Watson progress

Koppel, Ross J rkoppel at SAS.UPENN.EDU
Fri Sep 8 13:13:02 UTC 2017


I think Charlene Weir has articulated a key issue.  I would add to that great insight that it's hard for Watson et al to deal with the constant ambiguity that permeates medicine/healthcare. There's what we don't know about the patient, what we don't know about medicine/disease processes, what an individual clinician didn't/does not know, * what knowledge about the medications we don't know or know incorrectly, DDIs, what tests we didn't order...and which ones we should have ordered if we knew more, the distortions embedded in the EHR's displays (both data and confusing visualizations), what other clinicians have "concluded," what the patient or caregivers told us, the unintentional falsities of med rec, the intentional falsities of med rec...    I could go on but I'm going to mow the lawn.


Ross Koppel


*ft nt:  Rene Fox noted that one of the first things a young doctor must learn is the difference between what "I" don't know vs. what medicine does not know.

________________________________
From: Charlene Weir <charlene.weir at UTAH.EDU>
Sent: Friday, September 8, 2017 1:30 AM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: Re: [IMPROVEDX] Watson progress


I am wondering if all of what Brian described would fit one of the basic premises of the book: Godel, Escher and Bach by Douglas Hofstadter. If I recall correctly, it was something about how a system cannot explain itself at the same level of complexity that it is at. If you ask individual clinicians to explain healthcare, you always get a very confusing, distorted, reflection of what goes on. I recall being in charge of an EMR implementation in the VA and we needed to design a discharge process with automatically activated order pathways. Nobody knew how the discharge process worked – we had to gather the various individuals and really map it out. I think those companies are paying individual clinicians and believing everything they say as being representative.  Just a thought!



Charlene





Charlene R. Weir

School of Medicine, University of Utah





From: "Jackson, Brian" <brian.jackson at ARUPLAB.COM>
Reply-To: Society to Improve Diagnosis in Medicine <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>, "Jackson, Brian" <brian.jackson at ARUPLAB.COM>
Date: Thursday, September 7, 2017 at 10:06 AM
To: "IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG" <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>
Subject: Re: [IMPROVEDX] Watson progress



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
Tel: +1 703 879 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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