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waxess t1_j15o6td wrote

I work in intensive care and can only imagine the amount of money and time we're going to piss up the wall transporting patients for unnecessary scans just in case the algorithm is correct.

Also, most importantly, if the machine predicts a bleed is imminent, and we scan the patient, and they haven't bled, then they aren't going to go to theatre for any intervention anyway.

Modern medicine is still reactive, even if we think someone is about to bleed, I can almost guarantee that nothing will be done, except to wait and monitor the patient, and if they do deteriorate, then take them to scan and call the surgeons.

...which is exactly what we do now anyway.

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cal_sta t1_j16f9al wrote

Title is a bit misleading, the algorithm "predicts traumatic intracranial hypertension", i.e predicts if the pressure in the skull is going to increase to dangerous levels, which is caused by bleeding/swelling. We know your brains bleeding we just wanna know if it's gonna kill you.

https://www.liebertpub.com/doi/10.1089/neu.2022.0201?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub++0pubmed

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waxess t1_j16g9r0 wrote

Yes but we track intracranial pressures already, if its within normal limits, we continue to monitor, if it increases, we manage it with medical treatment and consider repeat scanning to assess if there is a bleed.

If the algorithm predicts a bleed, but ICP remains normal, we won't rescan a patient.

If it predicts a bleed and ICP increases, we will rescan the patient, but that's essentially what we would do anyway. This seems like a costly and unhelpful intervention, as I can't see how it would change our current practice. Obviously I stand to be corrected, but this seems a somewhat redundant discovery at first sight.

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[deleted] t1_j164czu wrote

[deleted]

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waxess t1_j16gu1i wrote

We already monitor intracranial pressure and we monitor it continuously, 24 hrs a day, as long as the patient stays in ICU. At best, this would give us a warning that the patient may bleed, and ICPs may rise, which may encourage us to watch it more closely, but good medical practice would mean watching the ICP all day, every day, continuously, without any breaks anyway.

Regarding your (presumably rhetorical) opening question, the harsh reality of modern healthcare is that a life does have a dollar value. In a system of finite resources, all interventions have to be weighed against their cost-benefit. If this algorithm can be shown to save one out of every ten thousand patients from a bleed that would otherwise be missed, but it costs $10 million to license, it would be highly unlikely to be picked up by any hospital that has to consider where else its funding may be better spent.

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