Is this the way an general internist diagnoses a cardiologic problem?

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douglas

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Aug 8, 2008, 3:51:01 PM8/8/08
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Is this the way an general internist diagnoses a cardiologic problem:

1. Review patient's chart and take a thorough history
2. Perform an auscultation
3. Based on the results of the ausculation, order a TEE to test for
anatomical problems, or skip to step 5
4. If positive, refer patient to either an interventional cardiologist
or a cardiac surgeon for further testing and treatment, depending on
the type of abnormality
5. If TEE negative for anatomical problems, order a magnetocardiogram
to test for electrophysiological problems
6. If MCG positive, refer patient to a clinical cardiac
electrophysiologist for further testing and treatment

Truth

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Aug 8, 2008, 4:30:04 PM8/8/08
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I'm an internist. It would depend on the presenting symptoms and
complaints as to what would be done. I've never heard of or used a
"magnetocardiogram." An EKG would be ordered by an internist. A
transthoracic echocardiogram is often all that is needed for
ventricular and valvular function. Transesophageal echo (TEE) may be
more sensative for seeing atrial septal defects or valvular
vegetations or patent foramen ovale but is ordered much less
frequently than a transthoracic echo.

If one is evaluating chest pain in a patient at low risk, many
internists can perform exercise treadmill testing themselves. Many
common medical cardiac problems such as atrial fibrillation and
congestive heart failure or stable coronary artery diseas are managed
by internists without any cardiologist.

douglas

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Aug 8, 2008, 4:49:26 PM8/8/08
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Ah. This is a magnetocardiogram:
http://www.futurehealthcareus.com/?mc=cardiomag-magneto&page=card-viewarticle

Would my diagnostic algorithm be useful, though?

Truth

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Aug 8, 2008, 5:24:18 PM8/8/08
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> Ah. This is a magnetocardiogram:http://www.futurehealthcareus.com/?mc=cardiomag-magneto&page=card-vie...
>
> Would my diagnostic algorithm be useful, though?- Hide quoted text -
>
> - Show quoted text -

No, your diagnostic algorithim would not be particularly useful and
doesn't reflect how medicine is currently practised or how internists
approach diagnosis. And the magnetocardiogram is not something
currently used in evidence-based medicine.

Why did you come up with the algorithim? For fun? For school? For what
purpose or application

douglas

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Aug 8, 2008, 5:45:48 PM8/8/08
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> purpose or application- Hide quoted text -

>
> - Show quoted text -

Partly for fun, partly after reading the cardiovascular section of my
college classmate's A/P book. I'll be applying for an observership in
the radiology department at Long Beach Memorial per my urologist
friend's advice. After I complete that, I'll see if I can observe in
the cardiology dept. Then I'll get to really see what goes on.

Why, exactly would my algorithm not be useful? I guess it can miss
stuff, right?

I believe that, at the time I become a cardiologist --around 12 years
away--, the magnetocardiogram will be a standard diagnostic test, just
like the MRI. A really interesting diagnostic would be coregistering
the magnetocardiogram w/ a 3D MRI of the heart, like how
magnetoencephalograms are routinely coregistered w/ brain MRIs, to
create a magnetic source image --http://uuhsc.utah.edu/uumsi/what-is-
msi.html --. Using a cardiac MSI, the need for long and expensive
electrophysiologic studies can be reduced, and used only where the
arrhythmia is transient or difficult to reproduce, and RF ablation
treatments can be made more precise and quicker, as the EP won't need
to first figure out where the abnormalty lies, s/he can just use the
MSI to locate where the errant signals are coming from, and destroy
that area.

Truth

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Aug 8, 2008, 6:22:23 PM8/8/08
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> that area.- Hide quoted text -

>
> - Show quoted text -

Your algorithim is good up to history, physical and chart review.
After that, the proper course for further evaluation depends on the
patient. It is not a one-size-fits-all undertaking that is suited for
an algorithm

douglas

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Aug 8, 2008, 6:43:33 PM8/8/08
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> an algorithm- Hide quoted text -

>
> - Show quoted text -

But, it could be used for guidance?

Truth

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Aug 8, 2008, 6:45:14 PM8/8/08
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> But, it could be used for guidance?- Hide quoted text -

>
> - Show quoted text -

No. It is not clinically useful. It doesn't help decision making or
guide work up at all. Sorry.

Cary Kittrell

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Aug 8, 2008, 7:14:13 PM8/8/08
to
In article <a8835a66-f0b5-4559...@v1g2000pra.googlegroups.com> Truth <yama...@aol.com> writes:
> On Aug 8, 2:45=A0pm, douglas <Protoman2...@gmail.com> wrote:
> > On Aug 8, 2:24=A0pm, Truth <yamant...@aol.com> wrote:
> >
> >
> >
> >
> >
> > > On Aug 8, 1:49=A0pm, douglas <Protoman2...@gmail.com> wrote:
> >
> > > > On Aug 8, 1:30=A0pm, Truth <yamant...@aol.com> wrote:
> >
> > > > > On Aug 8, 12:51=A0pm, douglas <Protoman2...@gmail.com> wrote:
> >
> > > > > > Is this the way an general internist diagnoses a cardiologic prob=

> lem:
> >
> > > > > > 1. Review patient's chart and take a thorough history
> > > > > > 2. Perform an auscultation
> > > > > > 3. Based on the results of the ausculation, order a TEE to test f=

> or
> > > > > > anatomical problems, or skip to step 5
> > > > > > 4. If positive, refer patient to either an interventional cardiol=
> ogist
> > > > > > or a cardiac surgeon for further testing and treatment, depending=

> on
> > > > > > the type of abnormality
> > > > > > 5. If TEE negative for anatomical problems, order a magnetocardio=

> gram
> > > > > > to test for electrophysiological problems
> > > > > > 6. If MCG positive, refer patient to a clinical cardiac
> > > > > > electrophysiologist for further testing and treatment
> >
> > > > > I'm an internist. It would depend on the presenting symptoms and
> > > > > complaints as to what would be done. I've never heard of or used a
> > > > > "magnetocardiogram." An EKG would be ordered by an internist. A
> > > > > transthoracic echocardiogram is often all that is needed for
> > > > > ventricular and valvular function. Transesophageal echo (TEE) may b=

> e
> > > > > more sensative for seeing atrial septal defects or valvular
> > > > > vegetations or patent foramen ovale but is ordered much less
> > > > > frequently than a transthoracic echo.
> >
> > > > > If one is evaluating chest pain in a patient at low risk, many
> > > > > internists can perform exercise treadmill testing themselves. Many
> > > > > common medical cardiac problems such as atrial fibrillation and
> > > > > congestive heart failure or stable coronary artery diseas are manag=

> ed
> > > > > by internists without any cardiologist.
> >
> > > > Ah. This is a magnetocardiogram:http://www.futurehealthcareus.com/?mc=
> =3Dcardiomag-magneto&page=3Dcard-vie...

> >
> > > > Would my diagnostic algorithm be useful, though?- Hide quoted text -
> >
> > > > - Show quoted text -
> >
> > > No, your diagnostic algorithim would not be particularly useful and
> > > doesn't reflect how medicine is currently practised or how internists
> > > approach diagnosis. =A0And the magnetocardiogram is not something

> > > currently used in evidence-based medicine.
> >
> > > Why did you come up with the algorithim? For fun? For school? For what
> > > purpose or application- Hide quoted text -
> >
> > > - Show quoted text -
> >
> > Partly for fun, partly after reading the cardiovascular section of my
> > college classmate's A/P book. I'll be applying for an observership in
> > the radiology department at Long Beach Memorial per my urologist
> > friend's advice. After I complete that, I'll see if I can observe in
> > the cardiology dept. Then I'll get to really see what goes on.
> >
> > Why, exactly would my algorithm not be useful? I guess it can miss
> > stuff, right?
> >
> > I believe that, at the time I become a cardiologist --around 12 years
> > away--, the magnetocardiogram will be a standard diagnostic test, just
> > like the MRI. A really interesting diagnostic would be coregistering
> > the magnetocardiogram w/ a 3D MRI of the heart, =A0like how

> > magnetoencephalograms are routinely coregistered w/ brain MRIs, to
> > create a magnetic source image --http://uuhsc.utah.edu/uumsi/what-is-
> > msi.html --. Using a cardiac MSI, the need for long and expensive
> > electrophysiologic studies can be reduced, and used only where the
> > arrhythmia is transient or difficult to reproduce, and RF ablation
> > treatments can be made more precise and quicker, as the EP won't need
> > to first figure out where the abnormalty lies, s/he can just use the
> > MSI to locate where the errant signals are coming from, and destroy
> > that area.- Hide quoted text -
> >
> > - Show quoted text -
>
> Your algorithim is good up to history, physical and chart review.
> After that, the proper course for further evaluation depends on the
> patient. It is not a one-size-fits-all undertaking that is suited for
> an algorithm

Picking semi-randomly an abstract on suchlike:

The paper provides an overview of the development of intelligent data
analysis in medicine from a machine learning perspective: a historical
view, a state-of-the-art view, and a view on some future trends in this
subfield of applied artificial intelligence. The paper is not intended
to provide a comprehensive overview but rather describes some subareas
and directions which from my personal point of view seem to be
important for applying machine learning in medical diagnosis. In the
historical overview, I emphasize the naive Bayesian classifier, neural
networks and decision trees. I present a comparison of some state-of-
the-art systems, representatives from each branch of machine learning,
when applied to several medical diagnostic tasks. The future trends are
illustrated by two case studies. The first describes a recently
developed method for dealing with reliability of decisions of
classifiers, which seems to be promising for intelligent data analysis
in medicine. The second describes an approach to using machine learning
in order to verify some unexplained phenomena from complementary
medicine, which is not (yet) approved by the orthodox medical community
but could in the future play an important role in overall medical
diagnosis and treatment.


...I get the impression that what douglas is interested in is
anything but straightforward.


-- cary

(unless, of course, you're "discerning" and can thus transcend
mere consideration of objective facts)

douglas

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Aug 8, 2008, 7:37:52 PM8/8/08
to
> guide work up at all. Sorry.- Hide quoted text -

>
> - Show quoted text -

Yeah, I guessed that. Though I don't see how it doesn't help decision
making...

Truth

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Aug 8, 2008, 7:57:16 PM8/8/08
to
On Aug 8, 4:14 pm, c...@afone.as.arizona.edu (Cary Kittrell) wrote:
> mere consideration of objective facts)- Hide quoted text -

>
> - Show quoted text -

Cary, he's a 17-year-old undergrad who is considering studying
medicine.

Truth

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Aug 8, 2008, 8:01:00 PM8/8/08
to
> making...- Hide quoted text -

>
> - Show quoted text -

You may find the Jerome Groopman, MD book, "How Doctors Think"
interesting. It's in paperback and it is written with a non-medical
audience in mind.

douglas

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Aug 8, 2008, 8:27:12 PM8/8/08
to
> audience in mind.- Hide quoted text -

>
> - Show quoted text -

I'll look for it. And, "considering" is a bit weak of a word.

Andrew B. Chung, MD/PhD

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Aug 8, 2008, 11:37:02 PM8/8/08
to
convicted neighbor Douglas (Protoman) wrote:
>
> Is this the way an general internist diagnoses a cardiologic problem:

Couple of comments:

(1) An Internist is actually a specialist in Internal Medicine (IM)
and not a General Practitioner (ie GP).

(2) Cardiac patients have one or more cardiac problem(s) and not
"cardiologic" problem(s).

> 1. Review patient's chart and take a thorough history

Wiser to start with an engaging heartfelt smile, warm greetings,
introductions, and a firm hand-shake in order to set the patient at
ease by earning his/her trust.

If you do not earn a patient's trust, your history-taking will fall
far short of being thorough.

Interviewing the patient is a practiced art and allows a discerning
physician to easily learn much more about his/her patient than either
the physical exam and/or testing. In this way, a discerning doctor is
easily 99% certain of the diagnoses from the outset. The physical exam
and/or testing simply serve to confirm the diagnoses allowing us, who
are discerning, to become 100% certain of the diagnoses so that an
effective treatment plan can be confidently recommended.

May you and other dear neighbors, friends, and brethren have a
blessedly wonderful 2008th year since the birth of our LORD Jesus
Christ as our Messiah, the Son of Man ...

... by being hungrier:

http://groups.google.com/group/sci.med.cardiology/msg/f891e617d10bd689?

Hunger is wonderful ! ! !

It's how we know what GOD desires, which is all that is good.

Yes, hunger is our knowledge of good versus evil that Adam and Eve
paid for with their and our immortal lives.

"Blessed are you who hunger NOW...

... for you will be satisfied." -- LORD Jesus Christ (Luke 6:21)

Amen.

Here is a Spirit-guided exegesis of Luke 6:21 given in hopes of
promoting much greater understanding:

http://groups.google.com/group/sci.med.cardiology/msg/cc2aa8f8a4d41360?

Be hungrier, which is healthier.

Marana tha

Prayerfully in the awesome name of our Messiah, LORD Jesus Christ,

Andrew <><
--
http://groups.google.com/group/sci.med.cardiology/msg/3558812d72ab4e17?

douglas

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Aug 9, 2008, 12:07:34 AM8/9/08
to
On Aug 8, 8:37 pm, "Andrew B. Chung, MD/PhD" <lov...@thetruth.com>
wrote:

That's what I meant by step 1.

Andrew B. Chung, MD/PhD

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Aug 9, 2008, 8:18:17 AM8/9/08
to
convicted neighbor Douglas (Protoman) wrote:
> Andrew, in the Holy Spirit, boldly wrote:
> > convicted neighbor Douglas (Protoman) wrote:
> >
> > > Is this the way an general internist diagnoses a cardiologic problem:
> >
> > Couple of comments:
> >
> > (1) An Internist is actually a specialist in Internal Medicine (IM)
> > and not a General Practitioner (ie GP).
> >
> > (2) Cardiac patients have one or more cardiac problem(s) and not
> > "cardiologic" problem(s).
> >
> > > 1. Review patient's chart and take a thorough history
> >
> > Wiser to start with an engaging heartfelt smile, warm greetings,
> > introductions, and a firm hand-shake in order to set the patient at
> > ease by earning his/her trust.
> >
> > If you do not earn a patient's trust, your history-taking will fall
> > far short of being thorough.
> >
> > Interviewing the patient is a practiced art and allows a discerning
> > physician to easily learn much more about his/her patient than either
> > the physical exam and/or testing. In this way, a discerning doctor is
> > easily 99% certain of the diagnoses from the outset. The physical exam
> > and/or testing simply serve to confirm the diagnoses allowing us, who
> > are discerning, to become 100% certain of the diagnoses so that an
> > effective treatment plan can be confidently recommended.
>
> That's what I meant by step 1.

What the Holy Spirit guided me to write is not a step in an algorithm.

If you wish to receive more insight in what is required to become a
good physician, consider contacting me through the HeartMDPhD web
site.

The purpose of the stringent medical school selection process is to
choose those who have the greatest potential to become good physicians
because we already have too many bad ones as evident by Ms. Laura
Stanbery's experience.

You have my apologies for your being distracted by the legion of
sockpuppets despairingly flitting about in panic because of the light
of the truth, Who is LORD Jesus Christ, emanating from my heart.

May we, who are Christians (either Jew or gentile), continue to pray
for your endangered soul, dear Douglas:

http://groups.google.com/group/sci.med.cardiology/msg/89cf71a93338e7d0?

Prayerfully in the awesome name of our Messiah, LORD Jesus Christ,

Andrew <><
--
http://groups.google.com/group/sci.med.cardiology/msg/4128be9f9918d825?

Thom Madura

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Aug 9, 2008, 9:38:22 AM8/9/08
to

Incorrect

Neither you nor any theist has ever proven in any testable and
repeatable way that any religious god has ever existed - does exist - or
even will exist in the future.

AS a person of science - unsupportable beliefs aside - you KNOW that to
be true and cannot argue.

Therefore - you cannot say that an god has guided you - the best you can
say is that you BELIEVE that.

WHy do theists eschew the truth?

J A

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Aug 9, 2008, 12:24:18 PM8/9/08
to
Douglas, I think that what you're you're thinking about, is using AI
(artificial intelligence) on medical data, which most MD's instinctively
dislike, for a mix of good and bad reasons. The type of AI you're thinking
about is of an "expert system" type, versus neural nets or GA's, etc.

Whether MD's like it or not, AI has a place in medicine, and if you go into
medicine, you'll be a leg up if you become acquainted with AI.

As for Chung, the only "intelligence" he has left is from imaginery voices
in his head that he thinks are coming from supernatural beings.


"douglas" <Protom...@gmail.com> wrote in message
news:4203bb81-91fd-4794...@w24g2000prd.googlegroups.com...

douglas

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Aug 9, 2008, 4:12:49 PM8/9/08
to
On Aug 9, 9:24 am, "J A" <a...@re.com> wrote:
> Douglas, I think that what you're you're thinking about, is using AI
> (artificial intelligence) on medical data, which most MD's instinctively
> dislike, for a mix of good and bad reasons. The type of AI you're thinking
> about is of an "expert system" type, versus neural nets or GA's, etc.
>
> Whether MD's like it or not, AI has a place in medicine, and if you go into
> medicine, you'll be a leg up if you become acquainted with AI.
>
> As for Chung, the only "intelligence" he has left is from imaginery voices
> in his head that he thinks are coming from supernatural beings.
>
> "douglas" <Protoman2...@gmail.com> wrote in message
> That's what I meant by step 1.- Hide quoted text -

>
> - Show quoted text -

I didn't mean to use AI blindly, I meant for it to be used as a basic
guide, like a general overview of where the problem might lie. I
wouldn't want a computer doing brain or heart surgery on me w/o a
neuro-/cardiac surgeon guiding it. Even I don't think I'd use this
mechanically. I have a brain too.

douglas

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Aug 9, 2008, 5:35:15 PM8/9/08
to
On Aug 9, 9:24 am, "J A" <a...@re.com> wrote:
> Douglas, I think that what you're you're thinking about, is using AI
> (artificial intelligence) on medical data, which most MD's instinctively
> dislike, for a mix of good and bad reasons. The type of AI you're thinking
> about is of an "expert system" type, versus neural nets or GA's, etc.
>
> Whether MD's like it or not, AI has a place in medicine, and if you go into
> medicine, you'll be a leg up if you become acquainted with AI.
>
> As for Chung, the only "intelligence" he has left is from imaginery voices
> in his head that he thinks are coming from supernatural beings.
>
> "douglas" <Protoman2...@gmail.com> wrote in message
> That's what I meant by step 1.- Hide quoted text -
>
> - Show quoted text -

I'd, along w/ my computer scientist friend, write a neural net to
assist me in evaluating patients, and use the neural net's diagnosis
as a starting point. As in plug in the results from my tests like the
echo and magnetocardiogram, as well as the patient's history and the
results of the physical examination, and have it list a range of
diseases the patient could be suffering from, and figure out either
what test needs to be done next, or possible treatments. Is this what
they use neural nets in medicine for? If this is wrong, how should I
use a neural net in cardiology?

Maybe, once the neural net is well learned, I could devote most of my
time to EP procedures, patient contact, and research, rather than
hours in the library.

J A

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Aug 9, 2008, 7:19:15 PM8/9/08
to

"douglas" <Protom...@gmail.com> wrote in message
news:f331a87c-291b-4768...@a2g2000prm.googlegroups.com...

It might channel you up the wrong path.

> As in plug in the results from my tests like the
echo and magnetocardiogram, as well as the patient's history and the
results of the physical examination, and have it list a range of
diseases the patient could be suffering from, and figure out either
what test needs to be done next, or possible treatments. Is this what
they use neural nets in medicine for? If this is wrong, how should I
use a neural net in cardiology?

Maybe, once the neural net is well learned, I could devote most of my
time to EP procedures, patient contact, and research, rather than
hours in the library.
<


Trained neural nets have a habit giving very good apparent results over the
training set, then failing badly when new cases it hasn't seen are
submitted. Keep that in mind.

Genetic algorythms *might* be more reliable. THe thing is, for any self
training AI method, you would need a VERY large database (100's or 1000's)
of many diverse patients / problems, to even have a hope of a reliable
predictive results.

I don't know it that's realistic. If you could get it, it would fun to apply
the results in comparison to cardiologists diagnosis and outcomes.

The problem is, all the MD's will hate you, becasue they'll see you as
somebody who wants to replace them with a black box. ;-))

Good luck.

If you

douglas

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Aug 9, 2008, 7:35:48 PM8/9/08
to
> If you- Hide quoted text -

>
> - Show quoted text -

I'd use breeder genetic programming to train and optimize the
architecture of the NN, like these guys:
http://citeseerx.ist.psu.edu/viewdoc/summary?doi=10.1.1.47.9891

I'll input every single case I've seen, plus my colleagues' cases, and
journal case reports. Then, I'd do a triple-blind study comparing it's
effectiveness compared to eight top cardiologists, one from the Mayo
Clinic, one from Johns Hopkins, one from MGH, one from UCLA, one from
the Cleveland Clinic, one from Heidelberg, one from Oxford Radcliffe,
and one from the Amrita Institute of Medical Sciences. Test them on
complicated simulated patients using the Mayo Clinic's simulated
patient training thingy. Loser is punished w/ perpetual infamy, and
gets fired.

If it wins, I'll sell it to hospitals, and use it to propose
diagnoses, tests, and treatment possibilities for review by the
cardiologist.

What should it be called? CardioDDX?

Andrew B. Chung, MD/PhD

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Aug 9, 2008, 10:01:54 PM8/9/08
to

douglas

unread,
Aug 9, 2008, 10:40:15 PM8/9/08
to

Andrew B. Chung, MD/PhD

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Aug 9, 2008, 10:46:48 PM8/9/08
to
convicted neighbor Douglas wrote:
> Andrew, in the Holy Spirit, boldly wrote:
>
> > http://groups.google.com/group/sci.med.cardiology/msg/3bfe03c8cfe7027c
> >
>
> Go to Hell Chung!

Instead of doing that, it remains my personal choice to continue to
pray for your perishing soul, dear Douglas:

http://groups.google.com/group/sci.med.cardiology/msg/89cf71a93338e7d0?

Prayerfully in the awesome name of our Messiah, LORD Jesus Christ,

Andrew <><
--
http://groups.google.com/group/sci.med.cardiology/msg/4128be9f9918d825?

douglas

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Aug 10, 2008, 4:48:52 PM8/10/08
to
On Aug 9, 7:46 pm, "Andrew B. Chung, MD/PhD" <lov...@thetruth.com>
wrote:

I AM A PROTESTANT CHRISTIAN....YOUR SPEEL IS MEANINGLESS

Now, would anyone here like to respond to my last post about a neural
network being trained using breeder genetic programming, being used in
cardiology?

J A

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Aug 10, 2008, 6:02:30 PM8/10/08
to

"douglas" <Protom...@gmail.com> wrote in message
news:29273b71-a849-437f...@v26g2000prm.googlegroups.com...

Blessed be the AI training that keeps things as simple as possible, and is
similarly blessed with a large database of blessedly diverse cases.

Then, pray to Athon (with a long "A", lord of rational thinking) that the
thing doesn't blowup when applied to out of training set data.

Andrew B. Chung, MD/PhD

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Aug 10, 2008, 6:13:21 PM8/10/08
to
convicted neighbor douglas wrote:
> Andrew, in the Holy Spirit, boldly wrote:
> > convicted neighbor Douglas wrote:
> > > Andrew, in the Holy Spirit, boldly wrote:
> >
> > > >http://groups.google.com/group/sci.med.cardiology/msg/3bfe03c8cfe7027c
> >
> > > Go to Hell Chung!
> >
> > Instead of doing that, it remains my personal choice to continue to
> > pray for your perishing soul, dear Douglas:
>
> I AM A PROTESTANT CHRISTIAN....YOUR SPEEL IS MEANINGLESS

Prayer is not a "speel" (sp)

Bottom line concerning your difficulties:

http://groups.google.com/group/sci.med.cardiology/msg/3bfe03c8cfe7027c?

May we, who are Christians (either Jew or gentile), continue to pray

douglas

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Aug 10, 2008, 8:53:23 PM8/10/08
to
On Aug 10, 3:13 pm, "Andrew B. Chung, MD/PhD" <lov...@thetruth.com>
wrote:

YOU'RE A BROKEN RECORD....YOUR WORDS HAVE NO EFFECT. WHATEVER "HOLY
SPIRIT" YOU BELIEVE IN IS NOT THE HOLY SPIRIT OF GOD ALMIGHTY

Andrew B. Chung, MD/PhD

unread,
Aug 11, 2008, 3:35:52 AM8/11/08
to
convicted neighbor Douglas (Protoman) wrote:
> Andrew, in the Holy Spirit, boldly wrote:
> > convicted neighbor Douglas wrote:
> > > Andrew, in the Holy Spirit, boldly wrote:
> > > > convicted neighbor Douglas wrote:
> > > > > Andrew, in the Holy Spirit, boldly wrote:
> >
> > > > > >http://groups.google.com/group/sci.med.cardiology/msg/3bfe03c8cfe7027c
> >
> > > > > Go to Hell Chung!
> >
> > > > Instead of doing that, it remains my personal choice to continue to
> > > > pray for your perishing soul, dear Douglas:
> >
> > > I AM A PROTESTANT CHRISTIAN....YOUR SPEEL IS MEANINGLESS
> >
> > Prayer is not a "speel" (sp)
> >
> > Bottom line concerning your difficulties:
> >
> > http://groups.google.com/group/sci.med.cardiology/msg/3bfe03c8cfe7027c?
> >
> > May we, who are Christians (either Jew or gentile), continue to pray
> > for your perishing soul, dear Douglas:
> >
> > http://groups.google.com/group/sci.med.cardiology/msg/89cf71a93338e7d0?
> >
> > Prayerfully in the awesome name of our Messiah, LORD Jesus Christ,
> >
> > Andrew <><
>
> YOU'RE A BROKEN RECORD....

Incorrect.

Remain a licensed board-certified cardiologist seeing patients in
Georgia.

Laus Deo :-)

> YOUR WORDS HAVE NO EFFECT.

Indeed, it is GOD's words that have affected you.

> WHATEVER "HOLY
> SPIRIT" YOU BELIEVE IN IS NOT THE HOLY SPIRIT OF GOD ALMIGHTY

The Holy Spirit is GOD:

http://groups.google.com/group/sci.med.cardiology/msg/c66a235b804e5aa3?

All those who have blasphemed against Him will never be forgiven:

http://groups.google.com/group/sci.med.cardiology/msg/ee019444a6840972?

<><

http://groups.google.com/group/sci.med.cardiology/msg/6c309b33d4c75613?

Cary Kittrell

unread,
Aug 11, 2008, 1:20:21 PM8/11/08
to
In article <f2b659c2-cbb5-4658...@b1g2000hsg.googlegroups.com> "Andrew B. Chung, MD/PhD" <lov...@thetruth.com> writes:
> convicted neighbor Douglas (Protoman) wrote:
> > Andrew, in the Holy Spirit, boldly wrote:
> > > convicted neighbor Douglas wrote:
> > > > Andrew, in the Holy Spirit, boldly wrote:
> > > > > convicted neighbor Douglas wrote:
> > > > > > Andrew, in the Holy Spirit, boldly wrote:
> > >
> > > > > > >http://groups.google.com/group/sci.med.cardiology/msg/3bfe03c8cfe7027c
> > >
> > > > > > Go to Hell Chung!
> > >
> > > > > Instead of doing that, it remains my personal choice to continue to
> > > > > pray for your perishing soul, dear Douglas:
> > >
> > > > I AM A PROTESTANT CHRISTIAN....YOUR SPEEL IS MEANINGLESS
> > >
> > > Prayer is not a "speel" (sp)
> > >
> > > Bottom line concerning your difficulties:
> > >
> > > http://groups.google.com/group/sci.med.cardiology/msg/3bfe03c8cfe7027c?
> > >
> > > May we, who are Christians (either Jew or gentile), continue to pray
> > > for your perishing soul, dear Douglas:
> > >
> > > http://groups.google.com/group/sci.med.cardiology/msg/89cf71a93338e7d0?
> > >
> > > Prayerfully in the awesome name of our Messiah, LORD Jesus Christ,
> > >
> > > Andrew <><
> >
> > YOU'RE A BROKEN RECORD....
>
> Incorrect.
>
> Remain a licensed board-certified cardiologist seeing patients in
> Georgia.

And I see patients every day in Tucson.

So what?


-- cary

Andrew B. Chung, MD/PhD

unread,
Aug 11, 2008, 8:48:35 PM8/11/08
to

Cary Kittrell

unread,
Aug 11, 2008, 9:23:08 PM8/11/08
to

While you seemingly are unable to comprehend a simple question.

Or perhaps just too intimidated to attempt an answser...


-- cary

>
> http://groups.google.com/group/sci.med.cardiology/msg/773bdee360f7775e?
>
> <><
>
> http://groups.google.com/group/sci.med.cardiology/msg/4128be9f9918d825?


Andrew B. Chung, MD/PhD

unread,
Aug 11, 2008, 10:06:55 PM8/11/08
to
convicted neighbor Cary Kittrell wrote:
> Andrew, in the Holy Spirit, boldly wrote:
> >
> > http://groups.google.com/group/sci.med.cardiology/msg/c09e2145ad197414?

>
> While you seemingly are unable to comprehend a simple question.
>
> Or perhaps just too intimidated to attempt an answser...

Bottom line concerning your difficulties:

http://groups.google.com/group/sci.med.cardiology/msg/a88f3caf4697e3e7

<><

http://groups.google.com/group/sci.med.cardiology/msg/4128be9f9918d825?

Cary Kittrell

unread,
Aug 12, 2008, 12:40:40 PM8/12/08
to
In article <38ab46a9-0832-4e96...@l42g2000hsc.googlegroups.com> "Andrew B. Chung, MD/PhD" <lov...@thetruth.com> writes:
> convicted neighbor Cary Kittrell wrote:
> > Andrew, in the Holy Spirit, boldly wrote:
> > >
> > > http://groups.google.com/group/sci.med.cardiology/msg/c09e2145ad197414?
> >
> > While you seemingly are unable to comprehend a simple question.
> >
> > Or perhaps just too intimidated to attempt an answser...
>
> Bottom line concerning your difficulties:

So, "intimidated" it is.

[ Ecclesiastes...you know the drill]

-- cary

>
> http://groups.google.com/group/sci.med.cardiology/msg/a88f3caf4697e3e7
>
> <><
>
> http://groups.google.com/group/sci.med.cardiology/msg/4128be9f9918d825?


MechaJesus

unread,
Aug 12, 2008, 2:10:51 PM8/12/08
to
On Aug 11, 3:35 am, "Andrew B. Chung, Usenet addict"

<lov...@thetruth.com> wrote:
> Remain a licensed board-certified cardiologist

...under review by the GA Composite State Board of Medical Examiners
as we speak...

> seeing patients in Georgia.

I see patients every time I walk into a *working* doctor's office, too
-- that doesn't mean *I treat* patients. And neither do you, lunatic.


Face it, Earthquack, your *entire life* revolves around Usenet. Your
practice is gone, your wife and daughter are gone, and your mind is
not far behind. Have someone check you into a psych ward (we know you
can't do it yourself -- you don't have admitting privileges at any
hospitals) before you hurt somebody with your "medical advice".

MJ

Cary Kittrell

unread,
Aug 12, 2008, 2:17:24 PM8/12/08
to
In article <6bc5d2f8-586e-4cb7...@z72g2000hsb.googlegroups.com> MechaJesus <belly...@yahoo.com> writes:
> On Aug 11, 3:35=A0am, "Andrew B. Chung, Usenet addict"

> <lov...@thetruth.com> wrote:
> > Remain a licensed board-certified cardiologist
>
> =2E..under review by the GA Composite State Board of Medical Examiners
> as we speak...

And seeing as our Andrew is singularly unwilling to tell us the
name of the alleged clinic of which he is the alleged "employer",
perhaps the Composite Board would be able to tell us this, if
we wrote and asked?


-- cary

douglas

unread,
Aug 12, 2008, 6:04:39 PM8/12/08
to
On Aug 10, 3:02 pm, "J A" <a...@re.com> wrote:
> "douglas" <Protoman2...@gmail.com> wrote in message
> thing doesn't blowup when applied to out of training set data.- Hide quoted text -

>
> - Show quoted text -

So, perhaps I should ask about this on comp.ai.neural-nets?

Andrew B. Chung, MD/PhD

unread,
Aug 12, 2008, 6:36:12 PM8/12/08
to
convicted neighbor Cary Kittrell wrote:

> And seeing as our Andrew is singularly unwilling to tell us the
> name of the alleged clinic of which he is the alleged "employer",
> perhaps the Composite Board would be able to tell us this, if
> we wrote and asked?

It is unlikely that the Medical Board would want to be party to
cyberstalking especially when they have noted that the clinic location
is passworded on the HeartMDPhD web site.

You will simply have to add this piece of knowledge to the list of the
infinite number of other things that you don't know.

Bottom line concerning your having less free will:

http://groups.google.com/group/sci.med.cardiology/msg/a88f3caf4697e3e7?

<><

http://groups.google.com/group/sci.med.cardiology/msg/f43db72a7c5c1da0?

Cary Kittrell

unread,
Aug 12, 2008, 6:54:14 PM8/12/08
to
In article <b785486c-e3df-47b3...@m36g2000hse.googlegroups.com> "Andrew B. Chung, MD/PhD" <lov...@thetruth.com> writes:
> convicted neighbor Cary Kittrell wrote:
>
> > And seeing as our Andrew is singularly unwilling to tell us the
> > name of the alleged clinic of which he is the alleged "employer",
> > perhaps the Composite Board would be able to tell us this, if
> > we wrote and asked?
>
> It is unlikely that the Medical Board would want to be party to
> cyberstalking

They doubtless { feel free to snip anywhere from here on out } would not.

However, asking an alleged physician the name of the
alleged clinic whose existence the alleged practicing
physician brought up in the first place -- and on Usenet at that --
hardly constitutes "cyberstalking".

{ don't forget your Ecclsiastes mantra }

> especially when they have noted that the clinic location
> is passworded on the HeartMDPhD web site.

Well, I suppose the only way to be certain is to try...

In any event, I have zero interest in its location.

Only in its name.


And exactly how will Andrew evade this time? Inquiring minds want to know...


-- cary

Andrew B. Chung, MD/PhD

unread,
Aug 12, 2008, 8:27:27 PM8/12/08
to
convicted neighbor Cary Kittrell wrote:
> Andrew, in the Holy Spirit, boldly wrote:
> > convicted neighbor Cary Kittrell wrote:
> >
> > > And seeing as our Andrew is singularly unwilling to tell us the
> > > name of the alleged clinic of which he is the alleged "employer",
> > > perhaps the Composite Board would be able to tell us this, if
> > > we wrote and asked?
> >
> > It is unlikely that the Medical Board would want to be party to
> > cyberstalking
>
> They doubtless { feel free to snip anywhere from here on out } would not.
>
> However, asking an alleged physician the name of the
> alleged clinic whose existence the alleged practicing
> physician brought up in the first place -- and on Usenet at that --
> hardly constitutes "cyberstalking".

Did not write that it were.

Moreover, asking bona-fide physicians the name of their clinics would
not be cyberstalking either just as their freely choosing to keep you
in ignorance would not be abuse :-)

Therefore, my keeping you in ignorance is not abuse despite your
complaints to the contrary, dear Cary (this alliteration glorifies the
Holy Spirit).

Bottom line concerning your cognitive difficulties here:

http://groups.google.com/group/sci.med.cardiology/msg/773bdee360f7775e?

<><

http://groups.google.com/group/sci.med.cardiology/msg/f43db72a7c5c1da0?

Don Kirkman

unread,
Aug 13, 2008, 2:48:33 AM8/13/08
to
It seems to me I heard somewhere that Andrew B. Chung, MD/PhD wrote in
article
<f1e6c045-2291-477f...@z72g2000hsb.googlegroups.com>:

>convicted neighbor Cary Kittrell wrote:
>> Andrew, in the Holy Spirit, boldly wrote:
>> > convicted neighbor Cary Kittrell wrote:

>> > > And seeing as our Andrew is singularly unwilling to tell us the
>> > > name of the alleged clinic of which he is the alleged "employer",
>> > > perhaps the Composite Board would be able to tell us this, if
>> > > we wrote and asked?

>> > It is unlikely that the Medical Board would want to be party to
>> > cyberstalking

>> They doubtless { feel free to snip anywhere from here on out } would not.

>> However, asking an alleged physician the name of the
>> alleged clinic whose existence the alleged practicing
>> physician brought up in the first place -- and on Usenet at that --
>> hardly constitutes "cyberstalking".

>Did not write that it were.

>Moreover, asking bona-fide physicians the name of their clinics would
>not be cyberstalking either just as their freely choosing to keep you
>in ignorance would not be abuse :-)

>Therefore, my keeping you in ignorance is not abuse despite your
>complaints to the contrary, dear Cary (this alliteration glorifies the
>Holy Spirit).

Parkway Medicine is the only name in the building Chung lists that
sounds like a clinic; it's shared by two doctors whose yellow pages
listing looks like they may be general practitioners, not
cardiologists, and that practice has a different phone number from
Chung's office. A total of four doctors have listings in the
building.
--
Don Kirkman
don...@charter.net

Andrew B. Chung, MD/PhD

unread,
Aug 13, 2008, 7:00:43 AM8/13/08
to

Many thanks, much praise, and all the glory to GOD for His compellinig
you to unwittingly testify that my cardiology clinic resides in a
large office building.

Laus Deo:

http://HeartMDPhD.com/LausDeo

Bottom line concerning why you have less free will:

http://groups.google.com/group/sci.med.cardiology/msg/6c3ca11187d0eb9e?

<><

http://groups.google.com/group/sci.med.cardiology/msg/3558812d72ab4e17?

Don Kirkman

unread,
Aug 13, 2008, 7:37:52 PM8/13/08
to
It seems to me I heard somewhere that Andrew B. Chung, MD/PhD wrote in
article <sdf5a41t4mcstfmu7...@4ax.com>:

>convicted neighbor Don Kirkman <don...@charter.net> wrote:
>>Andrew, in the Holy Spirit, boldly wrote:
>>>convicted neighbor Cary Kittrell wrote:
>>>> Andrew, in the Holy Spirit, boldly wrote:
>>>> > convicted neighbor Cary Kittrell wrote:

>>>> > > And seeing as our Andrew is singularly unwilling to tell us the
>>>> > > name of the alleged clinic of which he is the alleged "employer",
>>>> > > perhaps the Composite Board would be able to tell us this, if
>>>> > > we wrote and asked?

[. . .]

>>>Moreover, asking bona-fide physicians the name of their clinics would
>>>not be cyberstalking either just as their freely choosing to keep you
>>>in ignorance would not be abuse :-)

>>Parkway Medicine is the only name in the building Chung lists that


>>sounds like a clinic; it's shared by two doctors whose yellow pages
>>listing looks like they may be general practitioners, not
>>cardiologists, and that practice has a different phone number from
>>Chung's office. A total of four doctors have listings in the
>>building.

>Many thanks, much praise, and all the glory to GOD for His compellinig
>you to unwittingly testify that my cardiology clinic resides in a
>large office building.

There is neither thanks, praise, nor glory involved because as is your
wont you added things that I never said. I did not say you have a
cardiology clinic; I only mentioned an office, not "cardiology" or
"clinic." "Practice" and "clinic" typically connote something much
more substantial than an office; they imply a number of practitioners.

And nowhere did I say it is a large office building; I neither
mentioned "large" nor "office building." Since I only mentioned four
doctors, two of whom share space, one could reasonably assume the
building has only three or four office suites.

Simple it may be, but truth comes very hard for you.

He who is false in small matters cannot be trusted in large matters.

--
Don Kirkman
don...@charter.net

Andrew B. Chung, MD/PhD

unread,
Aug 13, 2008, 11:29:41 PM8/13/08
to

It remains my choice to give many thanks, much praise, and all the
glory to GOD for His compelling you to unwittingly provide written
testimony that you know that there is indeed a "building Chung lists
that sounds like a clinic."

Laus Deo :-)

Bottom line concerning your having less free will:

http://groups.google.com/group/sci.med.cardiology/msg/6c3ca11187d0eb9e?

<><

http://groups.google.com/group/sci.med.cardiology/msg/f43db72a7c5c1da0?

Don Kirkman

unread,
Aug 14, 2008, 2:21:13 AM8/14/08
to
It seems to me I heard somewhere that Andrew B. Chung, MD/PhD wrote in
article
<1e8712f4-fce3-4fb8...@m45g2000hsb.googlegroups.com>:

>> [. . .]

You lie so easily you probably don't even know you're doing it. You
left the full sentence I wrote intact above yet you change it into a
lie in what you wrote. The original does not say there is a building
that sounds like a clinic, but a practice/office that does: "Parkway


Medicine is the only name in the building Chung lists that sounds like

a clinic."
--
Don Kirkman
don...@charter.net

Andrew B. Chung, MD/PhD

unread,
Aug 14, 2008, 6:52:25 AM8/14/08
to

It remains my choice to continue writing truthfully.

Sadly the same can not be truthfully written about you.

Bottom line concerning the direction you have been taking:

http://groups.google.com/group/sci.med.cardiology/msg/9c5c55fcace06864?

Truth

unread,
Aug 14, 2008, 9:23:48 AM8/14/08
to
On Aug 14, 3:52 am, "Andrew B. Chung, MD/PhD" <lo...@thetruth.com>

wrote:
> convicted neighbor Don Kirkman wrote:
>
>
>
> > Andrew, in the Holy Spirit, boldly wrote:
> > >convicted neighbor Don Kirkman wrote:
> > >> Andrew, in the Holy Spirit, boldly wrote:


Chung, How many patients do you see / treat in an average week? How
many people come into your office, get examined and interviewed, have
a chart established and then pay you for your services? Are you on a
cash-only basis? Do you accept Medicare? Medicaid? What insurances do
you accept? Who is your malpractice carrier? What do you do when
patients need echos or stress tests or angiograms? What group of
cardiologists do you then refer to and in which hospitals? How many
ancillary staff work with you? Do you have a medical assistant? A
receptionist? Full time?

Answer truthfully, without evasive, wiggle, ostrich maneuvers.


Cary Kittrell

unread,
Aug 14, 2008, 12:45:45 PM8/14/08
to
Don Kirkman <don...@charter.net>

No doubt due to the same activity that's the answer to the
old joke "How do I get to Carnegie Hall from here?"...


-- cary

Andrew B. Chung, MD/PhD

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Aug 15, 2008, 2:51:35 AM8/15/08
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