Interesting article on big data in diagnosis

Jackson, Brian brian.jackson at ARUPLAB.COM
Wed Jun 8 16:10:00 UTC 2016


I'm disappointed.  NYTimes is usually one of the good guys in terms of high quality science journalism, but this article is the sort of uncritical hype that I usually see from lesser sources.  I suspect this is because the reporter in this case, John Markov, specializes in covering the IT industry.  I doubt any of NYTimes' excellent health and medicine reporters would have touched this story, because there's really not much there in terms of newsworthy science:


1.       The authors basically just demonstrated that you can find a signal within web searches that correlates diagnosis-related searches with previous symptom-related searches.  Which is sort of interesting in the sense that you could use this approach to study consumer health behaviors, etc.

2.       The initial symptoms used in the study were cherry-picked to be somewhat specific for pancreatic cancer, esp. when seen in combination.  In principle you could do the same for other cancers, e.g. "large hard lump in my breast" or "worsening constipation and blood in stool" but by the time such symptoms become diagnostically specific, the cancers are often quite advanced.

3.       The study provides zero new information about pancreatic cancer diagnosis, let alone ways to improve diagnosis.

4.       It's not clear to me whether they tested their model on a different data set than they used to train the model.  Unless I'm missing something in their methodology, this would be a pretty blatant violation, and would invalidate their calculated performance measures (true-positive, etc.)

5.       Cancer screening only works under a pretty narrow set of assumptions.  These assumptions are satisfied for cervical and colorectal cancer, but not for the vast majority of cancers at this point in time.  Framing the journal article around screening discredits the authors, and the same could be said about the news article and journalist.

--Brian Jackson

From: David L Meyers [mailto:dm0015 at COMCAST.NET]
Sent: Tuesday, June 07, 2016 8:51 PM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: [IMPROVEDX] Interesting article on big data in diagnosis

http://www.nytimes.com/2016/06/08/technology/online-searches-can-identify-cancer-victims-study-finds.html?hp&action=click&pgtype=Homepage&clickSource=story-heading&module=first-column-region&region=top-news&WT.nav=top-news
David
David L Meyers, MD FACEP
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