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Comment by haldujai | Hacker News Reader

You’re assuming a diagnostic test can be designed for 100% accuracy and this is not possible as disease states are spectrums not discrete categories.

“Normal ranges” in lab values are just confidence intervals of population means which by definition that some normal people will have abnormal values and some patients with a disease will have normal values.

The same is true for imaging. For example we use size criteria a lot. There is nothing different about 4.1 cm adrenal nodules and 3.9 cm nodules to explain why the former gets surgery and the latter gets called benign other than pre-test probability and acceptable false positive and false negative rates, whether this is measured by a human or AI.

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Eventually, diagnostic systems (whether AI or human+AI) will significantly outperform current human doctors.

If humans have different normal ranges, then the tests will be specific to the individual, based on their health history, DNA, tissue simulation in digital environment, etc. If adrenal nodules of similar diameter behave differently, then the tests will inspect more than just diameter.

The data to make the correct diagnosis is out there, we just don't have the tools or processing power to use it yet.

You’re loosely alluding to personalized medicine but envisioning is a very futuristic state we are very slowly moving towards. What you suggest is great but we are a few decades and several technological breakthroughs as well as new discoveries away from coming to what you are talking.

DNA is increasingly used in oncology, but is difficult to interpret elsewhere and in many tumors is not insightful.

> The data to make the correct diagnosis is out there, we just don't have the tools or processing power to use it yet.

Maybe, but we don’t know what or how to measure it.

> If adrenal nodules of similar diameter behave differently, then the tests will inspect more than just diameter.

Everything investigated so far such as: biopsies with histology, MR spectroscopy and measuring the diffusivity of water molecules has not been reliable in differentiating benign or malignant nodules so we still use size. These are nontrivial problems. There are technical limitations to our measuring tools.

I agree with everything you just said.

I believe these are very difficult but not impossible problems. There are technical limitations to our measuring tools, but I am optimistic that future medical advancements (maybe far in the future) will provide ways of measuring and diagnosing that may seem like science fiction today.

I am not attempting to trivialize the work that medical professionals do, or fault doctors for being fallible. I am attempting to encourage the development of medical technology to cut down on what I perceive to be a high rate of misdiagnosis (10-15%).

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