• 11 APR 12
    • 0
    More is not better

    More is not better

    It’s always difficult to take a decision under conditions of partial and possibly incorrect data. That is a fact of life for doctors and healthcare providers. It’s certainly a fact of life for information systems designers  and developers.

    The approach taken by the information technology industry is to collect as much data as possible, accumulate the data into big data warehouses and use powerful computing resources to automatically analyze and diagnose the data and arrive at a conclusion. This basically means deferring decisions until enough data has been collected.

    Conversely, doctors in life-threatening situations, triage patients, take decisions and defer data collection to later points in time.

    There is the notion in the healthcare industry that more information is better (the approach taken by Google Health (now defunct) and Microsoft HealthVault.

    With HealthVault our philosophy is to help improve people’s lives by enabling them to better manage their health. We know we can accomplish this by getting data into patients’ hands and giving them the tools to manage and make sense of this data. This leads to more efficient management of health, safer families, and healthier people. Read more

    Current EHR (electronic health records) and PHR (personal health records) systems store large volumes of information about diseases and symptoms in unstructured text, codified using standards like SNOMED-CT

    1, ICD-102. Codification is intended to enable machine-readability and analysis of records and serve as a standard for system interoperability.

    However, it is impossible to achieve a meaningful machine diagnosis of medical interview data that was uncertain to begin with and not collected and validated using evidence-based methods.

    A fundamental observation about utility functions is that their shape is typically concave: Increments of magnitude yield successively smaller increments of subjective value. For instance, a 2 scoop serving of ice cream is typically perceived as less than twice as good as 1 scoop serving. This holds true whenever a decision needs to be taken, not just for ice-cream.3

    In prospect theory, 4, concavity is attributed to the notion of diminishing sensitivity, according to which the more units of a stimulus one is exposed to, the less one is sensitive to additional units.

    Under conditions of uncertainty in a medical diagnosis process, as long as it is relevant, less information enables taking a better and faster decision, since less data processing is required by the human brain.

    To paraphrase Microsoft, our philosophy is to help doctors improve people’s lives by getting data from patients’ hands and bridging the gap between the patient’s personal experience and the doctors clinical knowledge and scientific training. This leads to more efficient management of health, and healthier people.

    1http://www.nlm.nih.gov/research/umls/Snomed/snomed_main.html

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