Daniel Barron completed his medical training and Psychiatry residency at Yale University, where he was the Chief Resident of both Yale’s Neuroscience Research Training Program and of the Clinical Neuroscience Research Unit. He holds a PhD in Human Brain Imaging from the University of Texas and is a regular contributor at Scientific American. He is currently a fellow in Pain Medicine at the University of Washington and lives in Seattle with his wife and son. Reading Our Minds:The Rise of Big Data is his first book. He also has a podcast named Science et al.
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Dear Dr Barron,
Re: WSJ The Rise of Big Data Psychiatry
I read your review pice in WSJ
Big Data is synonymous with GIGO ( garbage in garbage out)
When I did my 10 week Psychiatry rotation at Bronx Municipal Hospital in 1973 the locked unit had, I believe, 20 beds and every patient chart had he same diagnosis, Schizophrenia, undifferentiated. They were all on thorazine and stayed 1-3 weeks. The resident room had a full set of Sigmeund Freud’s works. When I took them off the shelf I found that the bindings were uncracked and that no one before me had opened or read them.
Today we have axes, thousands of scientific sounding diagnosis codes, and many medications that we believe work by” altering neurotransmitters”. We have the appearance of science. How sad.
In short, we do not have any idea of what we are doing in Psychiatry. Depression, bipolar, and schizophrenia are the only diagnoses that we have a good idea of how to diagnose and treat. IBM bet the house on the Watson project 10 years ago and tried to sell it to business and medicine. It worked so well that they are losing their company and selling off Watson before it pulls them under. The use of big data to find the answer to things we don’t already know has not worked. The scientific method as practiced for 400 years isolates variables and looks at problems on a scale that we can make sense of.
I know that I do not want my cellphone to monitor my mental health. I am pretty sure my patients also do not trust their cellphones to monitor them.
Isaac Gorbaty MD
internal medicine Geriatrics Nephrology
Los Angeles, CA
Hi Issac,
So happy you posted such a thoughtful and useful comment. Finding a useful way to understand and treat illness has always been at the heart of medicine. You’d really enjoy my book, esp the intro where I describe how oncology and cardiology have accomplished this. I hope you enjoy it!
Hi,
I have recently listened to the “big data” podcast and though I understand the rational for Dr Barron’ proposed utilisation of “big data” I find myself concerned that potential pitfalls and the rights of the patient to decline such “assessment” was not explored. Indeed, the ethical issues around the usage of such personal “big data” abound. Including, though not limited to, who may access such data mined information, to what usage it may be utilised for and whose right it is to grant access to it? The patient or the clinician?.
Further the potential for incorrect interpretation of such data by a researcher, a clinician or worse still the application of unmediated generalised “results” from such data such as generated by most statistical analysis when applied to an individual (as a unique being) may be nothing less than devastating in its sheer lack of relevance to the uniqueness of the individual and their experienced life.
I am both a time served registered clinician (nurse practitioner) within the domain of Mental Health (psychiatry) and within the domain of psychotherapy (registered (licensed)). In over thirty-five years I have not felt the need to look beyond clinical experience, training and a sound therapeutic relationship with the individual I am assisting to aid the individual to meet their own needs.
I also have been fortunate to experience the “old black dog” on occasion and thus to experience life from the side of a “service user”. From this perspective I can imagine nothing worse than to be “analysed” from “dry” incomplete data obtained from any online life I may have or via data obtained from any fitness application that I may have used. Then to have my life potentially decided for me by another who though well meaning has drawn incomplete and potentially incorrect conclusions about me and any prevalent presented “condition” impacting upon my experienced life.
I feel that it is far better to allow patient and clinician time to discuss and explore presented issues. Though the current time allowance given for this for most clinicians does not allow for this. For example within the UK currently a General Practitioner (MD) is allowed ten minutes per appointment per patient. This is not enough time to allow for for any meaningful interaction and exploration of an issue to occur. The time that a Psychiatrist spends with a patient in secondary care facilities (hospitals) is not much longer and again an authentic and realistic therapeutic relationship is not allowed to be fostered in such short time periods from which an “accurate” (helpful) diagnosis may be made.
The above stated I do appreciate that there may be occasion when such an intrusion of an individual’ right of privacy may be advantageous. For example when an individual has attempted suicide or to harm another and is not forthcoming with a clinician who is attempting to assist them. This stated the rights of the patient should always be upheld including the right to deny the clinician access to any “big data” that is pertinent to them.
Certainly, no “big data” should be routinely available to any health care provider or clinician therein, that would allow any individual to be identified, monitored or coerced into an unconsidered action or change of behaviour.
The greatest gift is time to be with a patient as a clinician and current time restrictions would be better addressed rather than introducing “big data” mining processes for either assessment purposes (analysis) or for monitoring of patient which only become a further restriction on actual contact with a patient.
I am afraid that Dr Barron’ proposals for the utilisation of “big data” does resonate too much with a “big brother” mentality and attitude, or at least an overly parental attitude being too readily accepted within society in regard to healthcare provision. Unfortunately these being long standing within healthcare, for far too long.
In ending I wish to complement you on a wonderful resource and to thank you for the many and varied discussions, explorations and presentations that you have made available via your podcasts.
A Jones