[gamegoblin]

My field of research is in machine learning, and upon chatting with medical folks about recent machine learning breakthroughs that outperform panels of experts at making diagnoses, they are all extremely resistant and think that using AI in medicine is somehow immoral.

I'd personally want to be diagnosed by a panel of experts with access to said AI.

[giardini]

Problem is they might override the AI's (more-likely correct) judgment. See the table labeled "Predictive modeling vs. the experts" at the bottom of the article "Predictive Modeling Holds Promise of Earlier Identification, Treatment":

http://www.managedcaremag.com/archives/0109/0109.predictive....

Here's the original article:

50 years of successful predictive modeling should be enough: Lessons for philosophy of science (2002) by Michael A. Bishop , J. D. Trout: http://citeseerx.ist.psu.edu/viewdoc/summary?doi=10.1.1.217....

In the end, we'll rely on the AI. We'll _want_ to rely on the AI. Doctor's roles will be reduced to that of nurses. Care will improve. See it all described in the 2006 movie "Idiocracy":

http://www.imdb.com/title/tt0387808/?ref_=nv_sr_1

[raverbashing]

"I'd personally want to be diagnosed by a panel of experts with access to said AI."

Exactly. Neither one nor the other alone, even though today the panel of experts seems the best bet

To see how the AI can go wrong, just try to diagnose something with flu-like symptoms using Google.

There's also an issue with incomplete tests. Oh the AI can improve the diagnostic using exam X but exam X is too expensive/too invasive/risky etc, someone needs to play "middle ground"

[julespitt]

To see how the AI can go wrong, just try to diagnose something with flu-like symptoms using Google.

Google isn't designed to diagnose symptoms, so I don't think that's a very good analogy.

[mjn]

Some kind of machine/human integrated medical system is a common goal of current research. Where many AI people think the lack of uptake is coming from, besides just general resistance to AI diagnosis, is that current systems don't have great real-world usability.

A few issues: There is a lot of information available to the doctor in a typical diagnostic setting that is not currently codified in machine-readable form, and asking the doctor to do custom data entry per patient is not likely to improve uptake. Ideally the systems should integrate with other patient-information-management systems, and such patient-information systems might need to be augmented with new or differently coded data collection. Perhaps equally or more importantly, if the AI system is going to be a component of the diagnosis rather than handed over full trust to make the diagnosis, it should ideally produce "white-box" diagnoses with justification for its reasoning and human-readable explanation of what it thinks the situation is, not just black-box predictions.

[DanBC]

Is the idea that i have an appointment, and the doctor / AI come to a diagnosis?

Or that an AI runs through a doctor surgery's collection of patient medical records and highlights patients that probably would benefit from an intervention?

[WhitneyLand]

Are any of the systems you refer to general purpose?

For example software outperforming experts at xray interpretation seems pretty easy to imagine.

However outperforming a general practitioner by asking questions of a patient seems more difficult because the problem space diverges so much...

[gtirloni]

Certainly agree for a panel of experts. Thinking about day-to-day use for the masses (which I don't know if they are targeting or not), Watson would certainly outperform most of the doctors I've been examined by in the last few years (and I'd trust it more than the doctors).

[wil421]

It may not be immoral but I doubt the malpractice insurance companies are going to back Doctors who rely on an AI to make diagnoses.

I agree that a combination of a panel and AI would make me feel better about a diagnoses.

[julespitt]

If the AI is more reliable than human diagnosis, actuarially speaking, the AI would be preferred by insurance companies.

Assuming it was more reliable, of course.

[ProblemFactory]

I would expect that Watson is used as a discovery, not a decision tool - something to point out the symptoms as matching an uncommon disease that the doctor had not otherwise considered.

There are around 500 000 biology and medical research papers published per year (http://www.stm-assoc.org/2012_12_11_STM_Report_2012.pdf), and it's completely impossible for a doctor to keep up with all of the latest knowledge. A search engine can help a lot in discovering otherwise unnoticed connections.

I'm not sure how insurance companies are going to approach this - but "the computer agrees with my decision" seems to be a good defense argument in a malpractice case. And if the end result is statistically better, then insurance companies will adjust their prices.

[ghshephard]

Kaiser makes use of an expert system when determining whether to schedule an appointment. I once called in with the the symptoms, "Excruciating pain in the chest, left arm just went completely numb at the same time" - and the admitting nurse (under the guidance of an expert system) determined with three quick questions that it wasn't urgent. (Any shortness of breath, are you light headed, if you press your fingernail down, how long does it take to return from white to red)

So, expert systems are already here and helping make decisions...

[mikenuman]

Shame the "expert system" was wrong!

With that history you should have been seen urgently. There are a number of serious things that are possible with those symptoms.

Plus, the nurse was relying on your accurate reporting of symptoms. Things are often very different face to face than over a telephone. People very often under/overplay their symptoms.

[ghshephard]

Presumably those people who've developed the kaiser system have come to a different conclusion than you. It may be the case that there is no scenario in which "Excrutiating Chest Pain + Numb Left Arm" is urgent when you have a full return to red on when pressing your fingernail (blood pressure check?)

Also, presumably, if I was having any shortness of breath, it could be determined just by talking to me. They may have also taken my age into account (32) and decided that 32 year olds don't have heart attacks in the way I was describing.

I came in for a checkup a week later, and all was well (except for a RSI issue that was contributing to the completely numb left arm)

[the906]

Oh yeah this would never be purely AI...think of Watson like the Tardis and the Doctor like ...The Doctor. They go hand in hand, Watson simply makes it so the Doctor doesn't have to waste time.

[wil421]

Or maybe ziggy from quantum leap.

[w1ntermute]

In practical terms, that would require having medical insurance from a company that supported that kind of thing. No idea when/how that will happen.