Watson progress

Peggy Zuckerman peggyzuckerman at GMAIL.COM
Thu Sep 7 20:25:07 UTC 2017


As we discuss the  value of WATSON or other data and literature reviews of
this magnitude, we must also assess the validity of the trial data and its
design.  In the cancer world, things are changing so fast that the
so-called facts that came from a trial 10 years ago may not longer be held
to be relevant.

The shifts in the ways that cancers are diagnosed--not just by organ
location--but by the genomic drivers of the cancer, must be recognized in
the data feeds.  Just as lung cancer encompasses a range of disease, NSCLC
does as well!  How then does one evaluate the data from older trials when
there was no stratification by disease type?

The drug which saved my life from Stage IV kidney cancer was approved in
1992, on the basis of a Phase II trial, with a limited percentage of
responders, both as to complete and partial responses. Would this trial
meet contemporary trial standards of evidence?  There were no restriction
as to the types of kidney cancers in the patients, certainly some who had
very rare subtypes, with far larger tumor burden than found today, and with
PR calling for  a tumor shrinkage of 50% vs 30% in current trials.

Lots to learn from this attempt, but without transparency about the
standards used, and to some degree, the biases that the experts carry, we
will have continued struggles.  Certainly more accurate diagnoses could
come from the latest data, but to link that data with the older 'evidence'
is not as simple as the press and public have come to believe.

Peggy Zuckerman
PS.  My drugs was high dose interleukin2...not recommended by MSKCC.  My
patient-reported outcome of  13 years free of metatstatic disease might
also be captured somewhere.

Peggy Zuckerman
www.peggyRCC.com

On Thu, Sep 7, 2017 at 12:39 PM, robert bell <
0000000296e45ec4-dmarc-request at list.improvediagnosis.org> wrote:

> Research is also never *completely* wasted and there is much that is
> never divulged initially that can be used in other ways or leads to
> contacts and information sources that make a subsequent project successful.
>
> With the 10 year moon shot endeavor there were numerous discoveries that
> led to products and patents in the years to follow. If we had not put the
> astronauts on the moon we would have still had all that discovery/invention.
>
> Rob Bell M.D.
>
> On Sep 7, 2017, at 10:17 AM, Tom Benzoni <benzonit at GMAIL.COM> wrote:
>
> There is a third explanation, not to be lightly tossed out.
> Health care might be really tough.
> It just seems easy after the fact.
>
> Your car is running roughly, poor performance and mileage.
> On presentation at the mechanic's, you're told "$50."
> Sounds good; you've wasted more than that on gas. You agree.
>
> She reaches under the hood and switches 2 spark plug wires.
> "$50, please."
> You feel cheated; it was too easy.
>
> It's always easy after the fact.
>
> tom
>
>
> On Thu, Sep 7, 2017 at 9:54 AM, Jackson, Brian <brian.jackson at aruplab.com>
> wrote:
>
>> It really is astounding just how badly the big tech companies keep
>> bungling their investments in healthcare.  GoogleHealth and Microsoft’s
>> personal health records were both a flop. Google also wasted an enormous
>> amount of money pursuing contact lens-based glucose monitors, despite
>> decades-old research showing that glucose levels in tear fluid is way too
>> variable to be useful for medical monitoring. GE spent a very long time,
>> and billions of $, trying to corner the market in healthcare IT before
>> admitting defeat.
>>
>>
>>
>> This is definitely not for lack of technical capability.  Watson is
>> technologically amazing for what it was designed to do; beating Ken
>> Jennings was a mind-boggling moonshot sort of accomplishment.  And
>> self-driving cars – that’s a crazy-hypercomplicated application.  IBM,
>> Google, etc. have a constant stream of computer science PhDs flowing to
>> them from MIT, CalTech, Stanford, and Harvard.  They can do stuff by brute
>> force that we could barely imagine.  But they keep biting off the wrong
>> healthcare problems to work on.  I don’t know if it’s because their
>> management doesn’t really understand healthcare, or because they partner up
>> with clinicians who don’t really understand the abilities and limitations
>> of machine learning, or some other combination of issues.  But it’s been
>> frustrating to watch this play out from the sidelines.
>>
>>
>>
>> --Brian Jackson
>>
>>
>>
>> *From:* Jason Maude [mailto:jason.maude at ISABELHEALTHCARE.COM]
>> *Sent:* Thursday, September 07, 2017 3:14 AM
>> *To:* IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
>> *Subject:* Newsletter / Marketing: [IMPROVEDX] Watson progress
>>
>>
>>
>> STAT has just published the most thorough and authoritative (and
>> longest!) article on the current state of Watson. Not surprisingly, it’s
>> not (yet) lived up to the marketing hype and proving more difficult to
>> train and implement than thought.
>>
>> https://www.statnews.com/2017/09/05/watson-ibm-cancer/
>> <https://clicktime.symantec.com/a/1/saRlXJyq3ZVleqWUrxkPIdzbCZ8twpAagqm4TzASsT8=?d=O6K66vqQtR851Ld2opwqtDOdPVyjy6-vTcHk84yhsO_Gx-irpDgvVf4o65IpRSnuJO2c8GAAwJOcve2ws8R9BUvlVmZKdbAGhccFBNYMwFtSc4vJ_STQ7pJg9xfAI81pukccwfmX-2yqw9Xdk8_PvGm_ckhZGKoBy51fcrWSQ0LVR7SYDGbisk4Q1vj1ahx9pL1_wQBBdeH2V5rF3NbG0y6YhN68pE_XisRJlxoM_rjVI6hcAZ4u7RkzqpLJ4Sc1v3Ln4xcMzfeBPvSTG5hD-p-N0KVNU3iPUTiA5vzQ2xwb2NU0OEbVjp6DZIoV26k1pYsNi_DBD78IpoL88KIvVya4o4y2yaV7F8NL4LdfCmnhnnqkEW_rji-GWYUuh9CBV7gU5-IyGhDC6HP8fglJQFWjdyg%3D&u=https%3A%2F%2Fwww.statnews.com%2F2017%2F09%2F05%2Fwatson-ibm-cancer%2F>
>>
>>
>>
>> Regards
>>
>> Jason
>>
>>
>>
>> Jason Maude
>>
>> Founder and CEO Isabel Healthcare
>> Tel: +44 1428 644886 <+44%201428%20644886>
>> Tel: +1 703 879 1890 <(703)%20879-1890>
>> www.isabelhealthcare.com
>> <https://clicktime.symantec.com/a/1/cRHc9LZPRot9us4Hu5PLINe6CkA5y-rYIoOWg4c1dNA=?d=O6K66vqQtR851Ld2opwqtDOdPVyjy6-vTcHk84yhsO_Gx-irpDgvVf4o65IpRSnuJO2c8GAAwJOcve2ws8R9BUvlVmZKdbAGhccFBNYMwFtSc4vJ_STQ7pJg9xfAI81pukccwfmX-2yqw9Xdk8_PvGm_ckhZGKoBy51fcrWSQ0LVR7SYDGbisk4Q1vj1ahx9pL1_wQBBdeH2V5rF3NbG0y6YhN68pE_XisRJlxoM_rjVI6hcAZ4u7RkzqpLJ4Sc1v3Ln4xcMzfeBPvSTG5hD-p-N0KVNU3iPUTiA5vzQ2xwb2NU0OEbVjp6DZIoV26k1pYsNi_DBD78IpoL88KIvVya4o4y2yaV7F8NL4LdfCmnhnnqkEW_rji-GWYUuh9CBV7gU5-IyGhDC6HP8fglJQFWjdyg%3D&u=http%3A%2F%2Fwww.isabelhealthcare.com%2F>
>>
>>
>>
>>
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Moderator: David Meyers, Board Member, Society to Improve Diagnosis in Medicine


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