No, not by a long shot, because physicians are a pretty rare commodity, care is expensive and sending nine out of ten people to the doctor for no reason is a huge drain on the system and public healthcare resources.
if you see this as success I don't think you're familiar with the concept of opportunity costs. For people who don't have any symptoms, have no history of heart conditions or other underlying risks, running around with an EKG on your wrist is absolutely ridiculous. All it will do is inflate healthcare costs with little improvement in outcome, which is already the primary disease of the US healthcare sector. And of course apple's and the healthcare sectors primary motivation to sell these things to begin with.
Not every cardiac condition even requires immediate attention by a physician, I wager most of the anomalies that show in the 10% are benign arrhythmias that would have been picked up on a yearly routine checkup in due time.
I don’t think this is anywhere near enough of an impact in terms of “false positives” to be a net negative.
10% positive predictive value for something like this is pretty good. It’s certainly better than “hey look at this weird mole.”
That's not happening. Only a small number of people went to the doctor. Of that number, 9 out of 10 ended up not being diagnosed with a (new) problem, but it seems that even some of them had related problems that were already diagnosed.
Regardless, we don't know the false positive rate. It's not 90%. You need to know the number of negatives before you can calculate it.
> No, not by a long shot, because... [opportunity costs, overloading the healthcare system]
Totally agree with all of that.
Why don't EKG salons exist (like nail and hair salons)? New market opportunity created by the Apple Watch?
In this case, all we know is they had they had a “clinically actionable cardiovascular diagnosis”. That action might have saved lives or might have added a few healthy months to the lives of a few, at the cost of requiring 20 to undergo treatment, spend time waiting for treatment, be worried, etc.
There can be a point where the cost and risks of testing people we can’t make healthier (either because they aren’t ill or because they are, but no effective treatment exists) outweighs the gains made by treating people we can treat.
That’s what the article being discussed, IMO rightfully, tries to measure.
A new device is created that alerts 50% of the US population that they have a condition that needs to be treated. Only 10% of those cases warranted further action.
Do you imagine there would be adverse side effects of hospitals being overrun with patients that didn't need to be there?
How can you utterly fail to see a problem with an influx of false positives to an already overloaded healthcare system?
I really have distaste for those comments that attempt to mask ideology with a veneer of logic. You attempt to use a limiting case argument that actually proves the original comment's argument and then end with rhetoric about how the healthcare system is being flooded already. That may be true, but that isn't relevant to the utility of the apple watch in this scenario.
Since we're overly simplifying, there _are_ devices that can detect conditions that 5% of the population has _and_ have far fewer false positives - X-rays, CT scans, MRI. In the grand scheme amazing things, but no-one's calling them "miracle devices".
Perhaps, but you can't wear one on your wrist and you generally have to be quite sure something is wrong first.
What would be more likely to happen in that scenario, is that so many people would be seeking care that the 5% who were positive would be unlikely to even get the care they need.
Further, such an influx would have knock-on effects on unrelated patients, whose care would suffer due to the severe lack of resources.
This is all magnified if the resource is not a general practice physician, but a specialist.
If the healthcare system - paid healthcare system - can't handle a slow baseline increase in non-emergency visits, then something is seriously wrong with this picture.
Hypothetically, let's assume over a long period of time new devices are alerting users to possible medical conditions. Those appointments are paid for (I'm guessing). Will that money not fund more availability over time? The supply of doctors is not supposed to be fixed.
Out of that haystack, only 41 referred to an Apple Watch alert about abnormal pulse detection.
And of that 7 were found to have enough concern to further explore potential cardiovascular disease.
So, out of three quarters of a million visits, there were 41 with concerns from an Apple Watch, and 7 people received early treatment they might not have otherwise received (which could potentially save millions of dollars of future healthcare costs).
34 people were false positives and inconvenienced with a doctor's visit.
This seems like a net positive.
Suppose a device is released that has a 30% false positive rate: two-thirds of the people it identifies have an actual underlying condition that requires treatment.
Presumably you would not be opposed to this. (If you do, you'd seem to be opposed to any effort to catch conditions early.)
So then we're at a discussion about what the correct percentage of false positives is for a further diagnostic - in this case, likely a holter monitor, to identify if it's an actual issue, which is not that expensive.
You believe it's obvious that ten percent is an outrageous number. But if the next step is a fairly inexpensive diagnostic, and the subject matter is a potentially lethal condition (often the case with hearts), it's not obvious at all.
What's your acceptable "brightline" of maximum false positivity to warrant additional diagnostic? Fifty percent? Twenty percent?
But what you described sounds reminiscent of the PCR test we have for COVID right now. I at least hope many are aware of this here.
It’s off topic, but I recommend you do it. I’ve found HN to be a great place for those types of discussions provided you have a relatively thick skin and don’t engage in hostility.
This just improved the lives of 16 million people. That is not insignificant. And that's assuming 16 million people would have the same condition.
This also might be underestimating the number of false positives doctors already deal with and that these devices may actually lower that number.
I... utterly fail to see the problem here.
If it were 0.01% that ended up having a problem, then OK I can see how this is not a signal worth paying attention to. But 10%?! 10% is huge.
Plus, there's no evidence of any harmful side effects here -- it's not like people are being sent into unnecessary surgery because of what their Apple Watch said. They're simply being given normal tests.
Now if Apple can make this more accurate, then great. But if this saves even a few lives, then the fact that 9 out of 10 warnings are false positives still seems extremely worth it, no?
The article paints this as a failure, when all I'm seeing is success.