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Stopping Unnecessary Tests Empty Stopping Unnecessary Tests

on Sun Nov 04, 2018 6:52 am
A troubling trend I've been noticing with the doctor AI is that even when the disease is at 100% the AI won't choose it and then choose the treatment. Instead they keep sending them to more un needed lab tests that take FOREVER and at the end of the day they go untreated and I lose prestige.
This wouldn't be so bad if you were payed by the test but it leads to insane micro to keep departments moving and making sure patients get diagnosed and not milling about waiting for a urine, stool, blood, etc test all at the same time.

Can I turn off other tests after the disease/issue is found or is it just an AI issue?
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Stopping Unnecessary Tests Empty Re: Stopping Unnecessary Tests

on Sun Nov 04, 2018 11:53 am
Try changing certainty level to medium.
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Stopping Unnecessary Tests Empty Re: Stopping Unnecessary Tests

on Mon Nov 05, 2018 12:19 am
I do have it on medium currently, would it be worth it to try it on low?
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Stopping Unnecessary Tests Empty Re: Stopping Unnecessary Tests

on Mon Nov 05, 2018 10:45 am
x85mkx wrote:Try changing certainty level to medium.

Where do you do that?
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Stopping Unnecessary Tests Empty Re: Stopping Unnecessary Tests

on Mon Nov 05, 2018 3:52 pm
You can change the certainty on the department overview. Click on the department icon in the botom left; and in the panel on the left hand side you'll see a certainty circle. It's on medium by default, but you can change it by clicking on the circle (medium > high > low).
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Stopping Unnecessary Tests Empty Re: Stopping Unnecessary Tests

on Mon Nov 05, 2018 4:25 pm
Ok thanks!
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Stopping Unnecessary Tests Empty Re: Stopping Unnecessary Tests

on Thu Nov 08, 2018 8:09 pm
I havn't seen that kind of behavior. What I have seen is that doctors will queue up a couple lab tests at the same time and then the first test confirms a diagnosis but the patient still has to wait until his other test results are in before the doctor will see him again. And the only way for a diagnosis to be "slotted" is during a doctors appointment.

Additionally, even after the diagnosis has been selected, doctors will sometimes attempt to find symptoms that the patient is complaining about (you can see these if you mouse over patient satisfaction. It will say "Unknown Symptom -") Indicating a negative satisfaction modifier.

What will also happen is that doctors will schedule a physical examination for ward patients in at the start of the day (not exactly sure how they decide to do this), or after a surgery. I have personally canceled these post surgery examinations before only for the patients to then spawn a complication and me being unable to reschedule the examination. This means the patients will sometimes bleed all over the hospital and I can't do anything to stop it until a nurse rolls their examination check well enough during checkup, or the day shift arrives and spawns these examinations I mentioned.
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Stopping Unnecessary Tests Empty Re: Stopping Unnecessary Tests

on Sat Nov 10, 2018 6:56 pm
Yeh I fid it annoying when a dr orders tests late in the day because you know the patient is going to end up going home untreated. Or I find patients with a fungal nail infection in the ward too which is ridiculous.
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Stopping Unnecessary Tests Empty Re: Stopping Unnecessary Tests

on Sat Nov 10, 2018 7:39 pm
The AI often seems to prescribe tests in batches, which sometimes leads to situations where the 1st few results pinpoint the illness 100% but the other tests that are still queued up are going to be performed anyway before seeing the doctor again for a treatment. You can cancel the tests after the illness is diagnosed 100% and assign treatment but as you say, this leads to very high micromanagement.

There's also the issue of certainty. Currently certainty doesn't seem to relate to accurately pinpointing the illness, but uncovering a certain % of all symptoms. At high certainty the doctors will be running tests to uncover every single symptom before deciding the illness and giving a cure, at medium certainty they will ignore a few hidden symptoms when an illness is already found. Sometimes that leads to miss-diagnosis. It can also lead to AI ignoring hidden critical symptoms that can lead to a collapse if a high enough % of the symptoms have been revealed when not using high certainty.

At the very least I would like to see AI, no matter the certainty level selected, always do everything they can to discover a hidden critical symptom.


Last edited by Soylent on Sun Nov 11, 2018 12:33 am; edited 1 time in total
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Stopping Unnecessary Tests Empty Re: Stopping Unnecessary Tests

on Sun Nov 11, 2018 12:29 am
The department settings "low medium high" are for the symptom severity I think. That means at medium setting doctors will keep looking to uncover symptoms that have medium severity and then attempt to treat them. I'm not sure if they can see the severity of the hidden symptoms, try to infer the severity based on other symptoms or will always try to uncover every symptom and then only treat them if they're at least medium. But that's what the setting does.

From what I have seen in my surgery and orthopedic departments, if a patient is diagnosed with a condition, but the symptom for that condition hasn't been revealed (damaged organ showing up on a CT scan, or a broken bone showing up on an X-Ray) they will always keep looking for that symptom even if it's the only one that isn't uncovered, and even if it's not required to be able to treat them. That's on medium setting.
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Stopping Unnecessary Tests Empty Re: Stopping Unnecessary Tests

on Sun Nov 11, 2018 1:43 pm
Presumably the patient themselves reveals the symptoms they are aware of, so a doctor wouldn't ignore something bothersome like pain. But a doctor doesn't know whether or not you have hidden symptoms until they decide to run some tests. So if they run the wrong tests to start with and they come back negative, you might never get the right diagnosis, instead being sent home for being a hypochondriac, along with your 7 hidden symptoms.
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Stopping Unnecessary Tests Empty Re: Stopping Unnecessary Tests

on Sun Nov 11, 2018 8:57 pm
I looked at it a little more. The game actually tells you directly that patients with low threat conditions will skip the reception.
On patients that go to the reception the reception nurse will actually reveal symptoms. Based on her reception skill I assume. So having a good reception nurse can save your doctors some time.

Also, I noticed that if a patient has a symptom with a negative modifier (if you mouse over their satisfaction it will tell you "Unknown -") the doctors will try to look for it after the diagnosis is already clear.
I was wrong about how the department treatment certainty works after all. It only affects how likely a wrong diagnosis is and how much time doctors spent on tests to make sure they don't pick a wrong diagnosis (which is probably caused by low diagnosis skills).
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Stopping Unnecessary Tests Empty Re: Stopping Unnecessary Tests

on Wed Nov 14, 2018 11:34 am
Well to put it mildly lab tests do take forever. A singe bacterial culture takes around 48 - 72 hours in the best case scenario. There are rapid tests but the equipment can be as expensive as a CT.

If you have the certainty level set high they are probably exploring the patient to find out the remaining hidden symptoms. This is common practice IRL as it lets the doctor prescribe the best treatment and it ensures that the diagnosis is 100% correct.

If you have inexperienced doctor and a lab this would another common practice called "shotgunning" this involves the doctor using the lab quite heavily in order to get to the diagnosis , it's expensive and it's a stopgap measure but it saves lives and doctor time in the absence of experienced doctors.

So the AI behaves 100% correct.
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Stopping Unnecessary Tests Empty Re: Stopping Unnecessary Tests

on Wed Nov 14, 2018 11:56 am
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So the AI behaves 100% correct.


Because in real life when you go to the hospital and the doctor is already 100% sure it's just a cold, but you don't show all the symtoms. he still orders all posible tests just to be sure you don't have the other symptoms What a Face


IRL If a doctor orders to many unnessairy tests without a good explanation, the head of department will very quickly withdraw the authorisation of that doctor to order these tests. Such a doctor will have to discuss these tests with his/her mentor before they will be done.
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Stopping Unnecessary Tests Empty Re: Stopping Unnecessary Tests

on Wed Nov 14, 2018 5:25 pm
Doctors in Wards will frequently schedule tests for patients that are already treated. Thinks like biopsies. I guess they want to make sure the 100% sure diagnosis is 120% sure or something. This is on medium as well.

Patient has all the symptoms revealed for a organ damage, but you don't have a CT to get "organ is damaged" symptom? You better believe the doctor will use every single diagnosis available to try finding that "high" symptom.

Clinic patient has a 100% diagnosis of a condition and the doctor automatically prescribes the treatment for it but there's some hidden symptoms left? Better give the patient a stool sample for the way home.
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Stopping Unnecessary Tests Empty Re: Stopping Unnecessary Tests

on Wed Nov 14, 2018 9:43 pm
Maybe i see this occur when the patient has any hidden symptom and doctor want to reveal it, although when diagnosis is 100% sure.
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Stopping Unnecessary Tests Empty Re: Stopping Unnecessary Tests

on Tue Dec 04, 2018 7:59 am
I have also seen this, and I agree with original poster. There are some arguments that the doctors try to make sure and blah blah. Point is, totally unnecessary test are often run after positive diagnoses, for mundane conditions.
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