The computer will see you now

‘The computer will see you now’ was the title of a UK TV Programme in the Horizon series screened this week investigating how Artificial Intelligence’s being used to try to develop computers that can be used by people all over the world to diagnose illness. It is already in use experimentally in Uganda where it enables few doctors to deal with huge numbers of patients. Apparently there is one GP practice in central London where 30,000 patients who work in the area have transferred from their home-location based practice and are interogated by machine and if necessary ‘seen’ by GPs via video, Local GPs are outraged because of loss of funding mostly of younger fitter patients - the ones they are paid to support and rarely see - and the Royal Colege because a loop hole in the law allows such practice to exist at all. Difficulties remained mainly because the law doesn’t keep pace with technology and discrepancies mean AI is only allowed to offer information and not give diagnosis but it’s accuracy certainly seemed excellent and will no doubt improve with time. Unlike mankind these machines can work 24/7 and aren’t subject to off days, don’t get colds, row with the wife before leaving home etc and so must ultimately prove consistent and reliable. It is already being used with a human as Control to deal with mammograms for which it seems ideal. A distinct advantage must be its decision is traceable, Surely this will be the way forward within a few years. I’d certainly be prepared to give it a go!

Much was made of a mistake in diagnosis by the AI, but, as we all know, doctors don’t always get it right either and I don’t suppose the aim is to do away with doctors completely but it must prove a useful tool. It would be interesting to know how AI will cope with individual’s perception, ie its definition of ‘vertigo’ as oppose to,’dizziness’ which could prove vital with MAV. `Under exam conditions it performed extremely well. It’s certainly an interesting concept. Interesting programme.

Under exam conditions it was given short specimen symptom lists and asked for a diagnosis, Just as an example, pretend you’re an AI computer and do try this one and see what you come up with. (I found this, it’s not from the TV programme).

Seeing things moving in peripheral vision that isn’t actually there
Dizziness
Motion and car sickness
Sensitivity to Bright Lights/glare
Blurred vision
Poor depth perception
Feeling ‘spacey’/disorientated
Head, neck and shoulder pain
Sinus discomfort
Sleep problems
Uncomfortable in department stores, overwhelmed in a crowd.

The above list of symptoms refer to ‘Vertical Heterophoria’

Which makes one think. Could so easiky be MAV. I’d noticed the similarities some time ago. One wonders what AI would make of that.

Helen

Are you referring to this, Helen?

https://www.gpathand.nhs.uk

As you say, the key word is ‘transferred’. Once you start using this service you are not able to use your local GP anymore.

Good point. Hadn’t thought of that before.

Must be. TV said there’s only one currently and no more authorised to start whatever that means. In UK it’s called ‘Babylon’. Dont really grasp how it works cos of the legality of ‘info’ v. ‘diagnosis’. That wasn’t clear in programme but as plp transfer and law requires you must have GP cover so how presumably it is workable. My interest was more in the theory behind the concept. London’s a foreign country to me, or may as well be. I’m actually more familiar with Paris believe it or not. Helen

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Open the pod bay doors Hal…

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I think computational diagnostics are going to be the wave of the future for the most part. Imagine a world where there was a repository of everyone’s symptoms and de-identified genetic information, and you’d be able to quickly tailor drug treatments to particular genetic markers.

My brother was a cancer researcher before getting his MD, and there he worked on using genome sequencing of tumors and various brute force methods to grow human tumors outside of a human and test various doses of chemotherapy on the tumors to determine the optimal drug/dose combo. They were able to do this within a short enough time-span to aid oncologists in choosing the correct drug for their patient rather than the typical “well lets throw spaghetti at the wall and see what sticks sort of methodology”. Really exciting stuff. It is expensive, but as more adapt the costs will come down.

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I kind of agree. Sometimes it’s just a fear of change and perhaps this can ensure more people are seen using less resources.

However, the issue here is complex.

GPs are acting in part like social welfare advisors (though they probably shouldn’t be). My local GPs give out free toothpaste or shampoo to those they think need it and who can’t afford it.

If we move these services online some people will lose a lot from the lack of physical one to one care. It’s very sad.

Yet another cut to social welfare essentially.

James, I agree on the importance of human to human interaction. There is no reason why human doctors can’t be aided by the diagnostic tools of a computer though. Our future doesn’t have to be a dystopian sterile environment if we don’t want it to be.

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I think the UK is going down this road too with cancer patients which is great. They reckon it will stop/reduce the need for Chemo. Brilliant. I’m sure it will come across the board with time. That’s so good.

@turnitaround I’m amazed. The National Health Service. What’s the ‘National’ bit in there for? Any idea. Your surgery gives out free shampoo. Mine only sees people by GP’s request. You phone, leave confidential details with admin, GP phones you back for ‘consultation’ and, invites you in if they feel you need to be seen. I’m not envious. I can fortunately afford to buy shampoo, and within reason (well, with MAV now I get sea sick these days so there’s no point in buying a yacht anyway) I can afford to buy anything I want/need, but it does make me wonder.

I’m all for technology. Cannot come in soon enough for me, and mine. Better use of resources. Be great in Third World Countries. Everyone gets equal treatment. If the GP can diagnose my SO with arthritis and prescribe exercise course (provided by NHS Physios and worked a treat) with one XRay and without setting eyes on him, give me a machine diagnosis. No problem.

GPs have illusions of grandeur. Consultants even more so. So inaccessible. With GPs it’s not fear of change, it’s fear of loss of the status quo! I cannot lose physical one to one care. I haven’t had it, for years. Helen

Yep, apparently so. Obviously it’s ‘means tested’ (suspect its down to the intuition of the doctor). The free stuff are probably marketing samples in any case. But it fulfils a need that other departments may not be.

It’s a sad sign of the times along with the necessity to provide food banks. When plp hv so little they cannot cover essentials like food and personal hygiene. So very sad. Helen

No doubt an unachievable idea but wouldn’t it be great if somebody on mvertigo.org actually knew somebody involved with this project and had some influence to use, This sort of diagnosis tool will surely go viral in not too distant future and will help billions. Be good to know it was programmed to understand MAV. otherwise, for MAVers it may become another case of ‘Garbage In, Garbage Out’. Helen

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https://www.newyorker.com/magazine/2018/11/12/why-doctors-hate-their-computers