their own mind, yet if you question them they call you a science denying homosexual nazi sex addict. You can say what you want about creationists, at least they are consistent. According the the hard core Christians, earth was made 6000 years ago and has always been 6000 years old. On the other hand in 1940 the earth was 2 billion years old. In the coarse of less then 100 years the earth has aged 2.5 billion years. Maybe some of these super scientist can figure out why the earth is aging so fast. Maybe they can use some large scale Demographic studies that show a weak correlation between drinking coffee and premature aging, and then say that they have determined scientifically that coffee beans are causing mother earth to age before her time, and that the only way to save the planet is spray agent orange over all the coffee plantations and replace coffee beans with cocoa plants.
Science is an unassailable master that can not be questioned. When you question scientist, they call you names. Fuck science. Do your own thinking. Stop with the scientific dogma.
Doctors and scientist are not some gods. They do not have some kind of exclusive trade agreement with reality.
Good comments above!
1) "Isn't it strange that some diagnoses seems to concur with the contours of state and county lines? Medical diagnoses has political overtones beyond those of the Affordable Care Act (ACA), aka, Obamacare. What the doctor tells you, whether she/he knows it or not, reflects these overtones."
2) "Money and Medical Care are intertwined to a point where the patient's health doesn't matter."
Copied the comments to help emphasize their importance. My research shows the same issues.
I needed FIVE medical opinions to get to the correct diagnosis of my condition, and I had to go to Mexico to get it.
Thank God that the doctor in Mexico correctly diagnosed my lung cancer, because FOUR American doctors kept on putting me off, two of them accusing me of being psychosomatic and telling me "nothing is wrong with me," and the other two incorrectly diagnosing me of, get this, allergies and asthma, respectively... because coughing up blood and having a constant metallic taste in the mouth are definitely characterizing symptoms of allergies and asthma.
The good news is that I have civil suits against four well-insured American doctors and an insurance company now that will guarantee my family's financial well-being once I am gone, which will be in 3-9 months from now, especially given that, had my cancer been correctly diagnosed 3 years ago, it would have been operable and I likely would have had a good chance of survival.
be careful. just because two doctors conclude the same or similar doesn't make it right. doctors frequently just back each other up following your chart notes in terms of diagnosis and are afraid to change diagnosis. you may not have a condition at all and still receive multiple false diagnosis. it's a really big problem if say you need medical care and you're in a prison or state hospital and you need care but they deny diagnosis; and if you don't need care for mental illness but they frame you to look mentally ill each doctor you see merely follows the previous doctors notes very rarely deviating or checking any of the facts. in the community doctors are usually closely associated and cook the books for insurance companies, cohorts and themselves to avoid liability and lawsuits. it can be hard to even find a doctor willing to do consults over another doctor who you accuse of abuse.
https://www.obamasweapon.com/
You're ugly too!
This sounds an awful lot like a Bayesian Trap, also called a Base Rate Bias. See here for a decent explanation.
https://www.youtube.com/watch?...
weylin
67.5% Slashdot Pure I guess I need to work on that....