

IBM's Watson Gets Its First Piece Of Business In Healthcare - antalkerekes
http://www.forbes.com/sites/bruceupbin/2013/02/08/ibms-watson-gets-its-first-piece-of-business-in-healthcare/

======
DeepDuh
People don't seem to realize how huge this is. This venture could easily turn
out to be the most profitable in IBM's history, and one of the most important
inventions in health care.

~~~
booruguru
Preach on. I'm baffled by how techies can be so underwhelmed by what IBM is
doing.

~~~
giardini
Such software has been available for decades, been shown to be superior to
human diagnosis, and yet has not been accepted by the medical community.
Doctors will likely continue to push back. It may require restructuring of the
medical education community (perhaps a' la the movie Idiocracy) to bring about
utilization.

"50 years of successful predictive modeling should be enough: Lessons for
philosophy of science (2002)"

[http://citeseerx.ist.psu.edu/viewdoc/summary?doi=10.1.1.217....](http://citeseerx.ist.psu.edu/viewdoc/summary?doi=10.1.1.217.949)

Idiocracy, the movie

<http://www.imdb.com/title/tt0387808/>

~~~
MoosePlissken
The book "Thinking, Fast and Slow" has a great chapter on human predictions
versus those made by forumlas. The superiority of simple forumlas was being
demonstrated way back in the 50s (see "Clinical Versus Statistical Prediction:
A Theoretical Analysis And A Review Of The Evidence"). Since then the evidence
for statistical rather than intuitive prediction has only become stronger.

From "Thinking, Fast and Slow":

"The number of studies reporting comparisons of clinical and statistical
predictions has increased to roughly two hundred, but the score in the contest
between algorithms and humans has not changed. About 60% of the studies have
shown significantly better accuracy for the algorithms. The other comparisons
scored a draw in accuracy, but a tie is tantamount to a win for the
statistical rules, which are normally much less expensive to use than expert
judgment. No exception has been convincingly documented."

Also interesting:

"Several studies have shown that human decision makers are inferior to a
prediction formula even when they are given the score suggested by the
formula! They feel that they can overrule the formula because they have
additional information about the case, but they are wrong more often than
not."

~~~
DeepDuh
60% out of 200 studies is not all that good, really. It allows the experts to
believe that if they're still in the top 25%, no machine can beat them (I know
that this is not exactly what the studies say, but statistics are almost
always being misinterpreted, so I do it here too).

The thing is: I expect Watson to perform significantly better than this. If it
can beat Jeopardy grandmasters consistantly and _if_ that technology is
correctly being reapplied to the medical field, Watson should easily
outperform anything we had before.

~~~
sesqu
It's worth noting that Watson didn't beat the Jeopardy grandmasters with
accuracy, but with speed - not that that isn't useful in healthcare, given
sufficient accuracy.

------
nolok
This is truly impressive. The only part that I'm unsure about it is when they
say they "WellPoint will be using the system [to help] health insurers
determine which treatments are fair, appropriate and efficient and, in turn,
what it will cover", the possibility for abuse their is significant.

Anyway, congrats to anyone at IBM who worked on this, when you make the future
so great it feels natural, you're doing it right.

~~~
Evbn
But is the potential worse than existing systems?

~~~
mdda
Suppose a doctor is paid by the visit - his incentive is to keep you alive for
as long as the insurance will allow him to (which could have minus points as
well as plus points). Watson's recommendations could be aligned more directly
to the insurance company's bottom line : Keep you healthy as long as possible,
but kill you quickly when things turn south.

Of course, it may be that Watson's choices are more optimal for the patient,
but there's an ethical debate in there somewhere, I'm sure.

------
busyant
Does anyone know what the specific metric is that they are using to compare
Wat son to doctors? What does it mean that doctors make the correct treatment
decision 50% of the time? I don't doubt that Watson is better at this task,
but it's difficult to have an appreciation of its ability without
understanding the test.

------
lignuist
I can imagine, how this will look like, so I illustrated it for your
convenience. :)

[http://img542.imageshack.us/img542/3633/watsondiagnosissm.pn...](http://img542.imageshack.us/img542/3633/watsondiagnosissm.png)

------
ScottBurson
_Watson doesn’t tell a doctor what to do, it provides several options with
degrees of confidence for each, along with the supporting evidence it used to
arrive at the optimal treatment._

That is, of course, as it should be (except for the comma splice, heh), but I
think there's a grave danger of doctors becoming complacent about it over time
and just doing what Watson recommends.

I think we need to make sure that "I did what the computer said" is not a
defense against malpractice, and similarly that not doing what the computer
said does not make one's defense more difficult. That will be a hard position
to maintain, but the alternative is that eventually, doctors will cede their
critical faculties to the machine.

~~~
ams6110
When Watson tells the hypertensive diabetic to stop smoking and lose 100
pounds of weight, is the patient going to be any more likely to do it than
when his human doctor tells him the same thing?

------
abcd_f
On one hand it's impressive and huge and through that is somewhat intimidating
and scary, because it makes one feel like losing control (to the "machines").

On the other hand it's a straight-forward extension of a basic calculator.
There are tasks that humans _can_ do, but not as fast, so why not automate
them? It doesn't mean that no one can subtract and divide by hand, it just
makes one's work more efficient. Similarly, Watson doesn't mean that next
generation doctors will be lazy incompetent asses at mercy of a powerful
computer system. It means that they will have yet another instrument to help
them do their job better.

~~~
gridaphobe
I don't think the concern is that the next generation of doctors will be
incompetent, but perhaps they won't be as quick as their elders. There are
times where you can't wait 30 seconds for Watson to suggest a course of
action.

~~~
mchusma
Im sure there are many concerns, but I don't think the time is fast enough to
be a non issue. How many decisions cant wait 30 seconds? Besides, moores law
indicates that this can probably be reduced to 5 seconds in 10 years (being
very conservative and assuming the scope of Watson increases dramatically).
Actually, by caching common results my guess is most things could be nearly
instant within a year.

------
Aron
I can imagine the use of this for political campaigns, wherein the strategy is
determined by the combinations of sub-electorate most likely achievable via
which policy positions, stumping, ad-spend, etc.

I'd like to see the sports version as well for team-building, drafting, etc.
I've long thought it would be entertaining as well to have a sports announcer
that was an AI.

Not as high-profile or morally impressive, but I'm concerned that healthcare
outcomes are difficult to measure and frequently marginal.

------
Gatsky
It's funny that so many resources have been put into training Watson... far
more than would ever go into training a medical student...

It has access to medical evidence that is stuck behind pay walls otherwise...
it has access to case histories that another clinician learning oncology could
never access...

Because of this, in some ways it's irrelevant to compare Watson to the old way
of doing things... Of course it's better!

It's a great development in technology... maybe in the end this is the only
solution to the general disillusionment with doctors... it's too difficult and
inefficient and failure prone to train warm bodies with their own
personalities to do medicine. Watson and its ilk are an alternative with a
better return on investment, and improving them is therefore easier to
incentivize.

A (closed source) triumph for technology... but a failure for education and
academia...

------
treerex
This initial rollout is not intended to be used by doctors to determine (or
even suggest) treatments for patients. IBM is usually very careful to point
this out: they are not looking to replace doctors, at least not yet.

(Source: work for a company that has worked with IBM on this)

------
entropy_
I think this goes to show, that even what we may now look upon as dinosaurs no
longer capable of innovation can do great things if they put in the R&D and
don't scuttle their own efforts with shitty corporate politics.

I really, really, respect IBM for being able to do this despite its size and
age as a company. They somehow have figured out how to keep(or start again)
innovating when most companies that grow to that size tend to become
complacent or just play catch-up with more innovative companies.

------
Calcite
This is the single most impressive use of artificial intelligence today. Let's
hope we can improve successfully improve the lives of everyone with this
technology.

------
lucidrains
i am in awe with the demonstration.
<http://www.youtube.com/watch?v=HZsPc0h_mtM>. i think anyone who has done any
sort of clinical reasoning in the hospital would be at least a little
impressed. the scary part is that such technologies can only improve, while
even the most seasoned physician eventually have to face mental decline.

~~~
Aron
Yeah interesting. It doesn't appear to characterize her bleak prognosis
(regardless of treatment).

------
gwern
> WellPoint’s chief medical officer Samuel Nussbaum said at the press event
> today that health care pros make accurate treatment decisions in lung cancer
> cases only 50% of the time (a shocker to me). Watson, since being trained in
> this medical specialty, can make accurate decisions 90% of the time.

That sounds very impressive if the number isn't being cooked in some way.

------
31reasons
education, marketing, sales, social networks, planning, ads, defense, science,
engineering, politics, games, news....

"Watson eating the world"

------
speeder
Why I have the eerie feeling that this sort of thing might be very dangerous?

I mean, what happen if too much people start to rely only on this, and then it
is used to mislead (WWII battle of beams style) or what happen if people start
to become dependant on it, and you have a power failure?

For example a massive solar storm might happen in our lifetime, the last time
it happened (about 150 years ago) it made telegraph lines catch on fire, and
people could read newspaper at night using the aurora in the middle of the
caribbean. If that happen again, it is very likely that we will have some time
of global power and communication loss. Of course, that will mean some chaos.
How hospitals that rely too much on technology will treat take care of the
emergency?

~~~
tluyben2
Blindly trusting your doctor is dangerous, yet most people do.

~~~
cfn
I suppose very few doctors have way less than 90% accuracy and, on top of
that, Watson is not sensitive to external factors. This is a fantastic tool
and may end up changing the way we interface with the health care system.

~~~
carbocation
> I suppose very few doctors have way less than 90% accuracy

It's a reasonable thought. When this has been studied at autopsy, however,
doctors seem to be right 70-85% of the time (higher when very confident of the
diagnosis) [1]. There are a bunch of studies that show this, and you can find
many in the linked meta-analysis.

Of course, this focuses on things that can lead to death. If your doctor
misdiagnosis RSV as metapneumovirus, you'll survive either way in all
likelihood, so for some diseases we'll probably never know the true diagnostic
accuracy.

[1] =
[http://www.pathkids.com/autopsy/hasleton%20on%20discrepancie...](http://www.pathkids.com/autopsy/hasleton%20on%20discrepancies.pdf)

~~~
lucidrains
another secret in medicine is that a lot of what patients come in for end up
to be self-limiting anyhow; the patients just gets better on their own. in
these cases, there may be misdiagnosis in there somewhere, but nobody would
really care.

------
pzxc
Please state the nature of the medical emergency.

