The genesis of an algorithm stems from the desire to break a BIG thing into many little parts. But when we relenquish control to expediency and efficiency we lose the ability to react in real time to what is now relatively automated. Think of Wall Street and the black box that hunts for electronic communications--moving a million shares through the market. Or the last economic crash. Nobody controlled the crash—only the monitor with a red button that said “stop”. We are writing things that we can no longer understand or seperate into components to inform behavior. We lost the sense of what is happening. Unfortunately algorithms are often in conflict with human oversight. Think of the automation strategies of Amazon and Netflix. These algorithms can go out of control and list books like The Making a Fly: The Genetics of Animal Design for $23,698,655.93.
Netflix and Pragmatic Chaos searched for a piece of code 10% more efficient than the current movie recommendation algorithm--and won a cool million in the process. Algorithms are evolving from being a metaphor to actual prophecy. I am thinking that we need to take a few gigantic steps backward. I figure--based on estimates derived on Google and by physician leaders there are literally thousands of guidelines for managing the health of patients. Many of them contradict the status quo and each other, few recommend less care or more deliberate watchful waiting.
The Guidelines International Network database currently contains more than 3,700 clinical practice guidelines from 39 countries. Additionally, there are nearly 2,700 guidelines in the National Guidelines Clearinghouse (NGC), part of the Agency for Healthcare Research and Quality (AHRQ). Because of the large number of clinical practice guidelines available, guideline users, including practitioners, find it challenging to determine which guidelines are of high quality. - See more here: Institute of Medicine
On the other extreme, there is an important area of medicine that is still lacking in treatment-based expert review or consensus guidelines. I will write more in another post but I thought it interesting that an important consideration for patients undergoing chemotherapeutic regimens is rarely discussed in public forums.
Examples of major mechanisms causing cardiotoxicity of anticancer treatments ( black text ), clinically used therapeutic agents ( green text ),and potential protective agents ( blue cursive text ). ROS = reactive oxygen species; ACE = angiotensin-converting enzyme, NSAIDs = nonsteroidal antiinfl ammatory drugs.--http://jnci.oxfordjournals.org/content/102/1/14.full.pdf+html
Published literature lacks information to guide practioners in the rate of cardiovascular adverse events associated with antineoplastic drugs, particularly for emerging targeted therapies.
In the context of potential overdiagnosis and preventing harms--it is important to understand risks as well as benefits of potentially life-saving at best, or life-altering at worse treatments for cancer amenable to chemotherapy. Quite often the algorithm is in the details--and it is best not to overlook them.
Thoughtful discussions about content development and outcomes analytics that apply the principles and frameworks of health policy and economics to persistent and perplexing health and health care problems.
Bonny is a data enthusiast applying curated analysis and visualization to persistent tensions between health policy, economics, and clinical research in oncology.