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Can Crowdsourcing Beat Dr. House?
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Laurianne
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Laurianne,
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4/18/2014 | 12:30:01 PM
Weigh in, doctors
I am curious to hear what doctors think of this idea. The dark side would be if a patient invested a lot of time in a crazy theory. Weigh in please, health pros. 
Alison_Diana
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Alison_Diana,
User Rank: Author
4/18/2014 | 4:50:27 PM
Wisdom of the Crowd
Having been in a similar position at one point, passed from doctor to doctor and receiving no real assistance (although most were very nice), I understand the allure of asking "the crowd" for suggestions. These could include the type of condition, which type of doctor to see, and what to do next, all good information when you're running into medical dead-ends. I think it was smart to allow the general public to participate as detectives if they know enough about a certain condition. It would be interesting to see the software in action, to see how the crowd performed in test cases where the diagnosis was known to testers but not the system or its detectives. 
Susan Fourtané
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Susan Fourtané,
User Rank: Ninja
4/19/2014 | 11:38:12 AM
Re: Wisdom of the Crowd
Alison, 

Very interesting. 

 "At the end of her struggle she ended up knowing more about her disease than most doctors because she ended up living it."

Exactly. This is precisely what many doctors fail to understand. 

It's infuriating when they think they can know more about how you feel, or what is normal or not in you than yourself. They love generalizing. Having the possibility of consulting the "crowd" sounds like a great idea that could help lots of people with not so easy diagnoses. At least, it's better than having the opinion of only one person who might be wrong. 

-Susan 
Alison_Diana
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Alison_Diana,
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4/21/2014 | 9:42:06 AM
Re: Wisdom of the Crowd
In my quest for a diagnosos I had the same experience, @Susan. The doctor, who had zero bedside manner, thought both the condition and the side effect were in my head -- until my husband told him about how this medication totally changed me. I took this medicine about 10 years ago; since then, I have read hundreds of posts on sites about the awful experiences people have had while on it. Yet this physician didn't want to hear one word about it. I understand pharmaceutical companies cannot ever replicate the tests that occur when real patients take medication for real conditions. Sites like CrowdMed give patients a useful way to share their insights and, perhaps, prevent people with the same condition from duplicating their mistakes.

The technology behind the system is what drives the crowd-given engine, a technology the founder wouldn't discuss too much because it is patented and viewed as their business differentiator. Like a stock market predictor, CrowdMed's tech uses the wisdom of the crowd to analytically discern which responses are most likely to be accurate, then shares that info with the person posing the question. 
Susan Fourtané
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Susan Fourtané,
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4/23/2014 | 5:27:21 AM
Re: Wisdom of the Crowd
Alison,

" . . . thought both the condition and the side effect were in my head . . ."

In other words, he meant: "I don't know anything about your condition, therefore, it doesn't exist."

" . . . until my husband told him about how this medication totally changed me."

Why is it that some physicians don't believe in what their patient says, but believe in anyone else? I think it's disrespectful. How can you trust someone who doesn't believe in what you say? 

 ". . . CrowdMed's tech uses the wisdom of the crowd to analytically discern which responses are most likely to be accurate . . ." 

I imagine there is a lot of big data behind that. I would like to try CrowdMed. Have you thought about it? 

The more I read about these cases we discuss here the more I want an AI as my MD. I am serious about this. 

-Susan 

 
Ariella
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Ariella,
User Rank: Ninja
4/23/2014 | 9:46:01 AM
Re: Wisdom of the Crowd
" I think it's disrespectful. How can you trust someone who doesn't believe in what you say? "



@Susan I couldn't agree with you more on this. Health care practioners often act incredibly arrogant and ignore what patients say b/c they believe they know better. That's why my first baby ended up born in the hospital elevator even after I had been admitted in the hospital fo nearly 20 hours before. 
Susan Fourtané
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Susan Fourtané,
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4/23/2014 | 10:43:38 AM
Re: Wisdom of the Crowd
Ariella,

"Health care practioners often act incredibly arrogant and ignore what patients say b/c they believe they know better."

Indeed. That after being with you for five minutes, and the fact that you have spent your whole life in your body knowing your own reactions pretty well doesn't mean a thing. 
"That's why my first baby ended up born in the hospital elevator even after I had been admitted in the hospital fo nearly 20 hours before."
 
Did they send you back home? :( Who was in the elevator with you?
 
-Susan
 
 

 
Ariella
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Ariella,
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4/23/2014 | 1:37:32 PM
Re: Wisdom of the Crowd
@Susan they didn't send me home b/c the policy is not to do so if the water already broke, as was my case. But they insisted that my labor was not advanced enough to put me in a birthing room, so I spend most of the night in just a room with no doctor checking on me. The nurses kept insisting my contractions were "mild." When the resident finally made it to my room, I was so far advanced that the baby was born in the elevator, a they tried to move me to the floor of the birthing room.
Susan Fourtané
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Susan Fourtané,
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4/24/2014 | 12:46:11 AM
Re: Wisdom of the Crowd
What an experience, Ariella. :( They all sound very inexperienced, careless, disconsiderate. The worst part is that they didn't listen to you, who was the only one who could really tell when the time was right.

Did you, or your husband make any kind of complain after that? What excuses did they make to justify what happened? :/ 

 

-Susan  
Ariella
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Ariella,
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4/24/2014 | 11:51:26 AM
Re: Wisdom of the Crowd
@Susan the problem was that at Columbia Presbyterian Hospital, they get overwhelmed and deal wuith it by adopting a haughty attitude toward their patients. All the birthing rooms were occupied when I arrived on Friday morning, and as they assumed it would be a long time yet until the birth and that they would probably just induce on Saturday morning (all doctors seem to like to induce early in the morning), they could just leave me off in a room until then. They only had caution enough not to send me home b/c the water broke at the beginning of labor. Once we got into Friday night, we were on the weekend, and ther was only a single resident there who felt stretched and exhausted. She didn't want to bother to check on me, and only came with a great huff of resignation. I didn't sue, but I refused to pay my doctor the full $5K she demanded b/c no one from her practice attended me for the birth.
TerryB
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TerryB,
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4/24/2014 | 1:18:45 PM
Re: Wisdom of the Crowd
Seems to me this kind of tool should be used by the doctors themselves. They are in much better position to understand the varied opinions than us non medical patients. But I suspect many doctors, especially specialists, have a little bit of ego involved. The "no one can teach me anything I don't know" attitude.

I do understand that there are many medical journals published that attempt to do this. But how many doctors really have time to keep up on them? At least versus a tool they can query by symptoms and see what comes back.

Not a whole lot different than the way IT used to be. You had to keep reading manuals and hoping you became aware of publications on various new IT technologies. Now? You can Google just about anything and get an answer, even if some technology you don't have a deep understanding of. Sometimes I wonder how I ever was able to troubleshoot anything back in old days. Of course, there was a lot less technology to have to troubleshoot. ;-)
Ariella
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Ariella,
User Rank: Ninja
4/24/2014 | 2:39:25 PM
Re: Wisdom of the Crowd
@TerryB true, my husband has to come up with solutions to computer problems for his job. He says he often finds answers on Google. It doesn't slow him down at all; on the contrary, he closes the most tickets on that team.
Alison_Diana
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Alison_Diana,
User Rank: Author
4/24/2014 | 5:42:53 PM
Re: Wisdom of the Crowd
To be in this position, you have to consider that most people coming to this site -- those willing to spend about $250 (because I'd imagine those are the ones who get answers much faster than the ones who don't offer a reward; it's human nature!) -- have probably been to several regular doctors, or even specialists in search of someone who can diagnose and treat them. I know, when I was in that position, I'd have loved this site. The thought of having a name for something would have been wonderful, to posit a potential solution to what ailed me would have been absolutely fantastic, especially with the doctor who told me it was imaginary (although i never returned to him anyway). The ability to potentially reach hundreds of people who have either had the same condition or research it must be extremely liberating and hope-inspiring. 

Once you have a potential diagnosis, you can find a doctor. You may not have even been seeing the right kind of doc! And from there, you may discover an entire world of treatments that allow you to live a full and active life. Of course, that may not happen but at least you've got a much better chance of connecting with someone who understands and knows about what ails you via the Internet and a specialized, crowdsourcing site than by physically traveling from practice to practice. 
Alison_Diana
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Alison_Diana,
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4/24/2014 | 5:37:12 PM
Re: Wisdom of the Crowd
Some of the people in this particular crowd are medical researchers, doctors, and other healthcare professionals, @Terry. And the way the software works is to determine the "odds," if you will, that some advice is better-suited than others. The more people who recommend an approach, the likelier it is to have an element of truth to it. Or the better-suited the individuals' providing answers are, the likelier it is that their response is correct vs. someone who has no training or personal experience in that particular condition. There's a lot of science in the wisdom of the crowd software at the back of this solution. Now, whether that's going to be correct all the time, who knows! The exec told me their tests and research were very strong -- but i doubt he'd have said otherwise. I'd be really interested in seeing external, unbiased research on the company's software and crowdsourced approach.

Either way, unless the crowd recommends a wait and see attitude or something like hot tea with lemon, most of those posing questions will go to their doctors. Since the site recommends people offer a reward of about $250, I'd think those posing questions are at their wits' end with the traditional approach and have already seen several doctors in search of a diagnosis. 
Susan Fourtané
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Susan Fourtané,
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5/5/2014 | 2:58:16 PM
Re: Wisdom of the Crowd
Gee, Ariella! What a story. :( Being overwhelmed is no excuse. They are dealing with human lives. It's not a business where you can choose the best time that suits you to receive a baby. It seems they do, though. They like to induce early in the morning so they don't have to be called in the middle of the night, or any other inconvenient hour that some babies dare to choose, you see.

And one resident for the whole hospital?!  

"I didn't sue, but I refused to pay my doctor the full $5K she demanded b/c no one from her practice attended me for the birth." 

You were too good. Someone who abandon her patients doesn't deserve anything. 

-Susan 

 
Ariella
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Ariella,
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5/5/2014 | 3:09:27 PM
Re: Wisdom of the Crowd
@Susan yes, I've grown a bit cynical about the schedules set by doctors. They like to induce or to begin surgery early in the morning. I'm sure there are practical reasons on the hospital's end for this, but it does push a one-size-fits-all mold on patients who are all individuals. 
Susan Fourtané
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Susan Fourtané,
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5/5/2014 | 3:24:40 PM
Re: Wisdom of the Crowd
Ariella, 

Yeah, let's put all the patients in the same box. They are all same. Most likely you have read some of my comments about my uncle. He was a doctor. A kind that doesn't exist any more. He used to say that illness doesn't know about times, or days of the week. For that, a doctor should always be ready to respond to a call of his patients ay day at any time, he used to say.

And that's what he did until he could. He was a pediatrician. His patients loved him so much they kept on going to see him for consultation when they were teenagers. Then, taken their own children. 

-Susan 
Alison_Diana
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Alison_Diana,
User Rank: Author
4/23/2014 | 2:25:48 PM
Re: Wisdom of the Crowd
I think a combination of AI, crowd wisdom, and an individual doctor's experience probably adds up to the best of both worlds. As we've seen with IBM Watson, that system recommends treatment but leaves it up to the physician to actually prescribe the course of action. Yet, for all their education, doctors are human and have their own biases based on what they've seen in their practices and what they practice. Often surgeons, for example, will lean toward surgery as the cure for what ails a patient -- and that's understandable. But it may not necessarily be accurate.
Susan Fourtané
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Susan Fourtané,
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4/24/2014 | 12:51:38 AM
Re: Wisdom of the Crowd
Alison, 

I love IBM Watson. :)

-Susan
Ariella
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Ariella,
User Rank: Ninja
4/19/2014 | 9:04:12 PM
Re: Wisdom of the Crowd
@Alison yes, sometimes doctors have rather limited views. For example, a doctor prescribed a medication for me once that made me feel very sick. I called her to ask about it because I saw the insert warned about just that side-effect. She just brushed it off, saying her patients had never complained. Right, so even if she has had several hundred patients taking that medication, that hardly represents the entire population.  But Dr. House would likely not ever trust the crowd over his own intellect. 
Juan MarioI563
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Juan MarioI563,
User Rank: Apprentice
4/20/2014 | 4:50:56 PM
Re: Wisdom of the Crowd
Really interesting Alison, thanks!

I think that you would be really interested in some of the most cutting-edge research that I have come across explaining crowds, open innovation, and citizen science. 

http://papers.ssrn.com/sol3/cf_dev/AbsByAuth.cfm?per_id=1919614

And you may also enjoy this blog about the same too: 

https://thecrowdsociety.jux.com/


 Powerful stuff, no?

 
Alison_Diana
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Alison_Diana,
User Rank: Author
4/21/2014 | 9:46:17 AM
Re: Wisdom of the Crowd
Thank you, @Juan, for sharing this research on crowd wisdom and citizen science. I look forward to exploring the page (already bookmarked!) later this week when I have a little more time. This is a really exciting area. Not a scholar in this area by any means, the concept of crowd wisdom makes sense: When you think about it, that's how we evolved to where we are today, by each of us telling friends and family and lore getting passed down from generation to generation, from village to village. Using the power of today's tools and technologies, we can really harness fact from fiction, truth from innuendo, to reap invaluable data and knowledge from millions of connected individuals. And this is only the beginning. Very exciting!
Susan Fourtané
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Susan Fourtané,
User Rank: Ninja
4/21/2014 | 4:01:30 AM
Re: Wisdom of the Crowd
Ariella, 

"She just brushed it off, saying her patients had never complained."

Maybe they all died before they could reach her. Seriously, she could kill someone if she thinks the side-effects won't affect anyone, ever. 

Once something similar happened to me. Since then, I always do my own little research on the Internet before even going to the pharmacy. 

Dr.House? I'd love to have a Dr.House around. 

-Susan

 
Ariella
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Ariella,
User Rank: Ninja
4/22/2014 | 9:36:43 PM
Re: Wisdom of the Crowd
"Maybe they all died before they could reach her" LOL @ Susan. Yes, or maybe they just left her practice then. I did.
Susan Fourtané
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Susan Fourtané,
User Rank: Ninja
4/22/2014 | 11:22:08 PM
Re: Wisdom of the Crowd
Ariella, 

"or maybe they just left her practice then. I did."

That's the reason why you are still alive.

Those "doctors" should pass certain controls from time to time to make sure they are not killing people, or making their condition worse. 

-Susan
Joe Stanganelli
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Joe Stanganelli,
User Rank: Ninja
4/25/2014 | 10:49:22 AM
As Dr. House would say...
> Lyme disease is frequently misdiagnosed as...Lupus


It's never Lupus.


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