Crowd Wisdom for Diagnosis?

Timothy Krohe tkrohe1 at GMAIL.COM
Wed Jul 17 14:35:04 UTC 2013


Agree with Dr Zamir the better utility of posting to physicians-only
services .



While my goal is not to provide a plug,  this type of assistance happens
regularly on sermo.com .  In frequent posts,   a physician  describes a
case,  requests help AND usually provides feedback to enhance learning. All
posts are visible to all physicians, so there are glimpses of "how (other)
doctors think".  Access is free to licensed physicians.  The website has
MANY other humor/stress release/political/administrative postings as well
so is not purely clinical and you need to sift for the clinically useful
posts.



In the DoD, there is a worldwide teleconsult service that emails requests
for help , often from the outlying combat or isolated bases. A large group
of specialists/internists from the larger military hospitals have
responsibility to respond quickly with comments/recommendations.   Very
collegial and supportive for those docs/corpsmen/NPs/PAs providing care in
isolated area. Access obviously limited to DoD.


I have enjoyed and learned (and I hope helped other MDs) from both
systems.  No fees for the reqeuster in either.


TL Krohe MD General Internal Medicine





-----Original Message-----
From: Ehud Zamir [mailto:ezamir at UNIMELB.EDU.AU]
Sent: Tuesday, July 16, 2013 9:23 PM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: Re: Crowd Wisdom for Diagnosis?



Interesting idea. However, one has to remember that in primary care, most
patients with unresolved symptoms (after medical assessment) have no
serious or significant underlying problem. Not sure anyone has ever counted
them, but I think one may safely assume that a competent GP is often
required to conclude, correctly, "I don't know what the reason for your
chronic headache is, Mrs Smith, but I can tell you it is unlikely to be
anything serious". The risk of such a project, is that, statistically, in
the majority of patients who believe they are a "diagnostic mystery", none
of the ideas raised by the "detectives" will really help reach a
significant diagnosis (simply because there is none). There will possibly
be an occasional misdiagnosis needle in the haystack, but that will be
diluted by a lot of background noise. That is the one of the challenges of
primary care in the first place, isn't it?

I think it would be more likely to help if the cases were ones where doctors
posted their unresolved cases where they felt the unease of a truly
unresolved, and potentially serious, problem. Statistically, it would
increase the utility of second opinions.



Just my two cents

Ehud



Ehud Zamir, MD, FRANZCO

Centre for Eye Research

Melbourne Australia



________________________________



From: David Meyers [dm0015 at ICLOUD.COM]

Sent: Wednesday, 17 July 2013 5:10 AM

To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG

Subject: Re: Crowd Wisdom for Diagnosis?





Dr Lisa Sanders, the NY Times medical correspondent, has been doing this
for quite a while in the Sunday magazine.  See link:
http://topics.nytimes.com/topics/news/health/columns/diagnosis/index.html.
 There
are also Twitter resources in emergency medicine like this.  One has to be
careful to use the wisdom of crowds  (see James Surowiecki, 2004) and not
the madness of crowds (Charles Mackay, 1841), if we can tell the
difference.



David



David L Meyers, MD, FACEP

dm0015 at icloud.com

Mobile: 410-952-8782

Fax: 410-367-0449











On Jul 16, 2013, at 1:59 PM, Bill Thatcher <BillThatcher at MINDSPRING.COM>
wrote:





      Yesterday I posted a short piece from Mark Graber, MD about an
intriguing new website:



      CrowdMed.com  <http://www.crowdmed.com/> is a new online startup that
uses the 'wisdom of the crowd' to suggest the correct diagnosis for
patients with unresolved symptoms. The project is the brainchild of Jared
Heyman, an internet-entrepreneur, who thought of the idea after his sister
suffered through an undiagnosed illness for over three years. Cases are
submitted by patients for a small fee, and anyone can register as an "MD"
(medical detective - cute, eh? No license required) to suggest a diagnosis
or vote on the suggestions already made.



      You can read the rest of the post from Mark Graber here:



      http://improvediagnosis.site-ym.com/blogpost/950784/Latest-News



      Bill Thatcher



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