CrowdMed: We've solved hundreds of the world's most difficult medical cases
crowdmed.com
crowdmed.com
> ... Dr. Auer augmented his initial plans to attend medical school and pursued a doctor of chiropractic degree instead...
This sounds like hiring a psychic to do my taxes. Thanks, guys, but no thanks.
Full disclosure: I'm an MD, and I practice science-based medicine. http://www.sciencebasedmedicine.org/about-science-based-medi...
EDIT: etc, as in et cetera
If you eat a sugar pill with an "imprint of camomile" and it makes you feel different, it's neither the sugar nor the imprint, but your own belief that does that. However the "evidence based medicine" may conclude it was the spirit of camomile or the lovely sperical shape that made all the difference. Evidence must be supplanted by the reliable reproduction of the results with all variable factors accounted for. Otherwise it's just guessing.
science: from all we know, we assume that cutting off his leg is bad, so we don't do it. => data and models
One quack in the crowd doesn't mean that they are all quacks.
PS If you actually believe you practice science-based medicine, you may be part of the problem. Medicine is mostly a guessing game, and will stay that way until we have genome-specific-personalized-medicine with real-time biofeedback mechanisms from sensors in the body.
> Medicine is mostly a guessing game
Can you be more specific with that sweeping generalization?
> and will stay that way until we have genome-specific-personalized-medicine with real-time biofeedback mechanisms from sensors in the body.
And why do you think that? Again, by what study, authority, knowledge or reasoning?
> you may be part of the problem.
Actually no, it's the other way around. You are part of the problem. I'm so tired of people who have zero training or background in medicine or science half-haphazardly proselytizing without any data or evidence to them up.
Please stop pretending like you know the answer to something this important if you aren't in the position to do so.
There's a difference between "we don't know everything" and "we have good reason to believe homeopathy is useful". Sure, maybe eating raw duck poop will cure asthma, but I'm not going to try it just in case it works.
Seeing a comment like this, on HN, in 2015, just boggles my mind.
I'm glad that very good "guesses" from people that have been studying medicine all their life, benefits from centuries of accumulated scientific knowledge on the subject, and used cutting edge diagnosing equipment were able to completely heal my crucial ligament when it broke, or were able to save my mother's life when diagnosed with breast cancer.
For whatever flaws may exist with naturopathy, at least it's a real thing with legitimate practitioners.
edit: Also, your assertion that Dr. Auer advertises himself as a homeopathic practitioner isn't even accurate. His actual bio states, "Dr. Auer is continuously furthering his education and understanding of the body through post-doctorate courses and various seminars ranging from functional medicine, functional endocrinology, natural hormone balancing, holistic nutrition, homeopathy, herbology, chiropractic neurology, and various chiropractic and soft tissue techniques."
In other words, he is saying that he has studied homeopathy to some extent. Which if you haven't done, you're probably not a very good doctor.
Since you don't actually support your argument with any data, citations, or rational points, what would you say all these things are based on?
> For whatever flaws may exist with naturopathy, at least it's a real thing with legitimate practitioners.
Can you please define "it's a real thing" and "legitimate" and "practitioners" in that statement?
>Studied homeopathy to some extent. Which if you haven't done, you're probably not a very good doctor.
Tell me again how you are able to judge what makes a good doctor? By what authority, knowledge or reasoning?
Wouldn't that make SBM not scientific by definition?
The problem is that it's not clear whose gets the decide what the existing scientific beliefs are, how the evidence should be weighted, whether this results in better patient outcomes than treating patients using evidence based medicine, etc.
While CrowdMed can help with rare diseases it's less useful in cases where a disease has never been diagnosed before.
In recent years we've seen a number of diseases/conditions essentially identified by patients discovering others sufferers (often through online campaigns) and the commonalities / genetic testing helping identify the cause. But these have largely relied on serendipity.
It would be great to have an online platform to allow people with unknown conditions to find each other.
(this is especially true with long-tail psychological issues where diagnose is often still very weak)
That and (according to the FAQ) the unusual design decision of making flagging public. I wonder if the "try homeopathic magic pills" suggestions are efficiently eliminated, and whether reciprocal flagging behaviour has ever been an issue.
The more expensive packages only allow higher-rated Medical Detectives to fully participate, which reduces the quantity but increases the quality of participants. FWIW, we've found that beyond 30 or so Medical Detectives, results quality doesn't really improve anyway.
We've gone back and forth a lot on whether to make flagging public. The advantage of public flags is that users flag more carefully, the disadvantage is the potential for reciprocal flagging behavior.
Granted the focus here is a little different. It's specifically tailored for people who have already asked a doctor and are at their wit's end. But I think the same principle applies to more mundane situations. Most of the time when I message my doctor with something I'm worried about, they call me in just to ask me some questions they could have asked me over the phone and then tell me I'm probably okay.
> "CrowdMed patients are advised to never act upon one of our diagnostic or solution suggestions without the care of a medical professional, who is ultimately responsible for determining the patient's correct diagnosis and treatment."
This seems reasonable to me.
1. It fits into the category of diseases which have amorphous and tricky symptomology eg Lyme disease, immunodeficiencies, Coeliac disease, temporal arteritis, rare inherited conditions. These are just cognitively difficult to diagnose. Having people from another perspective take a look (particular with the perspective of, hey, maybe this is something unusual) is helpful. Good primary care physicians usually have a list of 'easy to miss' conditions in their heads.
2. Patient related factors eg they don't communicate well, they can't afford to go to the doctor consistently, they have a huge anxiety overlay, they have many chronic conditions with overlapping symptoms etc. CrowdMed gives them another port of access to healthcare advice.
3. Doctor related factors eg just incompetence, over specialisation, too busy, too old, too young, too tired, too depressed, too male, too burnt out etc... Sometimes you just need to get a different type of person to look at the case.
But, I do have concerns about how it's marketed. To say that you have 'solved' hundreds of the world's 'most difficult' medical cases is not a responsible thing to put on a front page that will be visited by patients.
Firstly, what does 'solved' mean? I think to prove that you solved a case, you would need to have detailed and long term follow up, and I don't see any evidence of that. Do you have any evidence beyond the patient testimonial at a single time point?
Also, how many cases are not solved?
Secondly, 'world's most difficult' is silly marketing speak, like a detergent that gets rid of the 'world's toughest stains'. Presumably you haven't surveyed all the world's medical cases and ranked them by difficulty. It really puts me off signing up as a detective. Patients are vulnerable. They are scared and suffering. This sort of tagline just makes it look like you are trying to fleece them, despite all the goodwill elsewhere on the site.
I'm sure the non-doctors on this aren't exposed to any legal risk, or else the FDA would have closed this site already.
Of course with the expansion of the crowd and patients moderation will become a bigger problem. If it can be moderated at least for an acceptable size, this will be huge.
How can we invest? :)
See "How do you vet your Medical Detectives?" and "Who is your crowd?" at https://www.crowdmed.com/faqs
Our final reports are automatically generated in PDF format once a case closes.
It's funny, just a few weeks ago a patient offered to invest his life savings in our company because he so believes in our mission and the value we provided. Unfortunately we had to turn him down, because our seed round closed a couple years ago :)
Consider taking a guy's life savings because he felt he benefitted from "the value you provided", and "believed in your mission"?
Every doctor on your staff knows most patients have no clue to why they are feeling better, and placebo plays a huge role.
Besides being unethical for a patient to invest all of their savings into your startup; I think it is illegial in most states? Along with being a beneficiary in a trust, or will?
Have a Licensed medical doctor respond to these questions.
You might have a great service, but you're not coming across well on HN.
Bug report: http://crowdmed.theresumator.com/apply account is disabled.
https://www.crowdmed.com/our-stories/sanora
The speech pathologist is the one that is doing the treatment there.
That said I agree that there is a potential problem, and there ought to be a good resource that gives you a good sense of what is a "reasonable" amount of worry. I'm not sure how that could be structured though, especially with the potential legal issues.
We consider it up to our Medical Detectives to determine whether the patient's symptoms are physical or psychological in origin. If the latter, then 'somatization disorder' or 'hypochondriasis' are perfectly acceptable diagnostic suggestions.
That said, a lot of patients are given psychological diagnoses from physicians (i.e., "it's all in your head") only to discover on our site a physical root cause to their symptoms.
I was thinking of starting an educational institution, and a hospital that would teach and have doctors who can troubleshoot. But I don't have the time, connections, or money to do something like that. It seems like you're taking a different approach, a much better approach. I hope this isn't a money grab, and I hope you change the world.
-- no single diagnosis is more than 2% of the total, except for one (Lyme disease at 2.3%) -- 95% of these have come up as final diagnoses only once or twice in the history of the site
So it's fair to say that it's a VERY long-tail list. Also:
-- our current success rate is 70% (i.e., the patient told us that we brought them closer to a correct diagnosis or cure) -- about 50% of our final diagnoses are medically confirmed by the patient's doctor
These statistics are based on our post-case surveys, which not all of our patients answer, but they should be directionally accurate.