MDNews - Long Island

Unraveling Diagnostic Dilemmas Jared Heyman watched his sister Carly's health inexplicably decline as, beginning at age 18, she developed depression, expe- rienced hormonal problems and gained 50 pounds. More than 24 physicians sought a diagnosis to explain Carly's symptoms; no medication she tried offered permanent relief. Finally, a multidisciplinary team of specialists with the National Institutes of Health's Undiagnosed Diseases Program collaborated to come up with the correct diagnosis: fragile X-associated primary ovarian insuffi ciency. A hormone replace- ment patch resolved Carly's symptoms within weeks. "While Carly was sick, I was study- ing the wisdom of crowds at a company I'd founded, and I learned a lot about harnessing that wisdom and separating the mechanisms that allow for the com- munication and collaboration it takes for crowds to solve problems," Heyman says. Mining the Masses with MEDICAL CROWDSOURCING By Thomas Crocker TWO MODELS OF CROWDSOURCING — DRAWING ON THE COLLECTIVE WISDOM OF MANY PEOPLE TO SOLVE PROBLEMS — POINT TOWARD A NEW WAY OF ADDRESSING MEDICAL CONUNDRUMS AND EXPANDING ACCESS TO EXPERTISE. "I thought, 'Crowdsourcing should be applied to medicine.'" The result was CrowdMed, an online service that allows individuals with per- plexing illnesses to submit their cases to a crowd of "Medical Detectives." These healthcare gumshoes are active or retired physicians, nurses, and other providers from a variety of medical backgrounds. They suggest possible diagnoses, which are weighted and ranked by probability and presented to patients in a report. The aver- age CrowdMed patient has been sick for eight years, seen eight physicians and spent $50,000 trying to fi nd a correct diagnosis. Patients can offer cash compensation as a way to attract more Medical Detectives to their cases. Typically, case resolution takes less than two months. "What underlies CrowdMed is a pat- ented prediction market algorithm," says Heyman, CrowdMed's Founder, CEO and product visionary. "Medical Detectives suggest diagnoses and solutions, and other Medical Detectives allocate points to the most probable diagnoses. If they allocate points correctly, they can win points toward a higher Medical Detective rating in our system [detectives start with a rating of 3; 10 is the highest], or even cash. Our system looks at point alloca- tion behavior [based on detectives' ratings and backgrounds] and uses that to assign probabilities to the most likely diagnoses." Anyone can become a Medical Detective, but accuracy of suggestions determines success and status in the system. "We believe previous performance is the best predictor of future performance," Heyman says. "We don't care if you're a physician, nurse, medical student or acupuncturist — we care about how well you perform." Monetary compensation is a signifi cant motivator for Medical Detectives but not the primary one for most, according to Heyman. 2 4 | Long Island MD NEWS ■ M D N E W S . CO M

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