Then after a routine “heart health” check all my indicators were super out of whack - the doctors thought I was on my deathbed - but I am perfectly happy pain free, in shape, physically active person…
Then _i myself_ had to dig into all these tests and figure out that they were measuring the wrong thing - since they try to time where your body is “just about to eat after a fast” - normally for most people in the morning before breakfast, but since my first meal of the day is usually around 20:00 - my body had adopted to have higher levels of various things just to stay on top of my lifestyle choices.
Anyway I had to educate some doctors since they haven’t really had a case like mine, so they weren’t thinking critically of how to interpret the results…
I imagine an automated test _could_ take these things into account with large enough dataset, but it would need to do a lot more reasoning than statistical correlation.
I do believe current sota models should be good enough to come to the correct conclusions with the right harness though.
He was a firefighter in NY in his youth and had never stopped exercising even after retirement.
He went to his GP explained his workout routine and was basically told there is no precedent for it as people his age tend to not be running 10km a day. In short he was told if you're not in pain or fatigued keep at it.
I think he's nearly 90 now and has cut back the running to only a day or so a week, but last time we went to visit he was in his garage bench pressing 50kg
Now I either do gym before dinner (heavy exercise) or social dance after.
I’ve been given a lot of advice how I “should” be structuring it - like “don’t eat too much before bed” or “never eat before exercise” … but I haven’t had any issues with what I’m doing so far (~2 years)
They have unmatched breadth of knowledge by default, and can maintain attention across entire medical histories.
or
https://www.reddit.com/r/ChatGPT/comments/1oesnix/chatgpt_di...
or if you prefer from this site,
https://news.ycombinator.com/item?id=43171639
and
https://news.ycombinator.com/item?id=42999632
If you were looking for a published paper or something more official though, I don't have one.
There is a selection bias here. Not saying it wouldn’t work, but right now you hear about exceptional cases, not when the LLM wants to amputate for a wart.
We all work with LLMs, right? It hasn’t been long at all since an LLM gaslit me while attempting to recover an unbootable laptop. I should have been recommended a few simple steps to try; instead, it was unable to ignore the irrelevant details and led me on an hours-long chase. To me that means the LLM will also struggle to ignore irrelevant medical information.
But we would have great data over time, both individually (weird tends to only matter if they are changing) and as a population.
It's just hard convince people with a general feeling something's wrong and a specific picture of something wrong that the two are almost certainly unconnected.
Review the numerous comments that address this as a statistical issue -- which it very much is when talking about the scale that Midjourney is claiming.
This is more true for some cancers then other though. Prostate, breast, and maybe melanoma are the worst in this regard. This is why prostate and breast cancer screening programmes are controversial, although the needle is swinging towards them being more useful as surgeries and treatments get better. Some other cancers like pancreatic cancer will always kill you eventually, so it's always good to catch them. It's a nuanced problem.
This whole issue is called "overdiagnosis", and personally I used to be obsessed with it. Being aware of it mostly caused a lot of hand wringing and grief, it's just easier to believe that every cancer you catch is a good thing. However, one of the broader issues is that we will never know what we don't know if we don't look. So there exists another perspective that all the suffering caused by overdiagnosis will eventually pay off in the long term. This is the "collect all the data for science/AI" perspective, and I've personally tentatively adopted it myself, although perhaps that's just because it's nicer to believe that you do some good even when you do harm. I think it's more likely that [novel cancer therapies](https://www.nature.com/articles/s41586-026-10738-7) will solve the "harm" part of treatment before we solve overdiagnosis.
The reality is that important breakthroughs are often entirely unrelated to the data for you are collecting, and even worse that possibly helpful data is locked away due to regulation and never used. This is kinda why I've come to make some kind of peace with private clinics scamming people with whole body MRIs, as I'm sure they're secretly selling the data which might lead to some good. However, they would probably do even more good if they didn't exist so they didn't jack up the prices for MRI machines by inflating demand. The marketing they do is the most morally reprehensible part of the whole deal, as it's usually just lying and creating health anxiety for profit. The fact that midjourney here is marketing themselves in this direction is giving me some serious Theranos vibes. Quick and cheap MRI equivalents would be really useful in the clinic, and it would have to spend a few decades there to prove it is useful before moving on to the "spa" stage. That they are trying to market a render of an idea directly to the wellness crowd firmly puts this in the "scam" folder for me. The fact that midjourney is mostly irrelevant now also fits well with this, making it likely that this is either a marketing stunt or a desperate pivot to get funded. Hopefully there are not that many suckers who will put their VC money down on this loosing bet.
That's a tautology. We already have quite robust methods for detecting developed anomalies, treating every anomaly below standard human-to-human variation effectively raises the noise floor to already developed anomalies, defeating the purpose of population wide routine scans.
The faster and earlier we start to scan everyone regularly, as long as scanning methods aren't invasive, the more certainty we'll have what to warn people about and what not to tell them. Perhaps with the regular screening (imaging quarterly, if the scan is fast) you could see what is growing and what isn't.
You'd have a system where every resource is allocated for diagnostics, but no medical staff to treat it
Also a significant part of population avoids screening even if they are not required to paid anything from their pocket
MRI operators are specially trained technicians, because these are complicated machines. But like, semi trucks and photocopiers are fantastically complicated machines, and we seem to be able to keep a pipeline of people trained to operate and maintain them.
So I don't think there's an economic blocker for giving everyone a full-body MRI scan every year or two.
[0] https://www.blockimaging.com/bid/92623/mri-machine-cost-and-...
I'm saying there's no question that would be economically viable. The reason we don't and shouldn't do it is that it wouldn't be medically valuable, even compared to other cheap interventions.
TBH, this is already a red flag for me, like so many other "tech bro invents X" stories, though I am also aware of stories were "company realises Y is overpriced in medical purchases, makes Y cheaper, finds all hospitals think it is a scam and refuse to buy unless they raise prices".
What makes MRI machines expensive is that they are big helium-cooled superconducting magnets that have to be continuously kept at a few Kelvin.
But even if you disregard that, there's this:
It starts by stepping into a shallow pool of golden light. You then begin to descend into the water. Your body passes through a ring of underwater sensors, each acting like a dolphin, using its echolocation. The sensors send ultrasonic sound waves through your body from every angle. With enough waves, and enough angles, we form an image of what's happening inside your body.
The goal is for this process to take no more than 60 seconds.
You go into the water, you come out of the water, and you're done.
Note this does not mean I think the hardware proposed here is totally impossible*. Sure you could make an ultrasound scanner. Why not? But then, hyperloop was always physically possible, just never turned out to be a good idea to actually build**.
* That said, I am suspicious about the claim in the video "Each sensor resolves motions smaller than the width of an atom - not micrometers or nanometers but picometers!", which does sound impossible to me given the movement of atoms is the sense field itself, albeit I'm not an expert in this domain and may just be wrong like how there's weird tricks for photolithography smaller than the wavelength of light used.
** Back when hyperloop was taken seriously and I was still looking for genius behind things Musk said, I thought hyperloop was an excuse to develop here on Earth a transport system that for a Mars colony made more sense than cars and roads (and indeed I still think that, just there's no evidence Musk ever did).
I thought we were railing against Big Hospital/Big Insurance here? They'd love a cheap diagnostic.
Mammogram screening based on randomized-trial all-cause mortality, has not shown a measurable reduction in total deaths.
Randomized colonoscopy screening has not shown a statistically significant all-cause mortality reduction.
My grandfather went to the doctor complaining of chest pains, they gave him a colonoscopy, and he died of a heart attack a week later! Clearly colonoscopy doesn't reduce mortality!
There's no reason for almost any medical intervention to have a statistically significant effect on all cause mortality. That doesn't mean it doesn't have any effect on mortality of individuals.
You're right that we could take steps to fix it, but unfortunately, those steps involve mass education that every human body has anomalies, and many of those should just be ignored.
We'd get a wave of anxiety, lawsuits, and unnecessary interventions, until humanity collectively internalized this.
The steps to fixing it is to not take the test that takes you from a prior of 1/100000 to a posterior of 1/1000, because you're going to ignore it anyway. And you can't depend on multiple testing because those test results can be correlated.
ETA: I can be convinced that we can collectively get to a place where broader screening would be indicated. But I think it's going to require both of the tests getting better and being better about what we do with (and feel about) the results.
Would this be solved by routine scans, so you have a baseline you can compare against? Ignore anything slightly odd in the first scan but monitor for changes over time?
* Some kind of scans, like CT scans, use ionizing radiation and should not be done too often. * Looking at only imaging scans it is often impossible to tell apart a cancer and a benign growth. (More invasive tests would still be required, which was what the parent posters were warning about)
It might also reveal that every MRI shows ghost artifacts a half a dozen times that make it longitudinally useless, of course. I'm not foolish enough to think that epidemiologists haven't thought of this.
- At 25 years old or whatever you get a FBS. Pretty much no matter what, this FBS will not be used to do more checks, procedures, and so on.
- ... and now we give you another FBS every so-many years, and only those things that are different from the previous scan are investigated.
There's still an issue with needless procedures, but the amount of 'weirdness that are not going to cause an actual issue had the patient never been aware' is significantly reduced by looking only at changes. i.e. most 'weirdness' shows up early and is fairly stable.
The difficulty is the moral issue. You cannot show that first scan to the patient. Even if every soul agrees beforehand that the rule is that nothing on that first scan, no matter how scary it looks, is further investigated... any medical issues raised by patients are used as a major information input for diagnosing issues. If I show a patient a scan that has this tumor looking thing on the left lung, then no doubt a few months later they'll be back complaining about shortness of breath and a pain on the left side of the torso. The mind is a powerful thing. At that point you can do a scan and see... the same nasty tumor looking thing we saw on that first FSB, and we're right back to the issue of these scans doing more harm than good.
Is it morally acceptable to hide that first scan from the patient?
Modern medicine sort of requires us to suspend the idea that we can know everything happening in our body at any given time. If we could develop a diagnostic technique to instantly determine if shapes in our bodies are malignant or benign something like frequent full body scans could be interesting, but they really just introduce noise right now.
The diff can be meaningless as well. All sorts of benign things develop with age.
The resolution is the problem. You can't do the type of cytology and histology needed to understand all disease with just scans.
It is neither controversial nor complicated to detect some cancers by scent.
Taking the "headspace" of something is also not really complicated.
There are people who can reliably smell/detect Parkinson:
https://www.npr.org/sections/health-shots/2020/03/23/8202745...
To work, it would have to be incredibly accurate (specifically, have an incredibly low false positive rate).
The real crux of it remains though: Let's say it finds something that increases your death risk by x=0.1%. Could you sleep? I'm not sure. Let's say the operation has 2x=0.2% risk. What do you do? What value of x makes this a problem for you?
I'm thinking a possible solution to this signal-to-noise problem is to embrace the longitudinal view: instead of comparing each scan with the normal across the population compare only against past self, unless there's a risk factor that warrants it.
This way we could presumably make use of plentiful scan data and mostly look at the stuff that evolves in suspicious ways, not what looks suspicious.
Anything found can be monitored with focused follow up scans. It doesn't have to be immediately biopsied if it's in a location where that would pose a risk of iatrogenic harm.
More generally, no test is perfectly accurate, and for low base rate conditions the vast majority of positive tests will be false positives.
Like, again, as a data person I adore this idea in principle, but there would be a lot of details that we'd need to figure out to make it a reality.
There's a reason why billionaires like David Rockefeller, Larry Ellison, and Rupert Murdoch are able to live much longer lives than average, and having an oncall health team (that I'm sure does frequent testing and monitoring) is a big contributor to that.
More testing and data collection doesn't mean that every single anomaly would need to be investigated or communicated with the patient, but would provide a better longitudinal view that can help with disease prevention and health optimization.
From what I could found, billionaires die on average at ~83 years old. ( https://strygin.substack.com/p/how-billionaires-die )
It's not far off what a decent health care system is able to provide in most wealthy countries. It's even somewhat lower actually.
It's difficult to assess the risk factors, but in the end, I have the feeling their additional medical staff and their ability to "cut the queue" (S. Jobs-style) just barely offsets the additional common risk factors (stress, long hours, segregated life), specially if we compare to the upper-middle class.
In the end, there is no magic $100M pill giving you 10 more years. And in truth, access to food, drinking water, a non-toxic environment and really basic healthcare & medicine (vaccines, antibiotics) probably already brings you at a fairly high life expectancy.
Every system that exists as a black box is more understandable with more sensing, not less. Our bodies are not special.
It's also ridiculous that the proposition goes like:
1. Doctor knows some tests will flag tumors or variations that look weird and that we shouldn't then go investigate all of them
2. Doctor shuts off their brain and will then investigate all of them by doing invasive procedures
Just knowing how many such variations there are and if they grow or not is useful information. But the doctors pretend like they are super smart before the test and super dumb right after.
Ask yourself, do you think billionnaires have yearly MRIs or that they wait for later because the doctor and themselves will be anxious? It's an argument that treats regular people as stupid.
If you are a billionaire you also have a doctor with the time and expertise to properly evaluate the evidence in a Bayesian framework, and you have time to talk to them and understand and implications. That isn’t scalable.
Also, it’s quite likely that billionaires are having lots of unnecessary procedures and that harm is being caused. The mri scans are not the reason they live longer!
> Every system that exists as a black box is more understandable with more sensing, not less.
With perfect humans in a perfect society, maybe. But such is ignoring the elephants in the room here, from the actual experts on the topic.
Case in point, doing that during COVID I think amplified the wave of antivaxxers and medical denialists. Which itself had in my opinion a way worse effect on global health than almost anything else recently because now you have to convince a number of people to trust the medical system again.
sure, and there will be downsides.
But that data will be valuable nonetheless.