explain xkcd - User contributions [en]

1572: xkcd Survey

2017-01-25T18:40:48Z

Nayuki: Fixed typo in URL

{{comic
| number = 1572
| date = September 2, 2015
| title = xkcd Survey
| image = xkcd_survey.png
| titletext = The xkcd Survey: Big Data for a Big Planet
}}
*The entire comic is a link to [http://goo.gl/forms/B5RaBeZ6nw The xkcd survey] on Google.
**The survey has long since been closed.

==Explanation==
As the comic image states, it links to a survey created with [https://www.google.com/forms/about/ Google Forms], containing a series of questions. The questions range from mundane typical survey questions such as “Do you have any food allergies?”, to rather strange, such as “Fill this text box with random letters by randomly mashing keys on your keyboard.” (See [[1530: Keyboard Mash]]).

The stated goal of the survey is to “create an interesting and unusual data set for people to play with”. A strange data set is a ripe opportunity for a sampling of readers. It's also supposed to be “a search for weird correlations” – presumably the goal is to be able to say things like “people who have been skydiving are (more/less) likely than average to dislike cilantro”. (See also [[882: Significant]] about finding presumably-spurious correlations between unrelated data.)

This explanation will undoubtedly expand when the data comes in.

{{w|Image_map#Client-side_image_map|HTML image maps}} is a technique for marking up areas of an image on a web page, such that each area can be a link without the whole image being a link. [[Randall]] could have used this type of image map to make only the “Click here to take the survey” button be a link, and none of the rest of the image. But he cannot get the hang of it (or knowing his skills, does not wish to take the time to learn it). Not getting the hang of HTML image maps was also referenced on [http://imgs.xkcd.com/store/tour-news.png the banner for his book tour] from [http://web.archive.org/web/20140901023821/http://xkcd.com/ September 2014]

The title text is a joke off of {{w|Big Data}}, which is a name for analysis of a set of data that includes a huge amount of information. He also says "for a big planet" because the Earth is big.{{Citation needed}}

The survey is closed, and the questions replaced with the text: "The xkcd survey is now closed. Thank you for all your answers! Response data is being collected and will be posted soon." As of January 2017, the same caption is still there, with no indication of exactly how soon the data is intended to be posted. (Apparently, Randall crashed google forms, so the data is taking a long time to be retrieved [https://www.reddit.com/r/xkcd/comments/40mhve/what_ever_happened_to_the_survey_we_took/ (see this reddit thread)] - much like his breaking of [http://what-if.xkcd.com/imgs/a/62/balloon_wolfram.png Wolfram Alpha]] during answering a reader's question on [[what if?]])

==The Survey==
The Survey started off with the following statement:

<nowiki>This is an anonymous survey. After it's done, a database of everyone's responses will be posted.
There's no specific reason for any of the questions. The goal is to create an interesting and unusual data set for people to play with. This is obviously not going to be a real random sample of people, but in the interest of getting cooler data, if you're sharing this with friends, try sending it to some people who wouldn't normally see this kind of thing!

WARNING: This survey is anonymous, but your answers WILL BE MADE PUBLIC. Depending what you write, it's possible that someone may be able to identify you by looking at your responses. None of these questions should ask about anything too private, but don't write anything that you don't want people to see. If you're not comfortable answering a question, just skip it.</nowiki>

'''Note:''' The order of the possible answers (the list of possibilities) was random, and changed every time the page is reloaded. So do not try to fix the order here below...

===Plane===
*Have you ever been in a plane?
**No
**Yes

===Skydiving===
*Have you ever been {{w|Parachuting|skydiving}}?
**No, but I might someday
**Yes
**No

===The Dress===
*When you first saw {{w|The dress (viral phenomenon)|The Dress}}, what color was it? — (Also see [[1492: Dress Color]] and the [[Blag]] ENTRY [http://blog.xkcd.com/2010/05/03/color-survey-results/ Color Survey Results]).
**White and gold
**A color combination not listed here
**I don't remember
**Blue and black
**What dress?

===Popular food===
*What's a really popular food that you don't like?
**''Text box''

===Floaters===
*When you look at a blue sky, do you see those swirly {{w|floater|floaters}} in your vision?
**Yes, constantly
**I'm not sure what things you mean
**Yes, occasionally
**No

===Running out of gas===
*Have you ever had a car run out of gas while you were driving it?
**Yes
**No

===Animals===
*Name the first five animals you can think of
**''Multi line text box''

===Weather===
*What's the weather like where you are right now?
**''Text box''

===Activities===
*Which of these can you do reasonably well?
*(Check all that apply)
**{{w|slam dunk|Dunk}} a basketball — A "slam dunk" or simply "dunk" is the act of jumping up and putting the ball through the net with a lot of force
**Tie a {{w|sheet bend}} or {{w|bowline}} — A sheet bend is a knot that joins two ropes together; A bowline is a knot used to form a fixed loop at the end of a rope. Although tied differently, the resulting knots are identical.{{Citation needed}}
**Roller skate
**[http://www.huffingtonpost.com/news/high-heel-race/ Run in high heels]
**Drive a stick shift — See {{w|Manual transmission}} of a car
**Solve a {{w|Rubik's cube}}
**Dive headfirst off a diving board — See {{w|Springboard}} and {{w|Diving platform}}
**Ice skate
**{{w|Skateboarding|Skateboard}}
**Walk on {{w|stilts}} — Stilts are poles, posts or pillars used to allow a person to walk at a height above the ground
**Ski
**Cut vegetables with a knife
**Swim
**Ride a horse
**{{w|Unicycle}}
**Change the oil on a car
**Do a back {{w|Handspring (gymnastics)|handspring}} — A handspring is an exercise in gymnastics in which you jump through the air landing on your hands, then again landing on your feet
**Juggle — {{w|Toss juggling}} (the most recognizable form of juggling) consists in throwing objects into the air and catching them.

===Spelling===
*What word can you never seem to spell on the first try?
**''Text box''

===Condiments===
*Do you eat {{w|condiments}} directly out of the fridge as a snack?
**No
**Yes

===Thermostat===
*When you adjust a thermostat that was set by someone else, it's usually because you want the room to be...
**Cooler
**Warmer

===Clothing===
*What color is the shirt/dress/upper-body-clothing you're wearing right now, if any?
**''Text box''

===Colds===
*Do you get {{w|Common cold|colds}} often?
**No
**Yes

===Number===
*Pick a number from 1 to 100
**''Text box''

===Spelling===
*On a scale of 1 to 10, how good at spelling are you? (Note that the question does not specify which end of the scale is good or bad.)
**''Tick off list with numbers from 1 to 10.''

===Myers-Briggs===
*Do you know your {{w|Myers–Briggs_Type_Indicator|Myers-Briggs type}}?
**No
**Yes

===Astrology===
*Do you know your {{w|astrological sign}}?
**No
**Yes

===Siblings===
*How many older siblings do you have?
**''Text box''
*How many younger siblings do you have?
**''Text box''
*How many twin/etc siblings do you have?
**''Text box''

===Sleepiness===
*Do you feel sleepy a lot?
**Yes
**No

===Movie star===
*Name a movie star
**''Text box''

===Time in sun===
*Do you spend a lot of time in the sun?
**Yes
**No

===Broccoli===
*Does {{w|broccoli}} taste bitter to you?
**Yes
**No
**I've never had it

===Wakefulness===
*Do you regularly stay awake much later than you meant to?
**Yes
**No

===Keyboard mashing===
*Fill this text box with gibberish by mashing random keyboard keys (See [[1530: Keyboard Mash]]).
**''Broad multi-line text box''

===Driving===
*On a scale of 1 to 5, where 1 is terrible and 3 is average, how good a driver do you think you are?
**''Tick off list with numbers from 1 to 5.''

===Allergies===
*Do you have any food allergies?
**No
**Yes

===Thunder===
*Have you heard thunder or seen lightning in the past year? — (The title-text of [[831: Weather Radar]] mentions the belief that thunderstorms seemed more common when one was a kid. Since the survey also asks for age this question is likely a test of that belief.)
**Yes
**No

===Flavor preference===
*Which do you prefer? (It seems to be missing the ''neither'' option...)
**Chocolate
**Vanilla

===Number (reprise)===
*Pick another number from 1 to 100 (Supposedly should not be the same as in the first pick a number box).
**''Text box''

===Internet===
*When you think about stuff on the internet, where do you picture it being physically located? Even if you know it's not really how things work, is there a place you imagine websites and social media posts sitting before you look at them? If so, where is it?
**''Broad multi-line text box''

===Roll tongue===
*Can you {{w|Tongue rolling|roll your tongue}}?
**Yes
**No
**What?

===Toes===
*Can you pick things up with your toes?
**No
**Yes

===Age===
*How old are you?
**''Text box''

===Walls===
*What color are the walls around you right now?
**''Text box''

===Cell phone===
*What kind of cell phone do you have?
**{{w|iPhone}}
**{{w|Android (operating system)|Android}}
**Other smartphone
**Non-smartphone
**I don't have a cell phone

===Eating===
*What's the last thing you ate?
**''Text box''

===Difficult words===
*Which of these words do you know the meaning of?
*Some of these words don’t appear in any of the following dictionaries: the Oxford English Dictionary, the New Oxford American Dictionary, Wiktionary, or Dictionary.com. With one exception, however, reviewers on this site have found verifiable examples of use for the words in question.
*[http://dictionary.reference.com/ Dictionary.com] has an index of difficulty (measured in pixels, with class name <code>difficulty-indicator</code>). We add it at the right of the words that have it. N/A means that a word isn't present in Dictionary.com, or that it doesn't have an index.
**Slickle – Not in any standard dictionary. However, it [http://www.urbandictionary.com/define.php?term=Slickle is in] the crowd-sourced in Urban Dictionary, as well as a suggested planet name in [[1253: Exoplanet Names]]
**[https://en.wiktionary.org/wiki/rife Rife] – [http://dictionary.reference.com/browse/rife 117]
**[https://en.wiktionary.org/wiki/soliloquy Soliloquy] – [http://dictionary.reference.com/browse/soliloquy 150]
**Fination – not in any dictionary. Appears infrequently in Victorian texts (e.g., [http://books.google.com/books?id=ghNOAAAAYAAJ&pg=PA245&dq=Fination 1889], [http://books.google.com/books?id=nwlCAQAAMAAJ&pg=PA214&dq=Fination 1839])
**[https://en.wiktionary.org/wiki/stipple Stipple] – [http://dictionary.reference.com/browse/stipple 144]
**[https://en.wiktionary.org/wiki/peristeronic Peristeronic] – [http://dictionary.reference.com/browse/peristeronic N/A]. Randall used it and defined it for readers in [[798: Adjectives]].
**[https://en.wiktionary.org/wiki/modicum Modicum] – [http://dictionary.reference.com/browse/modicum 120]
**Trephony – Not available in reference dictionaries. An obsolete spelling of "{{w|Trephine}}" (especially when used as a verb for the process of {{w|Trepanning|trephination}}). Initially a transliteration of Greek [http://www.perseus.tufts.edu/hopper/text?doc=Perseus:text:1999.04.0057:entry=tru/panon τρυπάω] for the same.
**Tribution – A regular construction from [https://en.wiktionary.org/wiki/tribute#Verb Tribute (verb)] using "-tion" to transform into a noun. Using this regular formation, the term would mean the act of tribute, but no examples of actual use are available. It is worth noting that the use of "tribute" as a verb is generally considered obsolete and the few forms that persist in use relate primarily to the tributary and distibutary river systems
**[https://en.wiktionary.org/wiki/phoropter Phoropter] – [http://dictionary.reference.com/browse/phoropter N/A] 1.An instrument used in eye examinations to determine an individual's prescription, the patient looking through various lenses at a chart on the other side.
**Unitory – Not available in reference dictionaries. An obsolete spelling of "Unitary," chiefly British. While long obsolete in normal usage, it persisted longer in mathematics that it did elsewhere (particularly for "Unitory Method" and "Unitory Matrices"). Example of use: [https://books.google.com/books?id=Wl1BAQAAMAAJ&pg=RA5-PA27&lpg=RA5-PA27&dq=unitory+method&source=bl&ots=rfRKJXAJqV&sig=Wsr_gV7xG6Airah9Lx1M0hi-7Zc&hl=en&sa=X&ved=0CDsQ6AEwBmoVChMInd_R9qTbxwIVChU-Ch36IAh_#v=onepage&q=unitory%20method&f=false (1)]
**[https://en.wiktionary.org/wiki/amiable Amiable] – [http://dictionary.reference.com/browse/amiable 123]
**[https://en.wiktionary.org/wiki/salient Salient] – [http://dictionary.reference.com/browse/salient 69]
**[https://en.wiktionary.org/wiki/regolith Regolith] – [http://dictionary.reference.com/browse/regolith 162]
**[https://en.wiktionary.org/wiki/lithe Lithe] – [http://dictionary.reference.com/browse/lithe 105]
**Revergent – technical word from {{w|fern}} biology, referring to the edges of fern leaves which curl back on themselves (see [http://link.springer.com/article/10.1007%2FBF00985044 Schölch, 2000])
**[https://en.wiktionary.org/wiki/hubris Hubris] – [http://dictionary.reference.com/browse/hubris 117]
**[https://en.wiktionary.org/wiki/fleek Fleek] – [http://dictionary.reference.com/browse/fleek N/A]
**Cadine – A rare loan-word for [https://fr.wiktionary.org/wiki/cadine a sultan's wife or a noble ottoman woman] which comes to English through the French. Examples of Use: [https://books.google.com/books?id=4yz-Y-_OOO0C&printsec=frontcover#v=onepage&q=cadine&f=false (1)]. Also the name of an [https://it.wikipedia.org/wiki/Cadine italian city].
**[https://en.wiktionary.org/wiki/apricity Apricity] – Not available in reference dictionaries. An obsolete word for the sun's heat in winter (e.g., [http://books.google.com/books?id=CFBGAAAAYAAJ&pg=PT76&dq=apricity Bailey 1775]). According to the What If? book (page 80), this is Randall's single favourite word in the English language.

===cat===
*Please type "cat" here:
**''Text box''

===Dreams===
*Do you usually remember your dreams?
**No
**Yes

===Text editors===
*Do you have strong opinions about text editors? (See {{w|Editor war}})
**Yes
**No

===Emoji===
*How do you feel about {{w|emoji}}?
**Negative 😠 (Unicode 1f620 - Angry face)
**Positive 😊 (Unicode 263a - Smiling face)
**Neutral 😐 (Unicode 1F610 - Neutral face)

===Snow===
*Does it ever snow where you live?
**No
**Yes

===Taste of food===
*Do you strongly dislike the taste or texture of any of these things?
**Eggs
**Chocolate ice cream
**Beer
**White wine
**{{w|Carbonation}} (or Fizz)
**Red wine
**{{w|Cilantro}}
**Coffee
**Tomatoes
**Yogurt

===Beverages===
*Which of these do you regularly drink?
**Caffeinated soda (e.g. Coca-Cola, Dr. Pepper)
**Noncaffeinated soda
**Coffee
**Fruit juice
**Milk
**Beer
**Wine
**Tea
**{{w|Maple syrup}}
**Water

===Random words===
*Type five random words
**''Broad multi-line text box''

===Flying===
*Are you nervous about flying?
**Yes
**No
**A little

===Favorite number===
*On a scale of 1 to 5, which number is your favorite?
**''Tick off list with numbers from 1 to 5.''

===Sandwich===
*Which of these would you consider a {{w|sandwich}}?
*(Check all that apply)
**{{w|Taco}}
**{{w|Quesadilla}}
**{{w|Submarine sandwich|Sub/Hoagie}}
**{{w|Cheesesteak}}
**{{w|Hamburger}}
**{{w|Open-faced sandwich}}
**{{w|Calzone}}

===Animal affinity===
*Which of these describes you?
*(Check all that apply)
**Dog person
**Cat person
**Half-cat half-person
**Part of a subterranean race of dog people
**Literally named "Catherine Person"

===Sense of direction===
*Would you say you have a good sense of direction?
**Yes
**No

===Socks or underwear===
*Have you ever thrown out all your different pairs of socks/underwear, bought a bunch of replacements that were all one kind, and then told all your friends how great it was and how they should do it too?
**Yes
**No
**I did the throwing out thing, but didn't talk to everyone about it
**No, but I'm totally doing that now

==Transcript==
:[A simple comic with text only. The ''click here'' part is inside a black frame.]
:Introducing
:'''The xkcd Survey'''
:A search for weird correlations
:Note: This survey is anonymous, but
: all responses will be posted publicly 
:so people can play with the data.
:'''Click here to'''
:'''take the survey'''
:Or click here, or here.
:The whole comic is a link,
:because I still haven't gotten
:the hang of HTML imagemaps.

{{comic discussion}}

[[Category:Comics with color]]

1725: Linear Regression

2016-08-26T16:38:42Z

Nayuki: Added Russell's teapot

{{comic
| number = 1725
| date = August 26, 2016
| title = Linear Regression
| image = linear_regression.png
| titletext = The 95% confidence interval suggests Rexthor's dog could also be a cat, or possibly a teapot.
}}

==Explanation==

{{w|Linear regression}} is a method for modeling the relationship between two sets of data, assuming that the two have a linear correlation (as opposed to, say, a quadratic correlation or no correlation whatsoever). The model determines a "{{w|least squares|best-fit}}" line through a {{w|scatter plot}} of the datasets, together with a {{w|coefficient of determination}}, usually denoted ''r''2 or ''R''2. This is a number between 0 and 1, which indicates how close the points are to lying on a line. A value of 1 means perfect correlation, while values close to 0 indicate little or no correlation.

{{w|Constellation}}s are patterns created by linking the apparent positions of stars. One could create fake constellations by connecting assorted points.

In this comic, a set of data has had linear regression and some form of statistical analysis applied to it, indicating that there is insignificant correlation between the two. However, the data points are so widely-scattered that (as noted in the comic) it is easier to connect the data points in a constellation-like pattern than it is to determine whether the correlation is negative or positive (without looking at the trendline, of course). Because of this, [[Randall]] suggests we should be suspicious of any conclusions drawn from this data.

The mention of a teapot may be a reference to [https://en.wikipedia.org/wiki/Russell%27s_teapot Russell's teapot] in space.

==Transcript==
{{incomplete transcript}}
[A two-panel comic with a caption underneath drawn in a combination of black and red. The two panels show an identical square of scattered black dots, with only the red additions being different. A black caption is written below, spanning both panels.

[The left panel shows a slightly rising red line drawn through the middle of the panel, passing near a few dots but not obviously related to most of them]
:R2=0.06

[The right panel shows many of the dots connected by red lines to form a stick figure of a man resembling the constellation Orion, with the hand on the reader's right raised and holding an object.]
:Rexthor, the Dog-Bearer

[The caption below is black and applies to both panels.]
:I don't trust linear regressions when it's harder to guess the direction of the correlation from the scatter plot than to find new constellations on it.

{{comic discussion}}

1619: Watson Medical Algorithm

2015-12-21T18:47:53Z

Nayuki: Added table column data, copyedited a few words

{{comic
| number = 1619
| date = December 21, 2015
| title = Watson Medical Algorithm
| image = watson_medical_algorithm.png
| titletext = Due to a minor glitch, 'discharge patient' does not cause the algorithm to exit, but instead leads back to 'hunt down and capture patient'.
}}

==Explanation==
{{incomplete|much more on the different procedures etc.}}

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|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 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.

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 less than 100
* 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 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," 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!

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 healthcare robot named Baymax in the movie Big Hero 6 (2014).

==Transcript and Discussion of Medical Appropriateness==
{{incomplete transcript}}
{| border=1
| | Step
| | Medically valid?
| | Conditions and following step
|-
| |
Draw Blood
| background-color:green |
Phlebotomy is a normal early step in the diagnostic process, but not as first and unconditional step
| |
Record patient’s name
|-
| |
Record patient’s name
| background-color:green |

OK
| |
Measure Patient’s height and Weight
|-
| |
Measure Patient’s height and Weight
| |
OK
| |
Consult Standard height/weight chart
|-
| |
Consult Standard height/weight chart
| |
OK
| |
Surgically adjust patient to match
|-
| |
Surgically adjust patient to match
| |
May be considered ethically dubious unless there are [http://www.gosh.nhs.uk/medical-information/procedures-and-treatments/limb-length-difference-and-limb-lengthening sound medical reasons] for doing so. Could be an allusion to [https://en.wikipedia.org/wiki/Procrustes Procrustes].
| |
Is patient coughing up blood?
|-
| width="33%" rowspan=2 |
Is patient coughing up blood?
| width="33%" rowspan=2 |
OK, coughing up blood is generally a sign that there is something wrong. Typical causes are respiratory tract infections (e.g. tuberculosis), lung trauma or pulmonary embolism.
| |
Yes: Gather blood and return it to body
|-
| |
No: Is patient still here?
|-
| width="33%" rowspan=2 |
Is patient still here?
| width="33%" rowspan=2 |
Not usually considered a step, but missing patients are a problem in some fields, psychiatry or intensive care for example.
| |
Yes: Record pulse rate
|-
| |
No: Hunt down and capture patient
|-
| |
Hunt down and capture patient
| |
Valid if patient should not have left the bed/unit, but the wording is possibly dubious.
| |
Is patient still here?
|-
| |
Gather blood and return it to body
| |
Dangerous idea in this case due to likelihood of contamination, although if safely done autotransfusion is an accepted medical technique to ensure a matching blood supply prior to a major operation, or to enhance stamina (blood doping)
| |
Record pulse rate
|-
| |
Record pulse rate
| |
OK, but maybe a little late.
| |
Is patient screaming?
|-
| width="33%" rowspan=2 |
Is patient screaming?
| width="33%" rowspan=2 |
Very important question, indicating patient is conscious, in pain, and aware pain is bad. First attenders can use it in classifying priorities (quiet patients may be more severely injured). Generally useful in assessing nerve damage, pain relief, etc.
| |
Yes: Ignore
|-
| |
No: Check blood O2 saturation
|-
|-
| width="33%" rowspan=2 ` |
Check blood O2 saturation
| width="33%" rowspan=2 |
Only really indicated if the patient is in danger of hypoxia. Generally normal people should have a SpO2 of 98-100%, but in chronic lung disease this can fall as low to 80%, and in premature babies a SpO2 of 90% is usually targeted to avoid problems with retinopathy. If the SpO2 were to fall as low as 50%, the patient would definitely be dead or unconscious.
| |
>50%: Remove and inspect skeleton
|-
| |
<50%: Inject oxygen
|-
| width="33%" rowspan=2 |
Remove and inspect skeleton
| width="33%" rowspan=2 |
Fatal if patient is still alive when beginning. Also not a valid medical procedure in any way as it is impossible to remove most of the long bones of the body without destroying all surrounding tissue.
| |
Too many bones: Is fluid coming out of patient?
|-
| |
Too few bones: Request consult with human doctor
|-
| |
Request consult with human doctor
| |
Medically valid in the context of obtaining an opinion from a doctor in a different speciality who is better suited to treating the patient.
| |
Dissect doctor for parts
|-
| |
Dissect doctor for parts
| | This may be considered ethically dubious. Possible reference to the Doctor Who episode “{{w|The girl in the fireplace}}”
| |
Discharge patient
|-
Acceptable, but patient would generally be dead by then.
| |
Discharge patient
| |
| |
END STATE (before you read the title text)
|-
| |
Is fluid coming out of patient
| |
Unintended fluid release is always a problem. How significant a problem depends on where the fluid came from and if it is supposed to be coming from there. Red generally is due to blood, yellow is due to pus/tissue fluid/lymph and green signifies bacterial infection or bile salts (biliverdin). Could also relate to normal fluids being lost (e.g. urine, saliva, sweat)
| |
|-
| |
Squeeze patient
| |
Could be in the medical context is in providing external ventilation (see iron lung) or other means of removing fluid (e.g. squeezing pus from a boil).
| |
Is fluid coming out of patient
|-
| |
What color?
| |
Never underestimate the number of different types of fluid the body can produce.
| |
|-
| |
Activate sprinklers
| |
Not medically valid. Presumably a reference to how much cleaning up will be required by this stage.
| |
Subdue patient
|-
| |
Subdue patient
| |
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.
| |
Apply cream
|-
| |
Apply cream
| |
Medically valid as a form of barrier dressing to improve wound healing.
| |
Ask patient to rate pain level
|-
| |
Ask patient to rate pain level
| |
Useful in the sense that it provides the doctor with the means to ensure that the patient is receiving adequate analgesia during conditions of chronic and acute pain.
| |
|-
| |
Massage scalp
| |
This would belong more to the domain of palliative care and reflexology rather than being an accepted medical treatment.
| |
Patient is healthy
|-
| |
Patient is healthy
| |
A subjective assessment of the health patient is often helpful in ruling out certain diagnoses. For example, one is less likely to suspect cancer in a fit, healthy 30 year old than a thin, lethargic 50 year old.
| |
Admit for observation
|-
| |
Admit for observation
| |
Useful in the context of 'watchful waiting', in which the doctor may be unsure if the patient actually has a condition that they suspect that the patient has. By keeping the patient on the ward for a few days, the clinician can monitor the progression of symptoms and rapidly initiate adequate treatment if medically warranted.
| |
|-
| |
Laser eye removal
| |
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.
| |
Admit for observation
|-
| |
Sequence genome
| |
Useful in the association of extremely rare point mutations with an organic illness. See for instance the Genome 10K Project or the Cancer Genome Atlas. Or in diagnosing extremely rare mutations that are not picked up by most commercial DNA screening tests (e.g. kidney failure due to INF2 mutation).
| |
Apply tourniquet
|-
| |
Apply tourniquet
| |
Useful to stop acute bleeding from an injured extremity, but if it is drawn too tightly it can cause neuromuscular damage.
| |
Perform autopsy
|-
| |
Perform autopsy
| | Fatal if patient is still alive when beginning.
| | END STATE (taking the title text into account, the only possible one)
|-
| |
Inject oxygen
| |
May be fatal as injecting gases directly to the blood vessels can cause a serious embolism if it blocks blood flow to the brain or coronary arteries. However, if the oxygen is injected slowly into the venous circulation, it may be survivable as the bubbles may simply collect in the lungs where the oxygen is then slowly resorbed into the blood.
| |
Comfort patient
|-
| |
Comfort patient
| |
Psychological support to the patient and relatives is often useful after breaking news of a poor prognosis. It may also be useful in subduing the agitated or psychotic patient.
| |
Subdue patient
|-
| |
Review medical history
| |
Important early step, rather too late and conditional.
| |
Skin grafts
|-
| |
Skin grafts
| |
Only indicated if massive areas of the skin are damaged (typically due to burns)
| |
|-
| |
Count number of limbs
| |
Not really relevant in medicine, but may be of use to know the reason behind any missing or extra limbs on seeing the patient though a through review of the medical history will render this point moot. Probably a little late to be noticing this now.
| |
|-
| |
Remove extra limbs
| |
Medically indicated in cases of polymelia either due to cosmetic purposes or because the extra limbs pose a direct threat to the health of the baby.
| |
Subdue patient
|-
| |
Measure vitamin D
| |
Valid in diagnosis of bone related issues, for example if multiple or comminuted fractures were being counted as additional limbs/bones.
| |
|-
| |
Check whether build environment is sane
| |
Could be technical reference to the installation of the algorithm in the robot, or could relate to the sanity of:
* The robot doctor
* 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]])

NB: Whether the build environment is sane is irrelevant to the flowchart.
| |
Rinse patient with saline solution
|-
| |
Rinse patient with saline solution
| |
Tepid sponging may be indicated if the patient has a high fever. Could also refer to internally rinsing patient with saline solution i.e. providing intravenous sodium chloride to boost circulating volume or to perform peritoneal dialysis.
| |
|-
| |
Is patient phone battery low?
| |
Invalid in medical terminology, could be a technological metaphor for the patient's consciousness or stamina. "Your life-force is running out"
| |
|-
| |
Defibrillate
| |
Indicated in cases where there is ventricular fibrillation, and to a lesser extent in atrial fibrillation (chemical cardioversion with adenosine is usually preferred)
| |
Is patient phone battery low?
|-
| |
Sync photos from camera
| |
Definitely invalid. Could refer to the robot attempting to backup photos from a camera before attempting to repair it/attempting to back-up patient's consciousness.
| |
Administer general anesthesia
|-
| |
Administer general anesthesia
| |
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.
| |
Discharge patient
|-
| |
Blood loss?
| |
Useful. Patient may die if this clinical sign is missed.
| |
|-
| |
Patient address changed?
| |
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)
| |
|-
| |
Request organ donation
| |
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
| |
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
| |
| END STATE (before you read the title text)

|}

{{comic discussion}}

[[Category:Artificial Intelligence]]
[[Category:Flowcharts]]

1619: Watson Medical Algorithm

2015-12-21T18:36:21Z

Nayuki: Added a few words, made copyedits, fixed table formatting

{{comic
| number = 1619
| date = December 21, 2015
| title = Watson Medical Algorithm
| image = watson_medical_algorithm.png
| titletext = Due to a minor glitch, 'discharge patient' does not cause the algorithm to exit, but instead leads back to 'hunt down and capture patient'.
}}

==Explanation==
{{incomplete|much more on the different procedures etc.}}

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|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 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.

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 less than 100
* 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 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," 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!

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 healthcare robot named Baymax in the movie Big Hero 6 (2014).

==Transcript and Discussion of Medical Appropriateness==
{{incomplete transcript}}
{| border=1
| | Step
| | Medically valid?
| | Conditions and following step
|-
| |
Draw Blood
| background-color:green |
Phlebotomy is a normal early step in the diagnostic process, but not as first and unconditional step
| |
Record patient’s name
|-
| |
Record patient’s name
| background-color:green |

OK
| |
Measure Patient’s height and Weight
|-
| |
Measure Patient’s height and Weight
| |
OK
| |
Consult Standard height/weight chart
|-
| |
Consult Standard height/weight chart
| |
OK
| |
Surgically adjust patient to match
|-
| |
Surgically adjust patient to match
| |
May be considered ethically dubious unless there are [http://www.gosh.nhs.uk/medical-information/procedures-and-treatments/limb-length-difference-and-limb-lengthening sound medical reasons] for doing so. Could be an allusion to [https://en.wikipedia.org/wiki/Procrustes Procrustes].
| |
Is patient coughing up blood?
|-
| width="33%" rowspan=2 |
Is patient coughing up blood?
| width="33%" rowspan=2 |
OK, coughing up blood is generally a sign that there is something wrong. Typical causes are respiratory tract infections (e.g. tuberculosis), lung trauma or pulmonary embolism.
| |
Yes: Gather blood and return it to body
|-
| |
No: Is patient still here?
|-
| width="33%" rowspan=2 |
Is patient still here?
| width="33%" rowspan=2 |
Not usually considered a step, but missing patients are a problem in some fields, psychiatry or intensive care for example.
| |
Yes: Record pulse rate
|-
| |
No: Hunt down and capture patient
|-
| |
Hunt down and capture patient
| |
Valid if patient should not have left the bed/unit, but the wording is possibly dubious.
| |
Is patient still here?
|-
| |
Gather blood and return it to body
| |
Dangerous idea in this case due to likelihood of contamination, although if safely done autotransfusion is an accepted medical technique to ensure a matching blood supply prior to a major operation, or to enhance stamina (blood doping)
| |
Record pulse rate
|-
| |
Record pulse rate
| |
OK, but maybe a little late.
| |
Is patient screaming?
|-
| width="33%" rowspan=2 |
Is patient screaming?
| width="33%" rowspan=2 |
Very important question, indicating patient is conscious, in pain, and aware pain is bad. First attenders can use it in classifying priorities (quiet patients may be more severely injured). Generally useful in assessing nerve damage, pain relief, etc.
| |
Yes: Ignore
|-
| |
No: Check blood O2 saturation
|-
|-
| width="33%" rowspan=2 ` |
Check blood O2 saturation
| width="33%" rowspan=2 |
Only really indicated if the patient is in danger of hypoxia. Generally normal people should have a SpO2 of 98-100%, but in chronic lung disease this can fall as low to 80%, and in premature babies a SpO2 of 90% is usually targeted to avoid problems with retinopathy. If the SpO2 were to fall as low as 50%, the patient would definitely be dead or unconscious.
| |
>50%: Remove and inspect skeleton
|-
| |
<50%: Inject oxygen
|-
| width="33%" rowspan=2 |
Remove and inspect skeleton
| width="33%" rowspan=2 |
Fatal if patient is still alive when beginning. Also not a valid medical procedure in any way as it is impossible to remove most of the long bones of the body without destroying all surrounding tissue.
| |
Too many bones: Is fluid coming out of patient?
|-
| |
Too few bones: Request consult with human doctor
|-
| |
Request consult with human doctor
| |
Medically valid in the context of obtaining an opinion from a doctor in a different speciality who is better suited to treating the patient.
| |
Dissect doctor for parts
|-
| |
Dissect doctor for parts
| | This may be considered ethically dubious. Possible reference to the Doctor Who episode “{{w|The girl in the fireplace}}”
| |
Discharge patient
|-
Acceptable, but patient would generally be dead by then.
| |
Discharge patient
| |
| |
END STATE (before you read the title text)
|-
| |
Is fluid coming out of patient
| |
Unintended fluid release is always a problem. How significant a problem depends on where the fluid came from and if it is supposed to be coming from there. Red generally is due to blood, yellow is due to pus/tissue fluid/lymph and green signifies bacterial infection or bile salts (biliverdin). Could also relate to normal fluids being lost (e.g. urine, saliva, sweat)
| |
|-
| |
Squeeze patient
| |
Could be in the medical context is in providing external ventilation (see iron lung) or other means of removing fluid (e.g. squeezing pus from a boil).
| |
|-
| |
What colour?
| |
Never underestimate the number of different types of fluid the body can produce.
| |
|-
| |
Activate sprinklers
| |
Not medically valid. Presumably a reference to how much cleaning up will be required by this stage.
| |
|-
| |
Subdue patient
| |
Potentially very important if patient is behaving dangerously to themselves and others around them (due to mental health issues eg psychosis or drugs) and/or is moving too much to be given treatment.
| |
|-
| |
Apply cream
| |
Medically valid as a form of barrier dressing to improve wound healing.
| |
|-
| |
Ask patient to rate pain level
| |
Useful in the sense that it provides the doctor with the means to ensure that the patient is receiving adequate analgesia during conditions of chronic and acute pain.
| |
|-
| |
Massage scalp
| |
This would belong more to the domain of palliative care and reflexology rather than being an accepted medical treatment.
| |
|-
| |
Patient is healthy
| |
A subjective assessment of the health patient is often helpful in ruling out certain diagnoses. For example, one is less likely to suspect cancer in a fit, healthy 30 year old than a thin, lethargic 50 year old.
| |
|-
| |
Admit for observation
| |
Useful in the context of 'watchful waiting', in which the doctor may be unsure if the patient actually has a condition that they suspect that the patient has. By keeping the patient on the ward for a few days, the clinician can monitor the progression of symptoms and rapidly initiate adequate treatment if medically warranted.
| |
|-
| |
Laser eye removal
| |
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.
| |
|-
| |
Sequence genome
| |
Useful in the association of extremely rare point mutations with an organic illness. See for instance the Genome 10K Project or the Cancer Genome Atlas. Or in diagnosing extremely rare mutations that are not picked up by most commercial DNA screening tests (eg kidney failure due to INF2 mutation).
| |
|-
| |
Apply tourniquet
| |
Useful to stop acute bleeding from an injured extremity, but if it is drawn too tightly it can cause neuromuscular damage.
| |
|-
| |
Perform autopsy
| | Fatal if patient is still alive when beginning.
| | END STATE (taking the title text into account, the only possible one)
|-
| |
Inject oxygen
| |
May be fatal as injecting gases directly to the blood vessels can cause a serious embolism if it blocks blood flow to the brain or coronary arteries. However, if the oxygen is injected slowly into the venous circulation, it may be survivable as the bubbles may simply collect in the lungs where the oxygen is then slowly resorbed into the blood.
| |
|-
| |
Comfort patient
| |
Psychological support to the patient and relatives is often useful after breaking news of a poor prognosis. It may also be useful in subduing the agitated or psychotic patient.
| |
|-
| |
Review medical history
| |
Important early step, rather too late and conditional.
| |
|-
| |
Skin grafts
| |
Only indicated if massive areas of the skin are damaged (typically due to burns)
| |
|-
| |
Count number of limbs
| |
Not really relevant in medicine, but may be of use to know the reason behind any missing or extra limbs on seeing the patient though a through review of the medical history will render this point moot. Probably a little late to be noticing this now.
| |
|-
| |
Remove extra limbs
| |
Medically indicated in cases of polymelia either due to cosmetic purposes or because the extra limbs pose a direct threat to the health of the baby.
| |
|-
| |
Measure vitamin D
| |
Valid in diagnosis of bone related issues, for example if multiple or comminuted fractures were being counted as additional limbs/bones.
| |
|-
| |
Check whether build environment is sane
| |
Could be technical reference to the installation of the algorithm in the robot, or could relate to the sanity of:
* The robot doctor
* 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]])

NB: Whether the build environment is sane is irrelevant to the flowchart.
| |
|-
| |
Rinse patient with saline solution
| |
Tepid sponging may be indicated if the patient has a high fever. Could also refer to internally rinsing patient with saline solution i.e. providing intravenous sodium chloride to boost circulating volume or to perform peritoneal dialysis.
| |
|-
| |
Is patient phone battery low?
| |
Invalid in medical terminology, could be a technological metaphor for the patient's consciousness or stamina. "Your life-force is running out"
| |
|-
| |
Defibrillate
| |
Indicated in cases where there is ventricular fibrillation, and to a lesser extent in atrial fibrillation (chemical cardioversion with adenosine is usually preferred)
| |
|-
| |
Sync photos from camera
| |
Definitely invalid. Could refer to the robot attempting to backup photos from a camera before attempting to repair it/attempting to back-up patient's consciousness.
| |
|-
| |
Administer general anaesthesia
| |
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.
| |
|-
| |
Blood loss?
| |
Useful. Patient may die if this clinical sign is missed.
| |
|-
| |
Patient address changed?
| |
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)
| |
|-
| |
Request organ donation
| |
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
| |
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
| |
| END STATE (before you read the title text)

|}

{{comic discussion}}

[[Category:Artificial Intelligence]]
[[Category:Flowcharts]]