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Hugh Harvey Profile
Hugh Harvey

@DrHughHarvey

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Managing Director @HardianHealth SaMD and AIaMD consultancy

UK
Joined February 2014
Don't wanna be here? Send us removal request.
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@DrHughHarvey
Hugh Harvey
2 years
Everyone is talking about #ChatGPT and how it could save healthcare. But is it even possible to use it in #medicine , and what would the regulatory compliance journey look like? We've covered it all in our latest blog.
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@DrHughHarvey
Hugh Harvey
5 years
That Y axis tho....
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@DrHughHarvey
Hugh Harvey
10 months
Good work from @StanfordHAI showing that GPT 4 is not robust enough for use as a medical co-pilot for the following important reasons: 1) Non-deterministic: They found low similarity and high variability in responses to the same question. Jaccard and cosine similarity
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@DrHughHarvey
Hugh Harvey
4 years
I spent a lot of time debating whether to post this or not, but, do you know what, I'm actually really proud of what I've achieved. Today marks exactly one year since I started focussing on my health. So far, I've lost 15kg. Never felt better.
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@DrHughHarvey
Hugh Harvey
1 year
Babylon Health collapsed last night. I used to work there - it was my first industry job in healthtech 7 years ago. I left after 12 months, frustrated, disillusioned and wanting to do healthtech properly. What went wrong?...
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@DrHughHarvey
Hugh Harvey
5 years
Congrats to Google, but let’s not forgot the team from NYU who last year published better results, validated on more cases, tested on more readers, and made their code and data available. They just don’t have the PR machine to raise awareness.
@kjgeras
Krzysztof Geras
5 years
Great news! Our paper "Deep Neural Networks Improve Radiologists' Performance in Breast Cancer Screening" has been published at @IEEE_TMI ! This marks the end of a 3-year long endeavor, at @NYUDataScience and @cai2r , to demonstrate the potential of CNNs on this task. (1/8)
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@DrHughHarvey
Hugh Harvey
2 years
If you are building ‘ChatGPT’ for medicine, you are likely building a medical device. That means you need regulatory approval. And that means you need to qualify any third party providers (e.g OpenAI) to ensure they comply. Which they don’t. So you can’t.
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@DrHughHarvey
Hugh Harvey
2 years
Worrying findings. Billions invested. Thousands of start ups. 50,000 + papers Only 41 randomised control trials. None adhered to CONSORT-AI standards.
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@DrHughHarvey
Hugh Harvey
5 years
This says Paracetamol... apparently
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@DrHughHarvey
Hugh Harvey
6 years
@cecilejanssens This GIF sums it up nicely
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@DrHughHarvey
Hugh Harvey
6 years
The biggest impact of AI in medicine won’t come from making machines do human-like tasks, but from removing machine-like tasks from humans.
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@DrHughHarvey
Hugh Harvey
7 years
Twitter science. RT for exposure. Hypothesis: No two radiologists will create the same report. Method: Radiologists, please look at this CXR and type a report as a reply WITHOUT looking to see what others have said. Hx: 54 yrs Male, non-smoker, 2 weeks SOB, outpatient
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@DrHughHarvey
Hugh Harvey
5 years
I'm getting a lot of journalists asking my opinion on the Amazon/NHS news - asking me will AI replace doctors? This is not AI! It's a search of approved NHS online information triggered by speech recognition. It's exactly the same as going to and typing.
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@DrHughHarvey
Hugh Harvey
5 years
You can now download the seminal textbook "Artificial Intelligence in Medical Imaging" (including two chapters from me!) free of charge.
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@DrHughHarvey
Hugh Harvey
5 years
Me to VC: The ONLY route to market for your healthtech portfolio is regulatory approval & clinical evidence. I can help with both VC to me: Sounds slow and boring. My investments are disrupters on a fast track. Thanks anyway 6 MONTHS LATER VC to me: Hey can I pick your brains
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@DrHughHarvey
Hugh Harvey
4 years
My father is a portrait painter, and he painted @captaintommoore for his 100th birthday. If anyone knows how we can donate it to his family or charity so they may auction it, please let me know. It's 30x24 inches, unframed.
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@DrHughHarvey
Hugh Harvey
5 years
AI works best in ‘perfect information’ scenarios (e.g. chess). Unfortunately, in medicine there are no perfect information scenarios. It’s always incomplete. Which is why there will always be a need for human oversight given current AI capabilities.
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@DrHughHarvey
Hugh Harvey
5 years
Flight attendant: Is there a doctor on board? Dad: *nudge* You’re a doctor! Me: Yes, but I’m a radiologist. Dad: You went to med school! Go save someone! Me: Do they have a CT scanner on board the plane by any chance?
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@DrHughHarvey
Hugh Harvey
7 years
Why #AI will NOT replace radiologists -
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@DrHughHarvey
Hugh Harvey
9 years
Dermatology has a large female workforce. Or as Beyoncé calls them, "all the shingle ladies". #likealadydoc
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@DrHughHarvey
Hugh Harvey
2 years
Heard from a US radiologist today - they have AI installed at their hospital, but not at their home workstation. They far prefer reporting from the hospital now - ‘It’s just so much more efficient. I can’t stand working without it.’ AI is inevitable now.
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@DrHughHarvey
Hugh Harvey
5 years
Super rare - pregnancy implanted within the liver. Wow! source: /r/medicine
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@DrHughHarvey
Hugh Harvey
2 years
LLMs (eg ChatGPT) intended for medical use will be regulated as medical devices, requiring clinical evidence, quality management and compliance with ISO standards. From @MHRAgovuk
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@DrHughHarvey
Hugh Harvey
5 years
Great. How about hiring 300 more radiographers to run those scanners and 300 more radiologists to report the scans?
@MattHancock
Matt Hancock
5 years
NEWS: Today we’re announcing £200m for 300 scanners right across the country to boost early diagnosis of cancer
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@DrHughHarvey
Hugh Harvey
5 years
To everyone making 3D printed ventilator parts in the UK - there is good news from the regulators! You can apply for approval to supply a non-compliant medical device on humanitarian grounds during the #COVID19 pandemic. Decision made in 48 hours.
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@DrHughHarvey
Hugh Harvey
5 years
Advising three startups in health tech. I urged them all to consider a regulatory/compliance hire as early as possible. 2 didn't. 1 did. Guess which one now has market traction and revenue?
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@DrHughHarvey
Hugh Harvey
1 year
The day I started I was on the 'clinical AI' team and was shown the 'ground-breaking AI system'. Turns out it was just a bunch of Excel spreadsheets with some decision trees written by junior doctors. It was a disappointing start.
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@DrHughHarvey
Hugh Harvey
5 years
Comparison of the @GoogleHealth breast AI paper against the @radiology_rsna Editorial Board recommendations for Assessing Radiology Research on Artificial Intelligence
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@DrHughHarvey
Hugh Harvey
5 years
I made a useless graph to explain what's going on with AI in radiology right now...
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@DrHughHarvey
Hugh Harvey
5 years
Some say data is the new oil. Others say the algorithm is the gold. Actually, it’s the labels. Quality labels are hard to come by, expensive to generate, and without them, safe, accurate algorithmic performance isn’t possible.
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@DrHughHarvey
Hugh Harvey
5 years
Radiation-damaged hand of a radiographer (x-ray tech) back when daily set up involved x-raying yourself to check the machine. We don’t do this anymore, for obvious reasons.
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@DrHughHarvey
Hugh Harvey
7 years
If you ever need a reminder of how far medical radiation safety has come, look no further than the Pedoscope - originally designed to allow shoe shops to X-ray customers’ feet inside shoes to see if they fit! This old model is sitting in the staff room at Guy’s hospital.
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@DrHughHarvey
Hugh Harvey
6 years
US hospital first to replace entire radiology department with algorithms!
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@DrHughHarvey
Hugh Harvey
5 years
Irony isn’t dead. @babylonhealth publicly challenges @DrMurphy11 to “publish the entirety of your work, and let the totality of your data be assessed by any objective expert” despite having no objectively assessed published data themselves...
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@DrHughHarvey
Hugh Harvey
2 years
Newly qualified lawyers to get higher salary than full time NHS consultants after 19 years of service and a level 3 clinical excellence award. Something is broken.
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@DrHughHarvey
Hugh Harvey
2 years
Astounding paper in JMIR. Despite making claims on diagnosis, treatment and prevention (making them medical devices): - 44% of digital health start-ups have zero published research or regulatory approvals
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@DrHughHarvey
Hugh Harvey
5 years
Radiology in a nutshell...
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@DrHughHarvey
Hugh Harvey
1 year
Babylon always claimed that their AI would eventually start to help reduce the costs of delivering remote GP consultations. This was the central fallacy. Babylon is the most expensive failed experiment on digitising primary care to date.
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@DrHughHarvey
Hugh Harvey
5 years
Unsure about the evidence behind ‘personalised‘ medicine. Start pulling back the veil of hype, you find out it’s not all it seems... Lecture by @mendel_random And a brilliant read in Nature from @stephensenn
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@DrHughHarvey
Hugh Harvey
7 years
When Twitter meets medical research: results from my little 'twexperiment' on Chest X-ray interpretation.
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@DrHughHarvey
Hugh Harvey
5 years
Database of confirmed #COVID19 CXR and CT cases from Italy. Useful for radiologists to review features, or for any medical professional at the frontline.
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@DrHughHarvey
Hugh Harvey
3 years
Implementing AI solutions in healthcare requires IT interoperability, but actually more importantly is the rearranging of entire care pathways and breaking down interdepartmental silos. Tough problems to solve, and not solved by tech alone.
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@DrHughHarvey
Hugh Harvey
7 years
Happy to say I've accepted a consultant radiology post at Guys&Thomas' with funded academic time to work on #AI alongside data scientists!
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@DrHughHarvey
Hugh Harvey
7 years
@DrDLittle Medical students at Cambridge.
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@DrHughHarvey
Hugh Harvey
5 years
The *best* radiology report I have ever seen. Blunt, brave, brief. A masterclass.
@PMccoubrie
Paul McCoubrie
5 years
This is a genuine radiology report that I was sent. Not by a colleague. Not even from this country. I have to admit that, deep down inside, I’m jealous. I don’t have the cojones
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@DrHughHarvey
Hugh Harvey
4 years
My piece in @TheLancet with @EricTopol on AI for improving image acquisition. AI has the potential to be of use in predicting the appearance of high-resolution scanning from a lower resolution image. However, some argue this is a dangerous task.
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@DrHughHarvey
Hugh Harvey
5 years
This is how you do AI research, without the hype... Independent evaluators: ✅ Comparison of different models: ✅ Multi-site data at different disease prevalence: ✅ STARD criteria: ✅ Blinding: ✅ Next step: Prospective testing
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@DrHughHarvey
Hugh Harvey
6 years
Only 6% of radiology AI has been prospectively validated on external data. Not surprising - prospective studies take time (at least 3 yrs in the case of breast screening in the UK). Critics take this as evidence AI doesn't work - be patient, it's coming!
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@DrHughHarvey
Hugh Harvey
4 years
Sad day. My grandfather died aged 95 alone in his care home. It was his time, and he was peaceful, but I regret not being able to see him these past months. The cruelty of the situation is hard. RIP. Last of a family generation
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@DrHughHarvey
Hugh Harvey
6 years
At the time MRI was invented, there were fears that the technique would obviate the need for radiologists as the images were so clear that people thought anyone could interpret them. Today MRI is now the largest time sink for radiologists, and still no-one else is reading them.
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@DrHughHarvey
Hugh Harvey
5 years
Dear health tech investors, Growth and massive valuations are cool and everything, but do you know what’s cooler? Clinical evidence and strong health economics analyses. Regards, Hugh
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@DrHughHarvey
Hugh Harvey
4 years
My morning routine: 10am: Get up when I want except on Weds when I get rudely awakened by the dustmen 11am: Put my trousers on have a cup of tea and I think about leaving the house 3pm: Feed the pigeons, sometimes feed the sparrows too It gives me a sense of enormous well-being
@DrAmirKhanGP
Dr Amir Khan GP
4 years
Lots of people ask me about my morning routine, as I’m up so early, here it is: 0445: Alarm goes off 0500: 10k run 0600: Shower/breakfast 0630: Feed the birds 0635: Leave for work 0715: Blood results/hospital letters/referrals/Med education 0800: Start clinic A man of routine!
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@DrHughHarvey
Hugh Harvey
5 years
Current AI needs human oversight in order to be deployed safely. That’s why it is augmentative only. No-one is losing their jobs.
@EricTopol
Eric Topol
5 years
The 1st systematic review of deep learning #AI for medical imaging @LancetDigitalH shows how early we are in the science & validation by @DrXiaoLiu @FaesLiv @A_U_Kale @sktywagner @DunJackFu @Denniston_Ophth @pearsekeane me, et al; + @asset25 's ★ editorial
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@DrHughHarvey
Hugh Harvey
1 year
I remember I once gave an internal presentation explaining the importance of regulations, and even had a slide saying that Babylon did not want to be the next Theranos. That turned out to be fairly prescient...
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@DrHughHarvey
Hugh Harvey
1 year
So what happens next? Not much - Babylon's been broken up and sold for parts. GP at Hand still exists in some form - but for how long? For now, it joins a list of infamous healthtech companies including Theranos and Pear Therapeutics.
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@DrHughHarvey
Hugh Harvey
4 years
So, @OpenAI have released a 175 billion parameter meta-learning natural language AI called GPT-3 that can essentially answer any question you can throw at it, even on topics it’s not trained on. It’s passing exams, writing poetry and creating code. 1/6
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@DrHughHarvey
Hugh Harvey
5 years
My AI Predictions for #RSNA19 ... 1) Wired: AI to structure data at source, integration to improve workflow, and automation of operational tasks. 2) Tired: Niche image/pattern recognition tasks. 3) Needed: Multi-site prospective validation results to sort wheat from chaff.
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@DrHughHarvey
Hugh Harvey
4 years
I have a keyboard in my office that you can see behind me when I do video conferencing. I get asked a lot if I play it, and what the sheet music is. So here you go.
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@DrHughHarvey
Hugh Harvey
7 years
Didn’t study deep learning at MIT? Don’t worry - here’s the entire course
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@DrHughHarvey
Hugh Harvey
6 years
Lots of radiologists ask me how to get into AI. There’s enough data scientists already. Instead, focus on these important skills: Medical informatics Information theory Product life-cycle Quality management Clinical validation Medical device regulation Business development
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@DrHughHarvey
Hugh Harvey
2 years
This paper is making the rounds, so I thought I'd do a thread. The headline is "AI can't pass the radiology board exam" so let's explore what that actually means, and if it's even the right benchmark to test.
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@DrHughHarvey
Hugh Harvey
6 years
It arrived! Lovely to see the full print version @eranrad
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@DrHughHarvey
Hugh Harvey
11 months
Key takeaways from #RSNA2023 - Very few new start up entrants to the AI space. - AI vendors have unilaterally downsized their booths - indication of funding? - A few new point solutions (CDS or diagnostic) from established vendors but no game changers. - Talk is all about
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@DrHughHarvey
Hugh Harvey
1 year
@DrMurphy11 was the only person brave enough to talk publicly about Babylon's deception and AI hype at the time. But there was one thing that did work - and that was the telemedicine part... sort of...
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@DrHughHarvey
Hugh Harvey
1 year
The GP at Hand service actually did let people see a doctor conveniently. The price to pay was the destruction of the NHS services it was replacing. The service as a whole was apparently not cost effective - but patients did like it, and they did use it.
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@DrHughHarvey
Hugh Harvey
6 years
Prospective studies of AI will increasingly demonstrate how hard it is to get this technology to work in the real-world. False positives will be a real issue as demonstrated in this paper.
@EricTopol
Eric Topol
6 years
Primary care doctors/nurses used a deep learning #AI algorithm prospectively to help diagnose diabetic retinopathy. It didn't work very well. @JAMANetworkOpen #OA by @ehealthresearch
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@DrHughHarvey
Hugh Harvey
5 years
The most bizarre paper I have ever read! 300 women asked detailed sexual history, undergo physical exam, subjectively rated on their looks, and then have surgery to see if women with endometriosis are more attractive than those without.
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@DrHughHarvey
Hugh Harvey
5 years
Just like AI, Prof Hinton is incredibly good at what he does, but fails dramatically when outside of his domain of expertise. Poorly poised question. Medicine is not binary. AI is not robotics. No such thing as per surgeon cure rate.
@geoffreyhinton
Geoffrey Hinton
5 years
Suppose you have cancer and you have to choose between a black box AI surgeon that cannot explain how it works but has a 90% cure rate and a human surgeon with an 80% cure rate. Do you want the AI surgeon to be illegal?
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@DrHughHarvey
Hugh Harvey
4 years
A first for radiology AI - @WHO recommends that AI software may be used in place of human readers for screening and triage of TB on adult CXR based on evidence from @qure_ai @Lunit_AI and @CAD4TB
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@DrHughHarvey
Hugh Harvey
1 year
6 years after I left, the company IPO'd on the NYSE at over $4billion in 'value'. Today it's market cap is something like $5000. My only regret is not holding my short position for longer.
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@DrHughHarvey
Hugh Harvey
4 years
To buy or not to buy radiology AI? Latest paper in conjunction with @pomoumi @cekahn @pintodrad @MRITobi @TranslationalML et al.
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@DrHughHarvey
Hugh Harvey
5 years
Anatomy segmentation for brain MR with ZERO expert annotations! Game changer from MIT.
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@DrHughHarvey
Hugh Harvey
7 years
Thrilled to announce I’m joining @EricTopol et al. as an associate editor of Nature partner journal Digital Medicine! Open-access, peer-review on the cutting edge of healthtech. @Nature_NPJ
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@DrHughHarvey
Hugh Harvey
4 years
5 shockingly simple questions to ask clinical AI vendors before you buy. (You wouldn't believe how many can't answer!)
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@DrHughHarvey
Hugh Harvey
1 year
The company did everything to show it was 'safe' - but it wasn't accurate. You can send every query to emergency - that's safe, but entirely wrong. A demo hastily set up for some BBC filming was jury-rigged to look more accurate than it was.
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@DrHughHarvey
Hugh Harvey
5 years
Making a map of the AI radiology start-ups in the EU - have I missed any? Join me and @eranrad for a @EuSoMII webinar on the state of radiology AI in the EU this Monday evening
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@DrHughHarvey
Hugh Harvey
3 years
No-one is selling a continuously learning AI system yet for medical imaging (there are no regulations specifically for such systems, let alone legislation/policies for continuously sharing data), but the theory just became a little more real.
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@DrHughHarvey
Hugh Harvey
4 years
A tiny hospital at the base of the Himalayas has been using AI on the Assamese indigenous population who are at high risk for stroke. Oh, and no massive digital transformation required... Well done @qure_ai
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@DrHughHarvey
Hugh Harvey
1 year
It didn't work. Well, the NLP did to an extent - if someone wanted to ask about a nasal problem, it could recognise they were talking about their nose, but that was about it. The graph model became a tangled mess of data linkages, overly complex and practically dangerous.
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@DrHughHarvey
Hugh Harvey
6 years
Open source, cloud, deep convolutional neural networks for chest X-ray triage. Trained in 6 hours on publicly available data. 99.8% positive predictive value.
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@DrHughHarvey
Hugh Harvey
5 years
Ok, this is cool. A portable camera that takes CXRs. From a South Korean company called MiNe. Not much info, they don’t even have a booth. Integrates with AI for automated reads. Perfect for 3rd world healthcare. #RSNA19
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@DrHughHarvey
Hugh Harvey
6 years
I can highly recommend anyone involved in #AI or digital medicine to watch this superb Netflix documentary on medical device reguations: “The Bleeding Edge” on Netflix
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@DrHughHarvey
Hugh Harvey
4 years
It takes about 18 years to train the most advanced neural network in the universe (the human brain) to function at the level of a human adult. People who say AI will replace us in the next decade are being very optimistic!
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@DrHughHarvey
Hugh Harvey
7 years
What happens if you never update your IT past Windows XP? You get hacked, and patient's lives are out at risk. #nhscyberattack
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@DrHughHarvey
Hugh Harvey
5 years
I'll just leave this here...
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@DrHughHarvey
Hugh Harvey
4 years
The Apple and Android app stores need a separate category for regulatory approved medical apps, clearly differentiated from the 'well-being' and 'tracking' ones.
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@DrHughHarvey
Hugh Harvey
7 months
The AI Emperor has few clothes....
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@DrHughHarvey
Hugh Harvey
5 years
Literally all radiologists do: No. No. That's not clinically indicated. No. The word 'Pain' isn't a clinical history. No. There's no such thing as a quick look. Standing behind me wont make me faster. No. Nuclear is a different department. No. Yes, I've seen double IVCs before.
@rafalab
Rafael Irizarry
5 years
Literally all I do as a statistician: No. No. That's not the definition of a p-value. No. Trending towards significance is not a thing. No. No pie charts! That only works if data is normal. No. That's logistic regression not AI. No. Your "novel" method was invented in 1918. No.
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@DrHughHarvey
Hugh Harvey
7 years
@Jeremy_Hunt @JohnsHopkins You might want to read that paper before claiming it supports your argument. Staff levels have no effect.
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@DrHughHarvey
Hugh Harvey
1 year
A few months later, the RCP distanced themselves from Babylon and all online references to the event were taken down. Matt Hancock got involved somehow - we know how that turned out..
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@DrHughHarvey
Hugh Harvey
2 years
Has anyone yet figured out exactly why VCs are so attracted to generative AI that that can produce infinite amounts of bullshit? Asking for a friend...
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@DrHughHarvey
Hugh Harvey
1 year
As clinicians we were set the task of linking the probabilities of various diseases and symptoms, however random. A Herculean task that quickly became a joke - what is the probability of someone with RUQ pain having rhinitis? You can't answer this question with any accuracy.
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@DrHughHarvey
Hugh Harvey
6 years
Our grant-funded work with the NHS to test our breast cancer screening deep learning software has been picked up by the FT.
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@DrHughHarvey
Hugh Harvey
5 years
1/6 Everyone reading and talking about Google's "breakthrough" lung nodule detection paper in @NatureMedicine should also take at look at these, some of which report higher accuracy metrics, on a range of similar tasks.
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@DrHughHarvey
Hugh Harvey
6 years
💥 @KheironMedical featured in The Times today! Announcing that we have received the UK’s first CE class IIa approval for deep learning tech in radiology, and revealing our clinical partnership with @emradNHS . More details coming soon.
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@DrHughHarvey
Hugh Harvey
1 year
More and more hyped up demos came out - AI facial recognition, voice-to-text - anything to jump on the latest AI crazes. Almost all of it was vapourware. The company raised more and more money, expanding and hiring as if money was unlimited.
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@DrHughHarvey
Hugh Harvey
7 years
I love how doctors have been saying this for ages, but no-one believes them, and when a former google CEO says it, everyone listens.
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@DrHughHarvey
Hugh Harvey
1 year
The chatbot didn't work. The regulators came knocking and my job became to deal with them. I read the medical device regulations cover to cover, and worked my ass off to get a Class I self certification (allowed at the time). Babylon wanted FDA approval but of course never got it
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