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Scott Tuffiash's avatar

Thank you for writing this!

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Gagan Kumar's avatar

Hi guys... great book. I am a doctor and statistician. I had few thoughts and wanted to share. In medicine, prediction is one of the goals. Will my treatment work? In past we relied on simplistic linear or logistic regression models with limited features. Our predictions have been very poor. Why? 1. Medicine is complex with multiple 'features' affecting outcomes... many of them are unknown. Simple models do a poor job. Go to MDcalc and have a look. Also look at their sensitivity and specificity. 2. The outcomes in medicine are non linear and physicians researchers have been putting straight lines in all our models. Of course they will be bad.

There is advantage if AI in medicine predictions: it can use multiple features and is non linear.

So why is it still bad: because the data that we train it is bad. Lot of decisions that we make when we treat patients are subjective 'feelings' and are not recorded for models to see. E.g. a person on ventilator can have normal to worse lungs but most models will only use being on ventilator or not for prediction while not taking into account of varying degree of severity of ventilator use. In your book you gave example of sepsis. I do agree that epic got greedy. But that 62% was well above any other models at this time. The reason it cannot be good because we do not know most things about sepsis... even defining it is difficult... read sepsis 3 definition.. and see how badly it recognises sepsis...I am interested in keeping things "real" like you. If you have any questions, I can help with medicine part which is already seeing AI hype. I did comment other things on your book reviews....

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