I believe in any suit of misdiagnosis, proving negligence is a big part of it. You have to show that the Dr was negligent in his or her diagnosis. Now if a Drs has done all the right steps such a take a proper history, listened to the chest, done scans I think it would be very difficult to prove negligence. Just because there is a ResAPP wouldn't necessary automate negligence if it wasn't used, just as long as there is strong proof the Dr acted appropriate and within what his or her peers would do. Now maybe in 20 years, using ResAPP or maybe some other technology will be so mainstream that NOT using the app will be considered negligent, but definitely not in the foreseeable future.
As with any test, there is a sensitivity and specificity. The Gold Standard is the most reliable test (as indicated by the sensitivity and specificity). The Gold Standard for lung infections is sputum sample and growing out a bug on culture. According to this literature (
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3065928/) the Gold Standard clinically is in fact a boring, cheap old Chest XRay. Now we obviously don't culture everybody's sputum, because that's costly and onerous . And although it is the Gold Standard even when we misdiagnose we aren't considered negligent even if we haven't culture sputum. Why? Because we can prove we have acted within reasonable standards by other means.
On the flip side, if we were to diagnose or misdiagnose a chest infection based solely off ResAPP we would be considered negligent. Why? Because you should never diagnose ANYTHING off one test only. The claimants lawyer would grill you on the specificity of ResAPP "didn't you know that ResAPP had a 5% chance of misdiagnosing an infection blah blah blah". We still need to use our stethoscopes and ask for Xrays, because any diagnosis needs consideration of various tests and exams. That's why ResAPP won't revolutionize clinically medicine, because lung infections are easily diagnosed with other, more reliable (Xray) modalities.
In a setting where doing things like listening to the chest or ordering Xrays is not practical or easy to do, that's where ResAPP is exciting. And if you were diagnosed with ResAPP a raging chest infection and you were crook enough... guess what? You're going to hospital for a Chest Xray and IV Antibiotics.
It's also important to remember that Xrays can do things ResAPP can't either. If you're coughing up blood, is it because of a bad case of pneumonia (which ResAPP can pick up) or is it because you have undiagnosed lung cancer that is causing obstruction and leading to a pneumonia (which you can possibly pick up on Xray). What about if you have a serious pneumonia (which ResAPP picks up) but it's so serious that you have fluid on the lungs that can potentially be more serious than the infection (which ResAPP won't pick up and a Chest Xray will). Make no mistake, Drs are going to get sued for using ResAPP too. Telehealth Drs are going to get sued to using ResAPP because they've managed to diagnose the infection or cough, but missed a more serious underlying cause that you otherwise would have picked up with traditional medical investigations. They will be sued to not being able to judge the severity of the lung infection, and possibly undertreating the infection because they haven't been able to physically see the pt. Not saying the suit will be successful, but there definitely will be cases of that.
I would give the same quote as him, just by hearing what it can do. Given the fact he's been in the RAP trials, I assume he doesn't have to pay for it? Would be interested if his opinion would change once he has to start paying for it. Often times, it's the institutions that pay for the investigation, not the individual. I don't have to pay out of my own pocket if I want to order a CXR. Similarly, I wouldn't expect nor use ResAPP if I had to pay for it myself. There are other tools I could use. You would have a difficult time convincing public health institutions to be early adopters and paying the corresponding privilege fee for my reasons given here and above.
Also, pediatrics is slightly different to adult medicine. Kids as you can imagine are harder to diagnose. They often can't give a good history like adults can. They also pick up infections that can sound and appear quite similar that adults usually wouldn't get. For once again, this tool is more useful for pediatrics.
As you can see in my disclosure, I'm bullish on this. But I'm in for the long haul. The flippers out there thinking they're gonna become billionaires overnight as big public hospitals around the world fall over themselves to use ResAPP - they're dreaming. This stock will have a few big jumps with milestones, but otherwise will be a slow and steady rise as it becomes more mainstream.
