Editing 1619: Watson Medical Algorithm
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==Explanation== | ==Explanation== | ||
− | + | {{incomplete|More wiki links for the different procedures in the table. Also more on why the procedures makes no sense, even though they may be relevant in a different context. As it is now the table almost always makes it sound like the procedure could make sense., when it could not in said context.}} | |
− | In this comic, | + | IBM's {{w|Watson (computer)|Watson}} is a natural language system designed to answer questions posed by humans. Recently, IBM has extended Watson to act as a {{w|clinical decision support system}}, using image analytics to aid physicians in medical decision making. In this comic, Randall shows a {{w|flowchart}} representing a possible algorithm for Watson, including bizarre techniques including surgical alteration of a patient to match a height and weight chart and squeezing the patient to remove yellow fluids. Like [[416: Zealous Autoconfig]], this comic pokes fun at a rigid, poorly-designed setup that ends up potentially doing more harm than good. |
− | Modern | + | Modern medicine involves both standard processes and clinical judgement based around years of advanced training. An algorithm like this would have to be incredibly complicated in order to simulate the clinical judgement of a good doctor. |
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− | + | The algorithm depicted treats a patient as more of a machine or mechanical system than a living being, especially through decisions such as: | |
− | + | *Injecting oxygen into patients with low oxygen saturation, rather than treating the root cause. | |
+ | *Removing and inspecting a skeleton, then diagnosing the patient's condition with a bone count. | ||
+ | *Dissecting a doctor "for parts" after consulting him or her for advice. | ||
+ | *Removing extra limbs from a patient if the count is 100 or more (This might be a reference to different number systems used in computers, as 100 is read in binary as four.) | ||
+ | *Determining whether the "build environment" of the patient is sane. This is most probably a reference to the configure script used in the {{w|GNU_build_system|GNU build system}}, which emits "checking whether build environment is sane" as one of its status messages. | ||
+ | *Rinsing the whole patient with a saline solution. | ||
+ | *Removing organs from a patient regardless of response to an organ donation request. | ||
− | + | Other decisions appear to be entirely unrelated to the conditions upon which they are predicated: | |
− | + | *If the patient doesn't rate their pain on a scale from 0-10, sequence their genome, apply a {{w|tourniquet}}, and perform an {{w|autopsy}} | |
+ | *If the patient's phone's battery is low, defibrillate until the battery is charged, sync photos, then administer general anesthesia | ||
+ | *If the patient is successfully comforted after an oxygen injection, check their medical history and apply skin grafts | ||
+ | *If green fluid is released from the patient, begin to cauterize | ||
+ | *If the patient has less than 100 limbs, check their Vitamin D level | ||
− | The title text implies that, if the patient is so lucky to ever reach one of the two places with the option "discharge patient" | + | The title text implies that, if the patient is so lucky to ever reach one of the two places with the option "discharge patient," a minor glitch will cause to program to go back to the ''hunt down and capture patient'' option which thus force the patient and the program to repeat the process again in an infinite cycle, that will only end once the patient give another rating of their pain level than on the 0-10 scale. Then the program will start to sequence their genome then apply a tourniquet and finally perform an autopsy, on what will in the end for certain be a deceased patient, but maybe not when the autopsy began. This will finally cause the patient to leave the cycle as a corpse. |
− | + | ===Explaination of steps=== | |
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{| class="wikitable" | {| class="wikitable" | ||
| | <b >Step</b> | | | <b >Step</b> | ||
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Record patient’s name | Record patient’s name | ||
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− | + | OK | |
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Measure Patient’s height and Weight | Measure Patient’s height and Weight | ||
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No: Check blood O<sub>2</sub> saturation | No: Check blood O<sub>2</sub> saturation | ||
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| width="33%" rowspan=2 ` | | | width="33%" rowspan=2 ` | | ||
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Dissect doctor for parts | Dissect doctor for parts | ||
− | | | <b >This may be considered ethically dubious. | + | | | <b >This may be considered ethically dubious.<span > </span></b>Possible reference to the Doctor Who episode “{{w|The Girl in the Fireplace}}” |
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− | Discharge patient | + | Discharge patient |
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− | Discharge patient | + | Discharge patient |
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Acceptable, but patient would generally be dead by then. | Acceptable, but patient would generally be dead by then. | ||
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What color? | What color? | ||
| width="33%" rowspan=4 | | | width="33%" rowspan=4 | | ||
− | Never underestimate the number of different types of fluid the body can produce | + | Never underestimate the number of different types of fluid the body can produce. |
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Yellow: Squeeze Patient | Yellow: Squeeze Patient | ||
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Activate sprinklers | Activate sprinklers | ||
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− | Not medically valid. Presumably a reference to how much cleaning up will be required by this stage | + | Not medically valid. Presumably a reference to how much cleaning up will be required by this stage. |
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Subdue patient | Subdue patient | ||
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Subdue patient | Subdue patient | ||
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− | Potentially very important if patient is behaving dangerously to themselves and others around them (due to mental health issues e.g. psychosis or drugs) and/or is moving too much to be given treatment | + | Potentially very important if patient is behaving dangerously to themselves and others around them (due to mental health issues e.g. psychosis or drugs) and/or is moving too much to be given treatment. |
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Apply cream | Apply cream | ||
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Laser eye removal | Laser eye removal | ||
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− | This is not a standard medical procedure | + | This is not a standard medical procedure. This could be a pun on laser eye surgery where a laser is used to correct visual problems (e.g. short-sightedness), or laser hair and tattoo removal. |
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Admit for observation | Admit for observation | ||
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| | The patient has died, and Watson is being ordered to determine the cause of death. Note that the only way to reach this state is from "apply tourniquet", implying the cause of death is strangulation via tourniquet. | | | The patient has died, and Watson is being ordered to determine the cause of death. Note that the only way to reach this state is from "apply tourniquet", implying the cause of death is strangulation via tourniquet. | ||
| | END STATE (taking the title text into account, the only possible one) | | | END STATE (taking the title text into account, the only possible one) | ||
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*The robot doctor | *The robot doctor | ||
*The patient undergoing this procedure (before or after reaching this part of the process) | *The patient undergoing this procedure (before or after reaching this part of the process) | ||
− | * | + | *The person who programmed the robot to perform this flowchart |
− | * | + | *The person who allowed this state of affairs to occur (I'm looking at you [[Black Hat]]) |
This could also be a reference to the title text for [[371: Compiler Complaint]]. | This could also be a reference to the title text for [[371: Compiler Complaint]]. | ||
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Defibrillate | Defibrillate | ||
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− | Indicated in cases where there is ventricular fibrillation, and to a lesser extent in | + | Indicated in cases where there is ventricular fibrillation, and to a lesser extent in atrial fibrillation (chemical cardioversion with adenosine is usually preferred) |
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Is patient phone battery low? | Is patient phone battery low? | ||
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Administer general anesthesia | Administer general anesthesia | ||
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− | Valid, but not at this stage. Only used when the procedure will invoke unnecessary distress or pain to the patient if they were to be awake beforehand | + | Valid, but not at this stage. Only used when the procedure will invoke unnecessary distress or pain to the patient if they were to be awake beforehand. |
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− | Discharge patient | + | Discharge patient |
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| width="33%" rowspan=2 | | | width="33%" rowspan=2 | | ||
Blood loss? | Blood loss? | ||
| width="33%" rowspan=2 | | | width="33%" rowspan=2 | | ||
− | Useful. Patient may die if this clinical sign is missed | + | Useful. Patient may die if this clinical sign is missed. |
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Minor: Patient address changed? | Minor: Patient address changed? | ||
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Patient address changed? | Patient address changed? | ||
| width="33%" rowspan=2 | | | width="33%" rowspan=2 | | ||
− | Useful to ensure that the | + | Useful to ensure that the organisation has current contact details for the patient in the event that they may need to contact the patient (e.g. to arrange further appointments) |
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Yes: Request organ donation | Yes: Request organ donation | ||
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Request organ donation | Request organ donation | ||
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− | Generally done prior to registering an individual for a driving | + | Generally done prior to registering an individual for a driving licence or to a medical practice, or to the relatives of the deceased if consent had not been acquired beforehand. |
|Remove organs | |Remove organs | ||
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Remove organs | Remove organs | ||
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− | The only organs which can be safely removed from a living person without resulting in serious, chronic medical issues are the kidneys/lungs (only one can be removed), spleen | + | The only organs which can be safely removed from a living person without resulting in serious, chronic medical issues are the kidneys/lungs (only one can be removed), spleen, part of the liver (as long as one lobe is left it can regrow to its original size) and colon (usually consisting of the appendix only). With some serious lifestyle modifications, the pancreas, pituitary gland, frontal lobe of brain, half of the brain, adrenal glands, bladder and most of the gut can be removed. The heart can be removed from the body and replaced with an artificial pump for a few months at the most. However, such organ removals are only indicated if there is a genuine clinical need to do so due to the non-negligible risk of death associated with these operations. |
− | | Discharge patient | + | | Discharge patient |
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− | + | Discharge patient | |
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− | + | Appropriate, if the patient is no longer suffering from any conditions requiring in-hospital care | |
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+ | END STATE (before you read the title text) | ||
|} | |} | ||
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Is patient coughing up blood? | Is patient coughing up blood? | ||
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− | | rowspan=2 | | + | | width="33%" rowspan=2 | |
Is patient coughing up blood? | Is patient coughing up blood? | ||
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No: Is patient still here? | No: Is patient still here? | ||
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− | | rowspan=2 | | + | | width="33%" rowspan=2 | |
Is patient still here? | Is patient still here? | ||
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Is patient screaming? | Is patient screaming? | ||
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− | | rowspan=2 | | + | | width="33%" rowspan=2 | |
Is patient screaming? | Is patient screaming? | ||
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No: Check blood O<sub>2</sub> saturation | No: Check blood O<sub>2</sub> saturation | ||
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− | | rowspan=2 ` | | + | | width="33%" rowspan=2 ` | |
Check blood O<sub>2</sub> saturation | Check blood O<sub>2</sub> saturation | ||
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<50%: Inject oxygen | <50%: Inject oxygen | ||
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− | | rowspan=2 | | + | | width="33%" rowspan=2 | |
Remove and inspect skeleton | Remove and inspect skeleton | ||
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END STATE (before you read the title text) | END STATE (before you read the title text) | ||
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Is fluid coming out of patient | Is fluid coming out of patient | ||
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Is fluid coming out of patient | Is fluid coming out of patient | ||
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What color? | What color? | ||
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Ask patient to rate pain level | Ask patient to rate pain level | ||
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− | | | + | | width="33%" rowspan=4 | |
Ask patient to rate pain level | Ask patient to rate pain level | ||
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Perform autopsy | Perform autopsy | ||
| | [End state, and if taking the title text into account, the only possible one] | | | [End state, and if taking the title text into account, the only possible one] | ||
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Comfort patient | Comfort patient | ||
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Comfort patient | Comfort patient | ||
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Count number of limbs | Count number of limbs | ||
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− | | | + | | width="33%" rowspan=2 | |
Count number of limbs | Count number of limbs | ||
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Subdue patient | Subdue patient | ||
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Measure vitamin D | Measure vitamin D | ||
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Is patient phone battery low? | Is patient phone battery low? | ||
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− | | | + | | width="33%" rowspan=2 | |
Is patient phone battery low? | Is patient phone battery low? | ||
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Discharge patient | Discharge patient | ||
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Blood loss? | Blood loss? | ||
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Substantial: Apply cream | Substantial: Apply cream | ||
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− | | rowspan=2 | | + | | width="33%" rowspan=2 | |
Patient address changed? | Patient address changed? | ||
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==Trivia== | ==Trivia== | ||
+ | *This is one of many comics with [[:Category:Flowcharts|flowcharts]], amongst other a recent comic with that very name: [[1488: Flowcharts]]. | ||
+ | *This is the second comic in a row about health issues with the last comic being [[1618: Cold Medicine]]. | ||
+ | *The computer's behavior in this comic can be compared to the health-care robot named Baymax in the movie {{w|Big Hero 6 (film)}}. | ||
*The [http://www.explainxkcd.com/wiki/images/archive/1/15/20151222113107!watson_medical_algorithm.png original comic] was updated after it was first posted. | *The [http://www.explainxkcd.com/wiki/images/archive/1/15/20151222113107!watson_medical_algorithm.png original comic] was updated after it was first posted. | ||
**The decisions for number of limbs were swapped so it made sense. | **The decisions for number of limbs were swapped so it made sense. | ||
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[[Category:Artificial Intelligence]] | [[Category:Artificial Intelligence]] | ||
[[Category:Computers]] | [[Category:Computers]] | ||
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