I wasted $40k on a fantastic startup idea

I'm kind of concerned that people read this as satire but miss the most important part, namely the absence of concern about the safety and validity of the results. You know, the part where he stuck some statistical software in front of a database populated by a "motley crew" of contractors and wanted doctors to use it as a shortcut for making patient care decisions. The part where he implicitly compares the HTML spit out by his system to peer-reviewed work by professional researchers. The part where he is proud of "beating" a "record" for least discriminating meta-analysis.

Reading this story and talking about his marketing and product development process feels like watching Lovecraft Country and then then only talking about the time travel physics of it. There's something real and awful here, hopefully presented in a fictionalized or highly exaggerated form. The people in my social circles who mistrust tech and despise startup culture -- this is exactly how they see us.

But... this is peer-reviewed work by professional researchers[1]. He just tabulated them / made them searchable.

[1] Given the reproducibility crisis, I'm not sure we should trust these much either, but that's a discussion for another time.

Is his meta-analysis or its methodology peer-reviewed work by professional researchers? Has any suitably qualified professional reviewed his output?

You are on point. For common diseases there are guidelines manually created and periodically updated by 40 doctors. Doctors should just use the last updated protocol for easy decisions.

Even though for headache this is the recommended first line medication:

Ibuprofen 400 mg, ASA 1000 mg, naproxen sodium 500–550 mg, acetaminophen 1000 mg

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4541429/#!po=0....

No, he did, by his own words, a network meta-analysis[1] on the results which combined the results of many studies into a single table. However this was not a mere tabulation or summary of existing results but a fairly involved statistical aggregation of results. In scientific literature this would merit it's own publication and peer-review.

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5386629/

Yeah ... I was actually thinking he may have dodged a bullet because if he got any further with this he could have gotten on the end of a law suit or getting shutdown and / or fined by the FDA if things went the wrong way.

I'm kind of concerned that our gold standard in medical practice is "this needs to work for everybody". We should really be more intent on doing personalized medicine.

They're already searchable. He's claiming to extract usable information from them in a way that can be instantly used by doctors, so that they don't have to read the studies or find an up-to-date summary of the literature by a skilled professional.

He even called what his software did a meta-analysis. My understanding is limited, but a meta-analysis is difficult and laborious to do correctly. You have to design the standards you use to include and exclude studies and examine each study to decide whether including it will improve or harm the quality of your results. For example, maybe a method to evaluate outcomes that used to be common has been discredited. Maybe a study was done under a principal researcher who has been caught fabricating results in other studies. Maybe a study claims to be double-blind, but when you read it carefully, it turns out that it isn't. Maybe a study is well-designed in every way, but it was designed for a slightly different purpose, so the data can't be used the way you want to.

Factors like these result in the exclusion of a lot of studies from a meta-analysis, after painstaking examination by researchers who have the expertise to design and run the studies they're reading. It's scientifically difficult and important work. The author is bragging about not doing this work:

> On July 2, 2018, GlacierMD powered the world's largest depression meta-analysis, using data from 846 trials, beating Cipriani's previous record of 522.

That's for migraines, not general headaches.

For both in case it’s acute...table 2 and 3 starts the same :) (I was lucky though, I didn’t check)

The reason it takes so long to become a physician is because they have to tailor treatments to specific patients. Guidelines are there to help them make decisions.