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Comment Re:COMAPRISON REQUIRED (Score 1) 64

Sorry about the link, it was the first I found that was specific to heart surgery. The other reply was accurate in that I only had one issue and there were no other issues that would require more extensive access. The main contraindication for the treatment is having a lot of fat. (I don't remember if it's surface fat, or if it's fat around your organs.)

There are risks with any procedure, but believe me there are plenty of risks associated with open heart surgery and the following recovery. Without the robot, they would need to saw open my sternum and spread my rib cage. You can't just stitch the sternum closed when you're done. I would have faced a much, much longer recovery period after the hospital with open heart. Scars are cosmetic and inconvenient, but that shouldn't be the primary consideration for choosing robotic surgery.

I did a lot of research on robotic heart surgery because I know that open heart surgery is a well-understood procedure. It sucks (split sternum!!), but lots of surgeons know how to do it correctly. I made sure that the surgeon was well-practiced in robotic and non-robotic surgery (in case a problem occurred, they need to be able to do it the old-fashioned way). And at the time I found other research papers that did find benefits for some cardiac patients but not for gynecological/urological procedures. If I or someone I knew needed a non-cardiac procedure, I would prefer not using a robot. But if someone I know fits the treatment profile for robotic heart surgery, and has access to an experienced surgeon, I would tell them that they should definitely consider it.

Comment Re:COMAPRISON REQUIRED (Score 4, Informative) 64

"Critical Outcomes in Nonrobotic vs Robotic-Assisted Cardiac Surgery"
http://www.ctsnet.org/jans/cri...

"Robotic surgery was more expensive ($39,030 vs $36,340) but was associated with a shorter length of stay (5 vs 6 days), lower mortality (1.0% vs 1.9%), and lower overall complication rates (27.2% vs 30.3%)."

When I needed to have a mitral valve repaired, I was told I was a good candidate for robotic surgery because I was relatively young and in good health otherwise. I went in Tuesday morning and left the hospital Friday afternoon, and instead of a twelve-inch scar down the middle of my chest, I have a 3.5-inch scar on my right side surrounded by three puncture wound scars (for the robotic arms). I'm glad I had the option.

That said, I'm concerned that some hospitals, having made a big investment in a surgical robot, might be tempted to get additional use out of it by adding on other procedures where the cost/benefit analysis isn't so clear.

Comment Sesame Street and Bach (Score 1) 59

OK, so listening to this, I just now realized (30+ years later) that an alphabet tune that has been stuck in my head forever looks like it's based on the Well-Tempered Clavier.

Fugue No. 2 in C minor, BMV 847 (track 4) vs. start of Alphabet Chat (Found one for the letter L; still funny to me.)

"A-B-C-D-E C-D-E-F-G H-I-J-K L-M-N-O-P Q-R-S-T-U R-S-T-U-V S-T-U-V W-X-Y-Z and ... A ... B ... C."

Comment Satire *and* Parody (Score 4, Insightful) 255

Parody of Power Rangers. No one is mistaking this for an actual official Power Rangers movie. (Compare with Hustler v. Falwell.) The difference in fan fiction is that when looking at an excerpt of text, there is the potential that a reader might mistake a piece with officially sanctioned/published material. Non-commercial work faces a lower bar for being judged as fair use. (Thus firms are more likely to obtain permission/licensing when making a product or film.)

Satire of grimdark and remakes/reboots. "In the grim future of Hello Kitty, there is only war". http://onastick.net/sitz/image...

The video was interesting in spots; this article wasn't.

Comment Re:Helpful links for intelligence community devs (Score 1) 275

Health care applications typically don't have access to a master list of names. They use multiple criteria in addition to names to do master patient indexing. Similar names are an important component (Jaro-Winkler is a nice metric to consider), but are given less weight when the last name or first name is common. But if you include birth date, government identifiers (ssn, driver's license, medicaid/medicare), current/past addresses (allowing again for transposition or similar errors), your accuracy gets much better.

No idea if government intelligence apps do this, but I would expect they do (or at least there are staff members who know what to do, if they could only convince higher-ups).

Comment Re:If they charge $15,000 for a ten week course... (Score 1) 374

There are price levels where the risk of fraud and abuse may outweigh the costs of enforcement and compliance. People who travel to other countries cannot carry more than $10000 in cash without reporting it. The risk is money laundering and drug running.

Regulating everything or regulating nothing always leads to huge Type I/Type II errors. Reasonable people can disagree on the appropriate level of compromise.

Comment Re:More garbage (Score 2) 353

The article was adapted from a longer blog post. In the adaptation, they linked to Psychology Today (ugh) to discuss "micro-inequities" as the initial term for phenomena that were later covered under the term unconscious bias or implicit bias. Having it doesn't make you racist or sexist; it's as human as risk aversion and loss aversion, both well studied. But like risk aversion or loss aversion, implicit bias can dissuade humans from making an optimal, economically rational decision. It takes self-awareness and practice to overcome these tendencies (and then only sometimes).

If you can't explain it, and you can't define it, and you can't trace it back, perhaps it's not real.

These have been studied for decades in psychology, social psychology, and sociology. Do you really expect a full lit review in an article in the popular press, adapted from a blog post by an academic who is speaking from personal experience about topics not in his core field?

We are scientists.

We are humans. With quirky, bug-prone wetware.

Comment Da Vinci was great for me, maybe not for others (Score 5, Interesting) 99

I needed mitral valve repair surgery, and I was a good candidate for robotic surgery: relatively young, good health (other than the valve), not obese (fat gets in the way). Instead of sawing my sternum and spreading my chest open, the surgeon (who has a lot of experience in both robotic and open heart surgery) was able to go in through my right side and leave a 3-inch scar and three puncture wounds. I was in the hospital Tuesday morning, and out Friday afternoon. I'm grateful to have had access to this technology. The benefits of robotic surgery compared to open heart surgery are clear (at least in my case).

But when a hospital has a large fixed cost to acquire technology, it is all too tempting to spread that cost out over a greater number of surgeries. The benefits are not nearly so clear in surgeries that don't require bone-breaking or bone-sawing. If someday I need gall bladder surgery, or if my spouse needs a hysterectomy, I would have a strong preference to avoid robotic surgery unless a skilled surgeon can make a compelling argument that the specifics of our case are a good fit for robotic assistance. (And believe me, I read as much of the medical literature as I could in making the decision: when one of the surgical steps is, basically, "shut down the heart," you want to know as much as you can. Open heart surgery for valve repair is a well-understood, well-practiced technique, but for me the decision to use the robot was about the reduced shock to the body, shorter recovery time, and reduced scarring.)

Comment Re:Americans doing the right thing (Score 1) 999

Part of the credit for the deficit decline under Clinton goes to George HW Bush, who broke his "read my lips, no new taxes" pledge for the good of the country. I remember being really concerned about the revenue increases that Clinton signed early in his first term because I was familiar with Republican talking points about taxes being automatically bad for the economy. Then I saw that the world didn't end, I took some basic econ courses (micro/macro) and learned to take macro theories (left or right) with huge handfuls of salt when considering the real world.

Prototype designs always work. -- Don Vonada

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