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khafra comments on MetaMed: Evidence-Based Healthcare - Less Wrong
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Comments (191)
If she's tried all possible conventional and alternative medicine, MetaMed will not help. If she missed something (1) obscure but promising, (2) cutting edge and promising, or (3) unique about her particular body that makes an unusual treatment promising; MetaMed might be able to help.
So, if $5000 is what certain relief is worth to her, MetaMed isn't for her. If certain relief is worth $10000 to her, she should estimate how likely it is that paid, reasonably savvy researchers can find something she's missed; and go for it if she feels it's over 50% likely.
No, it's much worse than that: "how likely it is that paid, reasonably savvy researchers can find something she's missed" AND it has a near certainty of helping. Current prior: nothing has helped so far, so the odds of something she missed ended up being useful is pretty low. If the estimate of helpfulness is, say, 1% (that's pretty optimistic), and the odds that MetaMed will find something new is 50%, then certain relief has to be worth $100k.
You meant $1 mil, right?
Right, sorry.
So about what do you think it IS worth? FYI, I think, based on experience with people whom have tried everything, that a 1% chance of finding something is unrealistically low. 20% with the first $5K and a further 30% with the next 35K would fit my past experience.
Define tried everything? Your prior is that there is a 1/5 chance a handful of researchers can find something helpful in 24 hours that isn't listed in something like an Up-To-Date report on the diagnosis (a decent definition of 'everything')?
Does Metamed do patient tracking to see if their recommendations lead to relief? Or do they deliver a report and move on?
From the body of the main post (source):
Granted, I know very little about Up-To-Date, but I would be surprised if they completely eliminated that 17-year lag, especially in the more obscure conditions. They do, after all, have to cover all the conditions, and their return on investment is obviously going to be much higher on common conditions than on obscure ones. In fact, if they put out a fantastically detailed report on Stage III Boneitis (fictional) and nobody suffers a case that year, they've wasted their money. I strongly suspect Up-To-Date is aware of this, though I obviously have no way of knowing whether it affects their decisions.
MetaMed's offer is, as far as I understand it, "pay us 5k and we'll eliminate the 17-year lag for your particular case". This lets them plausibly offer value that Up-To-Date can't, in some cases.
Disclaimer: I am not associated with MetaMed, but I do think they're cool.
Have you actually read the metamed sample reports/what do you think metamed actually does? As far as I can tell, their core product is to have a team of medical and phd students do a literature search for about 1 working day (compare to Up-to-date, where actual researchers in various fields write the reports and clinicians edit the treatment plans). This seems highly unlikely to move that 17 year lag even a little bit.
I have no horse in this race, but I have worked as a statistician for hospital researchers and for health insurance companies. I just happen to think metamed's boosters here are dramatically underestimating the availability of evidence-based-medicine literature surveys in the clinical hospital setting.
This assumes she's good at sifting through the massive expanse of information available, and good at implementing the suggestions therein. These are two extremely questionable assumptions. Knowing nothing about her except that she has severe fibromyalgia and that she's the friend of a frequent poster on LW--two factors that hardly seem very relevant, and I'd put the likelihood of those two assumptions holding up to be very low. Quite bluntly, most people have no idea what's really out there. The Internet is a vast space.
No, because -$100k is much more than 20 times worse than -$5k.
Saying 1% is extremely optimistic... about the quality and competence of the medical profession as encountered by average people with mildly unusual conditions.
That assumes they find only one thing that she hasn't tried. I have a sister with fibro and some cursory googling on my part suggests that there are so many theories out about what's wrong and what can bring relief that it's difficult to believe that a systematic search by good researchers will only turn up a single thing that she hasn't tried. That said, you're right that 1% helpfulness is probably pretty optimistic.