Hacker News Reader

Comment by vmarsy | Hacker News Reader

For those curious about what kind of queries the researchers were interested in : "it typically produces a series of subtle symptoms, like itchy skin, weight loss, light-colored stools, patterns of back pain and a slight yellowing of the eyes and skin that often don’t prompt a patient to seek medical attention." [1]

The article name is: J. Paparrizos, R.W. White, E. Horvitz. Screening for Pancreatic Adenocarcinoma using Signals from Web Search Logs: Feasibility Study and Results, Journal of Oncology Practice, June 2016.[2]

[1]https://blogs.microsoft.com/next/2016/06/07/how-web-search-d...

[2] http://jop.ascopubs.org/content/early/2016/06/02/JOP.2015.01...

View on HN

First, this is a very scary first step in the assault on privacy. It is an opening for people to argue that a person who fits a certain search profile should be de-anonymized. After all, wouldn't you want to know if you had cancer? In addition, as it is not about law enforcement but public health, there are a lot fewer limitations on what information the government can access.

Second, after seeing the type of queries, I do not think that this is all that helpful. If a person has unexplained weight loss or yellow skin or eyes, they should always go see their doctor right away. My guess is that most of the specificity of this study comes from those two terms (weight loss combined with yellow skin). Just getting out that message will do a lot more to save people's lives than violating their privacy in this manner.

I don't think they necessarily have to deanonymize the data, it could be something like an alert that pops up when the search engine detects you may have a medical condition.

> Just getting out that message

How do you suggest getting out the message? Blanket public health advertising would be very expensive and would be ignored by most people.

I think search histories are potentially very useful but privacy is important too. It would be interesting to see if there's a way of using search history information in a way that preserves privacy.

> they should always go see their doctor

GPs often do not catch rare conditions or determine the underlying cause of milder symptoms.

The fact that these cancers go undetected until it's too late at present is evidence enough that GPs are not adequate for this purpose.

The rule GP's are taught to follow is "when you hear the horses running, don't think of zebras". Symptoms are frequently either non-present or unspecific for such a long time that GP's stick to what fits and is most propable and only look further if current approach isn't working.

This is Occam's razor. The horses saw is new to me.

The squeaky wheel gets oil. I would say that people who are less acquiescent will get more tests, sooner, especially in a scenario where demand outstrips supply. Women tend to be better in that way in my experience, men are more easily fobbed off.

This is unfortunately a systematic problem with medicine that probably arises from the fact that the signal to noise ratio is so low. If you see 100 patients/year who have indigestion but think they have stomach cancer, then the 1 patient that really has cancer is impossible to detect (without also spending unreasonable resources on the other 99).

I had a collapsed lung and went away from my GP with an inhaler for asthma (I've never had asthma). Luckily I went in after a few days and got x-rays and then got treated immediately, and I'm fine (I hope:-) 20 years later. Still though, it reduced my trust in doctors dramatically.

You're a cyclist, so you probably have very good lungs. I was in a similar situation (saxophone player, avid cyclist) so too ended up with a misdiagnosed collapsed lung. If you're not showing the regular symptoms (such as very low oxygen levels in your blood) then they are bound to assume something else is the cause. Sharp pain in your chest is a good reason to suspect a collapsed lung or a partial detachment of the lung from the chest wall if you're otherwise in very good condition and should be taken very seriously.

My 4 year old was treated for asthma by his ped then admitted to hospital for pneumonia a few days later. Two surgeries and 30 days in hospital later, he is all better. It is frustrating how subjective medicine still is.

We should get the word out that jaundice is a serious medical condition? I'm pretty sure that work has been done. "If your eyes turn yellow, you need to see a doctor" is an easy sell for anyone.

Should be an iPhone app

OTOH, there were, as recently as a few months ago, ads in Toronto's subway system exhorting people to go to the doctor if they found blood in their urine. And this is in Canada, where there's no financial barrier to going to see your doctor for "maybe it's nothing"-style ailments. I fear you might be overestimating the average person.

Not chumming for sympathy here, but I've mentioned before on HN that my own pancreatic cancer first manifested itself as a vague feeling of unease at the sternum, and persistent nighttime acid reflux. No other symptoms. My GP didn't recognize it for what it was, and treated the reflux symptom.

It would sure be spiffy if mining queries could identify early symptoms, working backwards if you will, rather than be used to find cancer patients by working forward from symptoms already identified by the medical establishment.

I have exactly the same symptoms and a history of pancreatic cancer in my family. Not sure how to try to escalate this further or if that seems ridiculous. What did you do to get further exams?

I became severely anemic after a few months and the e/r did an MRI, looking for internal bleeding. They found the tumor then.

My GP had x-rayed me, looking for a cardiac anomaly - he suspected an aortic aneurism. What he should've done is order some soft tissue radiology instead. Having your GP consider a CT or MRI is my advice.

Hope in your case it's all for naught. Best to check though.

I don't think I have anemia so maybe it is just GERD, but I will mention what you said on my next visit.

I really hope you are better.

Agreed. Perhaps this could be addressed by a personal medical 'agent' that could access condition profiles & statistics on your behalf, rather than having your data mined en masse by a search engine, ISP, etc.

Thank you! Your comment is 10x more informative than that NYTimes article. NYTimes used to be much better but now it's just no different than other small newspapers.

It's a fantastic concept, I search for medical symptoms all the time.

But it's funny, I was thinking the same thing the whole time I was reading the article... what are the search queries?!?

The insight gleaned into user health from this is phenomenal, the question is how does a search engine provide helpful feedback in a non alarming (with all the interpretations of that) manner in order to help the user seek professional help in a purely disinterested way (healthful with well being in mind rather than commercial interest, even if incidental).

> "it typically produces a series of subtle symptoms, like itchy skin, weight loss, light-colored stools, patterns of back pain and a slight yellowing of the eyes and skin that often don’t prompt a patient to seek medical attention."

But these symptoms map closely to other serious diseases as well, notably liver disease or liver failure. (I've had them; I know.)

While it might make sense to flag such symptoms as serious and requiring professional advice, in this case I don't see how you could possibly distinguish between the two given the vagueness of the input data.

That raises a real question about how you inform the user/potential patient without freaking the person out, or driving him or her down the wrong path.

Some other commenters have mentioned that they have been mis-diagnosed by a GP, and that perhaps this system would help. I think mis-diagnosis is a different problem. This system's real potential value is in driving more people to get professional help, who likely is a GP.

Tragic exceptions aside, most GP's are very good at what they do, which most days involves keeping "regular" people healthy. Perhaps the biggest problem in health care (at least in the US) is the lack of enough GPs in many communities and the inability of people to get access to them conveniently and affordably.

I don't understand why this function is needed if the search engine performs its purpose. Shouldn't searching on any of those symptoms return results that suggest the possibility of pancreatic cancer? As designed, it returns those results to the very person with the most vested interest in both the results and their own privacy.

How is this project anything more than "other people snooping around in my search queries," or any better than simply tuning the search engine to highlight those results more if they are believed under-represented?

It could find correlations based on search that were previously unknown. Imagine a world where the link between tobacco and cancer isn't known: perhaps it emerges that there's a correlation of people 10 years before searching for cancer also searching of where to buy cigarettes.

I think it's interesting that this research can happen.

Well, I admit that does sound like a promising concept, but it's not quite the same one described in the article. By my reading, this project seems oriented more towards correlating some number of searches and connecting the dots in a present-tense, Clippy "Your search patterns indicate you might have pancreatic cancer. Can I show you patient reviews of several good Oncologists in your area?" - sort of way.

That seems rather different than "Hey, 10 years ago you searched on some stuff that indicated you might have had pancreatic cancer. Sorry we didn't catch it sooner, since the 10 year survival rate is below 5%..."

To be clear, either one seems potentially quite cool and interesting. But if someone else besides me and Clippy are privy to these results - unless I explicitly shared them - then it seems a little creepy.

In retrospect, I suppose I wouldn't be too terribly offended if I died already, but my results were later able to help prevent someone else's untimely demise...

Looking up any symptoms at all on the web is pretty much the worst possible thing a health anxiety sufferer can do.

As it is, nearly any symptom you put in will bring up the possibility of cancer, so it’s all just noise.

Being able to connect disparate symptoms that the patients don’t connect themselves is a good thing.

Snooping on searches isn’t necessarily the greatest way of achieving that given all the privacy implications, but it may be reasonably effective.

Reply on news.ycombinator.com