The Uselessness of Phenylephrine

Re:The Uselessness of Phenylephrine by rscho on Wednesday March 30, 2022 @05:53PM (#30861281)

The number of factors you'd have to consider to achieve that is huge enough that it makes it completely unrealistic, both practically and financially speaking. In fact, I'm 100% convinced that it's currently impossible to build such a system, given the extent of medical knowledge.

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Re:The Uselessness of Phenylephrine by grog454 on Wednesday March 30, 2022 @05:56PM (#30861309)

I'm skeptical. I concede it's probably a hard problem but there is an entire field dedicated to hard statistical problems called data science. What is the point of having detailed patient histories and data if it can't be used to inform decisions?

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Re:The Uselessness of Phenylephrine by rscho on Wednesday March 30, 2022 @06:01PM (#30861362)

If data science was that efficient on healthcare records, we'd know it by now and everyone would do it. There is no 'big healthcare data'. We gather mostly noise, and records are full of blatant mistakes. Medicine is still more art than science today, and records mostly give you a 'feeling' for the patient's condition in light of your MD education, with a little hard data sprinkled on top.

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Re:The Uselessness of Phenylephrine by stuckonempty on Wednesday March 30, 2022 @06:50PM (#30861826)

This is a fallacy. At any point in history you can say “if X field was so good, we’d have Y by now”. In 1925 you could’ve said, “if biology’s understanding of bacteria is so good, we’d have antibiotics by now”. Within 5 years, they did.

There is certainly noise in healthcare data especially when patient-reported, but is it noise to say that a patient having X procedure later does or doesn’t have serious complications? Analyzes of medical care and their consequences can be evaluated and it’s not noise

And big healthcare data has lagged, partially because privacy concerns trump sharing. There are companies selling anonymized medical records for basically every American now though. Big data is coming

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Re:The Uselessness of Phenylephrine by rscho on Wednesday March 30, 2022 @06:57PM (#30861882)

> Big data is coming

Big _bad_ data... Let's see how we fare in 5y, then. My prediction as a clinician with a special interest in stats: close to zero medical progress. But insurance priced by a ML algorithm, and much greater efficiency in coverage and claim denials.

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Re:The Uselessness of Phenylephrine by nradov on Wednesday March 30, 2022 @09:35PM (#30862926)

Due to the Affordable Care Act (Obamacare), medical insurers have very little flexibility in pricing policies. There's not much point in using ML for pricing.

https://www.healthcare.gov/how-plans-set-your-premiums/

The more likely use case for ML is detecting insurance fraud patterns.

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Re:The Uselessness of Phenylephrine by webmaven on Monday April 04, 2022 @02:36AM (#30903859)

> The more likely use case for ML is detecting insurance fraud patterns.

I think that's covered under "much greater efficiency in coverage and claim denials."

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Re:The Uselessness of Phenylephrine by oaktrout on Thursday March 31, 2022 @12:05AM (#30863714)

The first flu vaccine came about in 1945. Knowing as much as we did about viruses then, you might think we would have a cure for influenza (or the common cold) by now. Here we are almost 80 years later... big data may be coming but if takes that long it won't be in my lifetime.

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Re:The Uselessness of Phenylephrine by BurningFrog on Wednesday March 30, 2022 @07:33PM (#30862139)

My impression is that data science on healthcare records is mostly illegal due to HIPAA and other regulations.

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Re:The Uselessness of Phenylephrine by sxg on Wednesday March 30, 2022 @10:02PM (#30863083)

It's not illegal. It's just very complicated to do correctly, and you risk large fines if you do it incorrectly.

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Re:The Uselessness of Phenylephrine by BurningFrog on Thursday March 31, 2022 @11:54AM (#30868610)

For most practical purposes, that's has the same effects.

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Re:The Uselessness of Phenylephrine by nradov on Wednesday March 30, 2022 @08:29PM (#30862504)

We mostly don't have detailed patient histories. Most of the relevant clinical data that would be needed for such a rigorous statistical analysis isn't recorded as discrete data elements, it's just unstructured text. NLP can be used to extract concept codes but the error rate is high so you still need an experienced (expensive) human to manually fix the errors. No one wants to pay for that.

The codes we do have are mostly CPT4 and ICD-10 for billing purposes. Those are generally pretty accurate, but not detailed enough to reliably assess whether one surgeon is better than another at a particular procedure.

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