Turun

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[–] [email protected] 2 points 5 months ago (2 children)

I know this is the plot from a movie, but I can't remember the name. Help me out here?

[–] [email protected] 0 points 5 months ago

It does not perform very well when asked to answer a stack overflow question. However, people ask questions differently in chat than on stack overflow. Continuing the conversation yields much better results than zero shot.

Also I have found ChatGPT 4 to be much much better than ChatGPT 3.5. To the point that I basically never use 3.5 any more.

[–] [email protected] 1 points 5 months ago

No, it's simply contradicting the claim that it is possible.

We literally don't know how to fix it. We can put on bandaids, like training on "better" data and fine-tune it to say "I don't know" half the time. But the fundamental problem is simply not solved yet.

[–] [email protected] 56 points 5 months ago* (last edited 5 months ago)

git tag "FINAL FINAL FINAL DRAFT - v20"

[–] [email protected] 0 points 6 months ago

Fair enough. If you can recognize that you have a strong opinion based on ethics, and are willing to read up on how things are currently done and what the problems are (both with the current way and with the way that your ethics would like it to be) thats fine.

Let me ask you this: are you opposed to professional fighting? Boxing, wrestling, wwe, etc?

I'm not a sports guy (at least watching sports, I do exercise weekly) and would barely notice if those would no longer exist tomorrow. So I am certainly not one to defend their existence.
And yes, I am super critical of professional sport and how much these people hurt themselves. In German we have a saying: "Sport ist Mord", sports is murder. I think in the broad population it's also used as an excuse if you're lazy and don't want to exercise, but for me it appropriately hits on the problem of professional sport. Some are better than others, for example I have not heard of many negative consequences from swimming on a professional level. But I think the problems that people get from playing rugby on a professional level are absurd. There are measurable levels of IQ drop after a few years of working as an athlete. I have absolutely no idea why anyone would willingly do that.

One difference is that in order to get to such a level you need talent and need to be into it from a young age. Yes, some people can lift their family out of poverty with it. But not because they needed some quick money.
A better comparison to paying big money for participants of clinical trials than sports is selling your kidney. You only need one, technically, so it's safe on paper. But it's a surgery that comes with some inherent risks to your life. And there is a reason we usually have two.

And again, the injury is tangential to the performance. In clinical trials a sizable fraction of the "patients" die (cells, animals, humans. The earlier in the trial the bigger this fraction. Animal test are there to hopefully have the number be zero when we get to human trials), until we know what dose is effective and safe at the same time.

[–] [email protected] 0 points 6 months ago

Fair enough. It would put a stop on developing new medicine for a while (5-20 years maybe?), but I can understand the opinion that "what's done is done, we just should not continue doing that".

[–] [email protected] 0 points 6 months ago* (last edited 6 months ago) (2 children)

Oh, I had hoped for some proper thoughts on the matter. The first suggestion is too vague and the other two are already the status quo. In fact I have heard (anecdotally) someone got treated for something that, with 99.9% certainty, was unrelated to the clinical trial they, were participating in. But it occurred during the trial, so their health care costs were covered in full by the clinical trial. And if you ever witness that participants of a clinical trial were not fully informed you should report it. The ethics committee and lawmakers take that extremely seriously.

Edit: to better explain my previous point about safety. When we talk about a usual job being dangerous what we mean is that you're supposed to do A, but B might happen and hurt you (build the scaffolding for a house, but pinch your hand when connecting two pieces). Therefore we mandate PPE, maximum working hours, machine assurance, etc. This is possible because the actual job is tangential to the risk associated with it.

A clinical trial is, going from beginning to end: we have simulated this drug in the computer and tested it on cells. Now we need to check for interactions with other parts of the body. For statistically significant results we need 50 animals, we put cancer in them, wait two weeks and then start treating them like we would treat a human who has this cancer. We vary dose and when to give it, maybe the mixture of compounds if the drug is not just a single active component. A lot of the animals will have to be put down when it becomes apparent that this configuration of the drug does not work. But we have a better understanding of the working of the drug in the body now. After that trials move on to human patients. First we start with people who are sick and for whom the current method of treatment did not work. They will die soon anyway, but there is a small chance that the new drug will work on them. Again we vary dose etc, but now we know much better what range of dose is useful. This results in much more difficult to handle data, because taking a few random people will introduce wild variations in confounding factors. But it's a necessary step to show that the drug works in humans, because we can't move on to testing the new drug on people for which the old method of treatment would have worked. After this trial is done it is finally time to try the new drug out on people who come to the hospital to seek treatment. The doctor may offer you the chance to participate in a trial for a new medicine if they think you're a fitting candidate. This trial will test the medicine for the first time against a proper sample of the population. Only now can we say for certain how much better it is than the old drug (or maybe it's worse) and tease out details from the data (e.g. It's usually better, but it's worse if the person has a cold and is overweight when starting treatment. Or it causes severe allergic reactions for people who have asthma that is triggered by grass pollen)

It's important to note that at every step of the process a drug can fail testing. Researchers want the drug to fail early, because every step costs money and time. When we get better simulations or artificial organs to test on they will be used, because it's so much faster and cheaper than going to animal trials with a promising drug, only to find out after three months of hard work that it doesn't work.

Now, the safety concerns in clinical trials is that we have a current drug that works, and we have a new drug that may work. Is it ok to not treat someone with the known working one, just to see if the maybe working one helps? Most people say no. The danger is inherent in the thing, which is why we have such a lengthy process. There is no PPE you can wear to reduce the effects of cancer when the trial requires you to have cancer. We must get to the stage of "it's most likely working better than the current treatment" before starting testing on otherwise healthy humans.

[–] [email protected] 0 points 6 months ago (4 children)

If you're a suitable candidate I'm pretty sure they already explicitly ask you if you'd like to participate.

I'm curious what methods you suggest to make medical trials more safe. In e.g. construction we can regulate personal protection equipment and mandate machines to do the heavy lifting instead of the workers. We can mandate more time off and corporate fitness programs to keep the people healthy. But how would you make a safer clinical trial?

[–] [email protected] 0 points 6 months ago (6 children)

Models and simulations are already used to develop new drugs. But the tech is simply not there yet to rely on that exclusively.

Voluntary human trials are already a requirement as well. The problem is that there are not many cancer patients that are beyond saving and still in the condition to take part in such trials.

I don't know how it is in other countries, but in Germany it's illegal to pay someone to take part in clinical trials. You are paid money to compensate you for your time and travel costs, but it's not proper pay. And there is very good reason for that. If you make medical trials a viable income, you will inevitably get poor people to take part in them. You may consider that more ethical than animal trials. I do not.
The comparison with risky jobs is not valid, because we do our best to make those jobs safer. A trial for a new drug inevitably involves getting infected with the disease the drug is supposed to cure.

[–] [email protected] 0 points 6 months ago (2 children)

You'd be surprised how many diseases were fatal once. Aside from fixing broken bones or something like that, drinking tea, suffering and praying it will get better are your only options for the vast majority of diseases if you truly want to live with a clear mind.

[–] [email protected] 0 points 6 months ago (1 children)

Assuming a young adult develops, idk breast cancer or something. Your sister or your daughter or you maybe. Should we treat it?
If we don't they'll die.
But careful, it will cost a hundred rats and a few rabbits their lives.

[–] [email protected] 0 points 6 months ago* (last edited 6 months ago)

i'm going to ignore your posting history and assume for a moment you aren't a contrarian debate pervert. what exactly is the point you are trying to get across?

Way to enter a discussion. I'd prefer if you could keep it civil.

you agree that animal testing is fundamentally wrong, but [...] we need to keep the animal testing?

This might sound off topic, but bare with me here: Do you agree that CO2 emissions are fundamentally wrong (leading to a mass extinction event, etc)?

(I will continue this argument under the assumption that we can all agree on that) And do you concede that these emissions are, for the foreseeable decade(s) inseparable from modern human life? Not that they are a basic necessity to survive, but that you and I are indirectly causing such emissions in one way or another for every day that we are alive and continue with our day to day actions (heating, cooking, buying stuff, transportation, etc). This may change in the future, but let's focus on today.

(Again I assume that you are not the 0.1% of the population that lives without any modern amenities (you have some way of writing comments on the Internet for example), and will continue my argument) Given these two basic building blocks of our mutual understanding of the world I would like to rephrase the question you find so inconceivable:
"you agree that emitting carbon is fundamentally wrong, but we need to keep emitting carbon?"
Neither you nor me have committed suicide, so there must be some reasoning that is acceptable to you, which justifies keeping a human alive even though it requires continuing something that is fundamentally wrong. Of course, different people draw the line at different points. But I hope I was able to show you that, even if you draw the line differently for this issue, the reasoning is not completely foreign to you.

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