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Study Finds Robot Surgeons Are Actually Slower and More Expensive (theregister.co.uk)

"Robot-assisted surgery costs more time and money than traditional methods, but isn't more effective, for certain types of operations," reports the Register, in an article shared by schwit1: In a study of almost 24,000 laparoscopic surgeries just published in The Journal of American Medicine, researchers from Stanford University School of Medicine analyzed data from 416 hospitals around the U.S. from 2003 to 2015. Robotic assistance provides 3D-visualization, a broader range of motion for instruments, and better ergonomics for physicians, according to the study. While it has advantages in scenarios where a high-degree of precision is required or where improved outcomes have been demonstrated (like radical prostatectomy), it appears to be a waste of resources for the two operations examined... But the patient outcomes were more or less the same.

A thematically-related economic study presented by the National Bureau for Economic Research on Monday suggests that while AI and machine learning have received substantial investment over the past five years and have been widely touted as a transformative technologies, "there is little sign that they have yet affected aggregate productivity statistics... The simplest possibility is that the optimism about the potential technologies is misplaced and unfounded," muse Erik Brynjolfsson and Daniel Rock (MIT), Chad Syverson (University of Chicago) in the paper.

But instead the paper's author suggest that fully realizing the benefits of AI "will require effort and entrepreneurship to develop the needed complements, and adaptability at the individual, organizational, and societal levels to undertake the associated restructuring."

44 comments

  1. So? by mark-t · · Score: 5, Insightful

    There was a time when what were once called horseless carriages was slower than using a horse,.

    Give it time.

    1. Re:So? by Hognoxious · · Score: 3, Insightful

      The study says even less than that. It's more like some horseless carriages were slower than some horses, on an odd-numbered Wednesday if there's an R in the month and the wind's blowing from the east.

      --
      Confucius say, "Find worm in apple - bad. Find half a worm - worse."
    2. Re:So? by Anonymous Coward · · Score: 1

      There was a time when what were once called horseless carriages was slower than using a horse,.

      Give it time.

      There was a time when only simple minimum wage jobs were being threatened by robotics and automation.

      Now, those making six figure salaries are being threatened. I doubt that "time" will ever come.

    3. Re:So? by rhsanborn · · Score: 1

      And I don't think the authors say we should never use robots and stop developing robots. But it is probably worth questioning using these robots for the surgeries in question, and whether it's valuable for hospitals to buy these robots. It's almost certainly worth making sure insurance companies and medicare don't pay hospitals extra for using these robots in these procedures at this time.

    4. Re:So? by Anonymous Coward · · Score: 0

      Godel says ... wrt AI or any machine ... there can be no time when unrestricted human performance will be matched or exceeded.

    5. Re: So? by Anonymous Coward · · Score: 0

      Like programmers? LOL!

      Doctors have people above them calling the shots, that's what AI will replace last. Everyone else is fair game.

    6. Re:So? by K.+S.+Kyosuke · · Score: 1

      There was a time when only simple minimum wage jobs were being threatened by robotics and automation.

      I would have thought that in some areas, the opposite happened: we had brilliant computer algebra systems and automated theorem proving systems long before people seriously started considering self-driving cars to replace badly-paid drivers.

      --
      Ezekiel 23:20
    7. Re:So? by mark-t · · Score: 2

      There's no such thing as unrestricted human performance because human performance is always limited by what is actually physiologically possible in our biological framework. AI is restricted only by what is physically possible, which is a far broader domain.

    8. Re:So? by Anonymous Coward · · Score: 0

      One argument for Robotic Surgery in the case of difficult surgery is that the surgeon isn't as worn out while doing the surgery. The results may wind up being the same in terms of efficacy but it's less work overall for the surgeon.

    9. Re:So? by godel_56 · · Score: 1

      One argument for Robotic Surgery in the case of difficult surgery is that the surgeon isn't as worn out while doing the surgery. The results may wind up being the same in terms of efficacy but it's less work overall for the surgeon.

      The surgery typically takes an hour longer than doing it manually, so I don't know what that will do to the doctor's efficiency.

      Hundreds of thousands of dollars to buy the robot, one or two thousand dollars extra in consumables per operation and fewer operations performed each day . . . hmm.

      Here's a radio interview from last week with the guy who did the study:

      http://www.abc.net.au/radionational/programs/healthreport/no-benefits-to-robotic-colorectal-surgery,-study-says/9122822#transcript

  2. Way to miss the point by Anonymous Coward · · Score: 5, Insightful

    Wow, these people completely missed the point of these procedure techniques. They are not intended to make surgery more efficient or cheaper. They are intended to make them SAFER. They have a much lower impact on the human body and produce much less shock. They have shorter recovery time. They produce drastically less scarring.

    Amazing how wildly out-of-touch technologists can be that they consider speed and cost to be more important than the health and well-being of the patient.

    1. Re:Way to miss the point by Anonymous Coward · · Score: 0

      Safer is a secondary benefit of FEWER LAWSUITS. That is the key metric.

    2. Re:Way to miss the point by sjames · · Score: 5, Insightful

      Nobody did that here. They looked at 3 cases: Open surgery, laparoscopic surgery, and robot assisted laparoscopic surgery. They found that laparoscopic beat open in patient outcomes (so it's a good thing). They further found that adding the robot did nothing to improve outcomes but did cost more (a bad thing) and take longer (also bad and potentially a safety risk).

      An exception, called out in the summary, is radical prostatectomy where the robot did improve outcomes.

    3. Re:Way to miss the point by Anonymous Coward · · Score: 1

      they consider speed and cost to be more important than the health and well-being of the patient.

      RTFM:

      "But the patient outcomes were more or less the same."

      Amazing

      is that you can't even read

    4. Re:Way to miss the point by bws111 · · Score: 1

      And how does safer appear, other than a different patient outcome (which did not happen)?

    5. Re:Way to miss the point by JaredOfEuropa · · Score: 0

      I looked at bikes, cars and aircraft for travel. Driving beat biking in that it was way faster. Flying added little, it is way more expensive and it took longer (you need to get to the airfield first). One exception is long distance travel, where flying did improve outcomes.

      The short version is: hammers are useful tools, but not for all jobs.

      --
      If construction was anything like programming, an incorrectly fitted lock would bring down the entire building...
    6. Re:Way to miss the point by Kjella · · Score: 2

      They found that laparoscopic beat open in patient outcomes (so it's a good thing). They further found that adding the robot did nothing to improve outcomes but did cost more (a bad thing) and take longer (also bad and potentially a safety risk).

      Unfortunately when you make statistics like this it's never the same doctor operating on the same patient. For example, it's quite possible that younger doctors are prevalent when it comes to robot-assisted surgery while older and more experienced doctors who had to learn to do it on their own continue to do so and that the actual difference is due to differences in experience not technique. It's also possible that those who do robot-assisted surgery can do it with less training than the unassisted ones without being properly reflected in direct costs. If you don't correct for the selection bias then sometimes you get the result that the most experienced doctors have the worst outcomes - because they treat the most difficult cases. It's not always that more data is better data, sometimes case studies where you go really in-depth and make really sure you have apples-to-apples comparisons are more valuable.

      --
      Live today, because you never know what tomorrow brings
    7. Re:Way to miss the point by jellomizer · · Score: 1

      In many ways we seem to but everything of value into dollars and cents. The value of money is based on how much there is of it and how badly do you want it.
      There are some things in life are quite valuable however it may be overlooked or very common. We have as a culture have gotten too fixated about money and the economy. I am no hippie or communist I understand the need for money and wish to make more of it, however it isn’t the only thing in life. Technology doesn’t always save money, but it can help make things faster, or more consistent. A surgeon like other people have good days and bad days. So there is wider variation on the quality of his work then there is of a robot which does things the same way every time. So the robot may be as good as a.surgeon on an average day, will be valuable because it doesn’t have the bad days which could hurt the patent more.

      --
      If something is so important that you feel the need to post it on the internet... It probably isn't that important.
    8. Re:Way to miss the point by laird · · Score: 2

      How is "But the patient outcomes were more or less the same" a statement that all we care about is dollars and cents. If the more expensive equipment didn't yield better medical outcomes, it's just wasting the patient's money (or the insurance coverage). The US already has bloated healthcare costs, because people like the latest, greatest stuff. But if the medical outcomes are the same, we're all better off doing things at lower cost, because that leaves more resources for other things of greater medical value.

      And these weren't robots replacing surgeons, they were robots supporting surgeons.

    9. Re:Way to miss the point by Anonymous Coward · · Score: 0

      Fewer Lawsuits = less costs. See how that happened there?

  3. in a world without antibiotics by Anonymous Coward · · Score: 0

    If antibiotics are really becoming obsolete then we should be sterilizing everything in the operating room, including the surgeons.

    I don't think your average surgeon is going to survive a trip through the autoclave.

  4. How do they know JFK was Jewish? by Anonymous Coward · · Score: 0

    .
    .
    .
    .
    He was shot in the temple.

  5. Re:"Study finds Trump is a lying scumbag traitor" by NicknameUnavailable · · Score: 1

    If you guys keep bitching like this for the next 7 years we're going to have a national crisis trying to find a place to store all the salt.

  6. Not factoring cost/time of training a surgeon by Anonymous Coward · · Score: 1

    If you factor in how much it costs to raise and train a human surgeon then the maths come out a lot different. And yes, there's a tremendous upfront cost in creating and training an "AI" surgeon but that is ultimately spread across all the units developed, even completely new models will generally build off of previous generations. The cost of training a human surgeon is per-unit and will only decrease when we get wet wired to accept pluggable skills/memories and/or vat grown humans "born" mature.

  7. Re:"Study finds Trump is a lying scumbag traitor" by Anonymous Coward · · Score: 0

    What with all the salt we have from the other side whining and crying for the previous eight years there's damn little space for any more to begin with.

    And three years. The next election is in three years. Y'all need to go back to fifth grade social studies. You might want to brush up to on the First Amendment too while you're at it.

  8. Re:"Study finds Trump is a lying scumbag traitor" by Anonymous Coward · · Score: 0

    Are you in Alabama? Are you going to vote for the pedophile? You Republicans and your family values – you'll vote for pedophile before you'll vote for for a Democrat! Just like you voted for the Pussy Grabber. There's a special level of Hell just for you hypocrites.

  9. Design you fools by gurps_npc · · Score: 2

    In other words, human doctors have made absolutely sure that the surgeries they design are easily done by the surgeon doing the planning, rather than saying "Hey, I'm not sure if I can avoid killing you, but what the hell, let's give it a shot."

    No freaking da.

    --
    excitingthingstodo.blogspot.com
  10. Re:"Study finds Trump is a lying scumbag traitor" by AutodidactLabrat · · Score: 1

    You have to believe in a god first
    Trump apparently doesn't.

  11. Re:"Study finds Trump is a lying scumbag traitor" by Anonymous Coward · · Score: 0

    If you guys keep bitching like this for the next 7 years we're going to have a national crisis trying to find a place to store all the salt.

    You're in for a shock next November.

    #BlueMidterm

  12. My 2 cents. by Anonymous Coward · · Score: 0

    Health and well being is a variable subjective thing that seems to jive, change with the times. Usually culturally / technologically speaking. And they are always fads. Which is why we end up alienating those whom tend to operate outside the supposed norms of culture. Under whose guidelines does one consider the best of states to be in. Who has the right to decide. Many may not think there is a debate to this, yet look at the use of over prescribed medications as an example. The mortality rates. So yes, there is. And while I agree to simply focus on speed and cost alone is quite shallow in it's approach, some people, patients for example, simply well, have no patience.

  13. Sample size by The+Cynical+Critic · · Score: 2, Insightful

    I hope that I'm not the only one puzzled with the number of surgical procedures being evaluated here. A single procedure done carried out using 3 different methods is hardly going to produce enough data to make any kind of assessment as how the different methods compare. Sure, you can talk about how they compare for this particular procedure, but even at that we're talking about footnote-level importance here.

    Hell, I'd even go far as to argue that the real story here is how something as insignificant as this was given this much attention and how badly it's very specific conclusions were over-extrapolated to make a headline as eye-catching as possible.

    --
    "Why should I want to make anything up? Life's bad enough as it is without wanting to invent any more of it."
    1. Re:Sample size by rhsanborn · · Score: 4, Insightful

      That's actually the point. We aren't trying to determine if robots are good or bad in general. It's irrelevant. The researchers are trying to determine if robot assisted surgery is better than non-robot assisted surgery for specific surgeries. This is how doctors determine the best course of action to use in a specific situation, and whether insurance companies will cover extra costs for those particular actions. It looks like 2 particular surgeries show no benefit of robots and that doctors probably shouldn't generally use those robots for those procedures, and insurance companies shouldn't pay anything extra for the use of robots in those procedures. We should hope they're working on studying the efficacy of robotic assistance in more surgical procedures.

  14. Re:"Study finds Trump is a lying scumbag traitor" by Anonymous Coward · · Score: 0

    Well at least he's got that going for him.

  15. Somebody didn't read Clayton Christensen by Anonymous Coward · · Score: 0

    One of Christensen's main points is that disruptive innovators usually offer products that are clearly inferior to the state of the art in one or more dimensions that matter to the majority of the customer base of the industry giants. For example, the IBM PC was dismissed as a toy by DEC's Ken Olsen, and many others. They weren't entirely wrong. But the upstarts gain a foothold, and that helps fund rapid improvement of their products.

  16. 2nd Opinion by Neuronwelder · · Score: 1

    I always thought in a perfect world that we would be merged with robots, working side by side, making anything we do; perfect.. I personally would want a human beside the robot in case it gets hacked or breaks. But alas, $$$ Money rules $$$!!

  17. What?! by Anonymous Coward · · Score: 0

    Silicon Valley is proven yet again an over-inflated, delusional hype balloon? GET OUT. Soon to not follow: robot lawyers, judges, teachers, mission to mars etc. ad naseum.

  18. Welcome to the Internet! by Anonymous Coward · · Score: 0

    Hell, I'd even go far as to argue that the real story here is how something as insignificant as this was given this much attention and how badly it's very specific conclusions were over-extrapolated to make a headline as eye-catching as possible.

    Welcome to the Internet!

    Also, all of mass communication for the last two-thousand plus years.

  19. Re:"Study finds Trump is a lying scumbag traitor" by rally2xs · · Score: 0

    "Chairman Mao" disarmed his people, then killed 20 million of his countrymen who opposed him. The bottom line is that we vote against ANYONE that we feel is likely to pass even the slightest of "gun control" legislation. Between the despots exterminating opposition, and the fact that "gun control" legislation absolutely does not work, the opposition cannot find anyone that we would not vote for as long as Democrats demonstrate their willingness to go down the same road as past communists.

  20. Who is going to do the developing by Anonymous Coward · · Score: 0

    if the scientists say "optimism is misplaced and unfounded"? There is no progress without optimism.

  21. Comment removed by account_deleted · · Score: 1

    Comment removed based on user account deletion

  22. My wife is an anesthesiologist by mark_reh · · Score: 1

    and she tells me that she and all her coworkers hate robotic surgery cases. They take much longer which increases the risk of anesthesia related complications, especially for older patients.

    1. Re:My wife is an anesthesiologist by Anonymous Coward · · Score: 0

      Yeah I agree. They add at least an hour to operating time just for set up