[upghost]

It's so much worse than you could possibly imagine. I worked for a healthcare startup working on patient enrollment for clinical oncology trials. The challenges are amazing. Quite frankly it wouldn't matter if the data were in plaintext. The diagnostic codes vary between providers, the semantic understanding of the diagnostic information has different meanings between providers, electronic health records are a mess, things are written entirely in natural language rather than some kind of data structure. Anyone who's worked in healthcare software can tell you way more horror stories.

I do hope that LLMs can help straighten some of it out but anyone whos done healthcare software, the problems are not technical, they are quite human.

That being said one bright spot is we've (my colleagues, not me) made a huge step forward using category theory and Prolog to discover the provably optimal 3+3 clinical oncology dose escalation trial protocol[1]. David gave a great presentation on it at the Scryer Prolog meetup[2] in Vienna.

It's kind of amazing how in the dark ages we are with medicine. Even though this is the first EXECUTABLE/PROGRAMMABLE SPEC for a 3+3 cancer trial, he is still fighting to convince his medical colleagues and hospital administrators that this is the optimal trial because -- surprise -- they don't speak software (or statistics).

[1]: https://arxiv.org/abs/2402.08334

[2]: https://www.digitalaustria.gv.at/eng/insights/Digital-Austri...

[sebmellen]

Have you read Jake Seliger’s pieces on oncology clinical trials https://jakeseliger.com/.

[upghost]

Oh wow. No, that's heart breaking. I'll have to read up on this. Reminds me of David explaining the interesting and somewhat surprisingly insensitive language the oncology literature uses towards folks going through this. Its there for historical reasons but slow to change.

It also shows how important getting dose escalation trials are. The whole point is finding the balance point where "cure is NOT worse than the disease". A bad dose can be worse than the cancer itself, and conducting the trials correctly is extremely important... and this really underscores the human cost. Truly heartbreaking :(

[triska]

David has since also made extensive progress with his category-theoretic approach, available in a new repository:

https://github.com/Precisfice/DEDUCTION

[slaucon]

This is a fascinating idea!