Saturday 31 July 2021

Trading and Medicine analogy (complexity, uncertainity, technology) - Blog Series

Planned to be published in journal in coming months. This blog series can be considered a preprint and I am looking forward to inputs. 

comments from Dr. RB Sir - https://casereports.bmj.com/pages/bmj-case-reports-student-electives/

👏you are opening a new way of looking at medicine and it is just at the right place at the right time. 

Let's utilize this learning analogy to further the field of medicine 👏


RB - It's a breakthrough analogy 👏👏👏  Try reviewing the literature to see if anyone has had this analogy idea before.

Avi - Thanks a lot sir 🙏🙏 . I am having this thought since a few days that may be it becomes an educational strategy someday as checklists became from airline industry correlation.  

no such literature sir. its commonly said that trading is like medical decision making as a wrong decision may destroy whole capital(like can kill a human)... but nothing more than that.. but here the discussion is from medical perspective, there is zero literature in pubmed and i didn't find also in gray literature.

RB - It will become better than that 👏


part 1 - https://classworkdecjan.blogspot.com/2021/07/trading-and-medicine-analogy-complexity.html


part 2 - https://classworkdecjan.blogspot.com/2021/07/trading-and-medicine-analogy-complexity_31.html


part 3 - https://classworkdecjan.blogspot.com/2021/07/trading-and-medicine-analogy-complexity_61.html


part 4 - https://classworkdecjan.blogspot.com/2021/07/trading-and-medicine-analogy-complexity_54.html


part 5 - https://classworkdecjan.blogspot.com/2021/07/trading-and-medicine-analogy-complexity_49.html


part 6 - https://classworkdecjan.blogspot.com/2021/07/trading-and-medicine-analogy-complexity_56.html


part 7 - https://classworkdecjan.blogspot.com/2021/07/trading-and-medicine-analogy-complexity_83.html


part 8 - https://classworkdecjan.blogspot.com/2021/07/trading-and-medicine-analogy-complexity_28.html


part 9 - https://classworkdecjan.blogspot.com/2021/08/trading-and-medicine-analogy-complexity.html 


part 10 - https://classworkdecjan.blogspot.com/2021/08/trading-and-medicine-analogy-complexity_3.html


part 11 - https://classworkdecjan.blogspot.com/2021/08/trading-and-medicine-analogy-complexity_8.html

part 12 - the institutional structure of research and analysis of a trade and using evidence to explain and decide on the possibility for best trades. 

part 13 - 

part 14 - decision support systems

part 15 - AI - https://classworkdecjan.blogspot.com/2021/10/ai.html







Trading and Medicine analogy (complexity, uncertainity, technology) - part 8

After learning to play well with equity in various styles like scalping, intraday trading with and without heavy leverage. positional trading and swing trades, which range from low-risk low profit to high-risk high profit, i succeded managing some amount to cover my monthly expenses while also keeping my savings safe as it is. The market stabilized from the bull run and became sideways and in such case, good decisions become important as bad decisions can easily cause some money loss which is not during the case of a bull run where there is lots of freedom to make mistakes and still be in some profit (bull runs seems to be like self-healing / limiting diseases). Worst for these trading styles could be a bear (falling) market where there may be no profit and even the losses may break even with a long gap if they grow too much. There are derivatives which helps to make investments for trading in all kind of market scenarios, they are known as futures and options and they allow to make bets in both up down and range bound market to earn. Options are a very high risk money making instrument with great complexity but when utilizing its power, the real focus needs to be on a few key features like intrinsic value, delta and maybe just time decay also to some extent for practical purpose. Derivatives have more than 75% money of whole stock market of India and out of that 90% is just in the index options.

playing with derivatives, i lost 30% of capital while trying to learn, where major losses were on a single day when i made the intentional mistake of trading too aggressively with clear mind that either i will learn or leave this to may be neve do again (at least for a few years).. The day i lost 30% it was actually a 45% loss with 15% recovery, and being able to make recovery made me confident in trading with options. While option selling is the safest way and hedged option buying is some risk some profit, the option buying is the maximum and very fast profit making technique though it causes huge losses and at extreme speed.

within a week I recovered all losses and made my capital 1.5 times from what I had when started trading options.

Great success, and while options buying is said to be equivalent to gambling (can be better said as high risk high profit and uncertainty) I understood to utilize multiple factors to deal with uncertainty to some extent. What helps most in such high risk high uncertain scenarios was the real-time data, price action, and indicators.  The Price action analysis is highly subjective while indicators are objective but all indicators are derived from price itself by applying some mathematical formula and all are lagging indicators compared to the price, and having this feeling and being able to profit better with price action, now my trading screen is much cleaner and not having multiple indicators anymore, just occasionally I add one or 2. This price action seems to be equivalent to the subjective and objective status of SOAP. Subjective as the overall price action now, an hour back, yesterday, this month etc.. and objective as the current real-time status, better if more complete and with more accuracy and in a form such that can be easily grasped by mind..

Another change is using different type of candles rather than the common heiken ashi candles, depending on the need of analysis. what i am using is heiken ashi sometimes and volume candle most of the time, it helps tract the real time movement with finer view of reality to understand what is happening in the market.

While trading options there are some index heavy weights too, i track them too and they are equivalent to the heavy weight objective markers that can make drastic impact on a patients health over time or suddenly eg. SpO2 in a case of covid pneumonia.




its the tape and tape reading is frequently used for trading, their won't be zeroes but real numbers of orders floating and hence the real game of supply and demand.



My trading terminal a while back with technical indicators overload and now simple but equally enjoyable -> 









Trading and Medicine analogy (complexity, uncertainity, technology) - part 7

98% of retail investors make no profit over a duration of 1 year. 

90% traders loose 90% money in 90 days.. (Trading and investing is a lil. Different but overall just a game to Make money). 

2% who makes money, many times they are correct, evidence based, strategic, very good at managing risk, lucky, etc. (but that all are just 20% , a random) 

And rest 80% game is played by time, helping them win sooner or later.. Simple best practices help them get time more strongly in their favour. 

Good that we say EBM and whole science is 1% of knowledge, rest 99% yet to be discovered and that's where lots of good/bad (benefits and harms to patients) happen but it's mainly time game at play after applying all the little amount of deployable science we have (medical knowledge doubles every 72 days but deployable knowledge doesn't change so fast when we look both the best available evidence {1/2 goes wrong every 5 year} and available resources to help practice any among many of the best/better possible things.) 

The technology software in world for data , evidence, and analytics (Bloomberg terminal) and the best (complexity ranging from zero to 100%) techniques as quant/algo or human mind (precision) have things that are futuristic in medicine like whole environment data , or whole past data (womb to tomb) etc. Are available but as human behavior/human psychology / mass psychology / mass psychology built in into the algorithms replacing humans, affect the stock prices alot, they are not exponentially efficient to be accurate at prediciting future price, nor exponentially efficient to generate higher returns.. 


And the catch is 1) into this image below

2) into inability of all these combined together and analysed with current analytics to capture the uncertainty of human mind/life & interactions in the biosphere.




- a screenshot of best software available



Do this very low level analytics help in making time in our favour? 

- yes. Tremendously

Do simplicity win in long run

- yes. Without overcomplicating it can give decent returns and prevent big damages.



can time be an enemy too? (yes. especially when analytics is wrong. diagnosis or wrong harmful treatment may harm, and for diseases where prognosis is know to be bad as not much possible to do, then also time is enemy and in later case we may have no control)

not finding the triangle, it basically says, more advanced technique gives more reward but with more risk. so net gain is not exponentially high in general.

its very important skill to develop psychology to match with time game, else there will be again just losses/damages.


RB - 👍👏



data from the biosphere - climate, disaster, huge vessels in sea carrying cargo (metal cargo arriving at a small time frame may lead to reduce metal price in state/country).. or tesla car cargo reaching/delivering to/from some port causing possible price gain in tesla etc


all the news and their predicted impact giving buy/sell signal



technical and fundamental indicator and chart (price on chart, the most important signal)

and even news ranked in orders for helping as CDSS








correlations - (suppliers on left, the company in center and its branches below and customers on right and each having variable stake causing varying degree of impact and correlating together)




near top left (64%) -> collective intelligence, taking average of all inputs of world's best analysts.. and interesting to note none getting hundred % and rather sometime all 3 options may get equal weightage giving no decision and showing so much variability in decisions / recommendations of experts (and experts collective intelligence)


global status indicator.. combinantion of every individual trade everywhere in world in any microsecond




RB - Wow! Envision an individual health record getting updated every second globally!


Avi - could be so easy if the variety of data points were so few.. but technology may help overcome that and is already helping a lot.. we saw a glimpse of such global updating, dashboard views, and their use in prediction, planning, resource execution and various other decision making and it failed repeatedly, but not without a HUGE impact (and in some countries highly successful impact)


a cheap tool for retailers democratizing access to such cdss kind of data.. the data and evidence and analyst quality is not my point here but the access and democratization is. 

various such cheap tools to do nearly everything in the costly software to some extent if not full with some troubles may be.. commenting on accuracy won't be a good thing at my stage without having a RCT with a living meta analysis

price - The cost of a Bloomberg Terminal is $24,000 per year, and terminals are leased on a two-year basis. The price drops to $20,000 per terminal per year for 2 or more terminals. while the low cost ones are like 10-20$ per year. 

there are have social network kind of discussion facilities used globally i think, with other hedge fund managers, while for retailers there are many UDFCs (user drive finance care) networks on whatsapp telegram twitter and everywhere, world is connected.  (UDHC = user driven healthcare - https://classworkdecjan.blogspot.com/2020/01/udhc-resources.html )


market and industry inter-relationship

RB - May need a break down of the image to simplify it for a larger audience?

Avi - yes sir.

















Trading and Medicine analogy (complexity, uncertainity, technology) - part 6

I am able to discover some black boxes in stock market system so big bulls become bigger by taking money from retail investor (common man)..as there are many black boxes in EBM

- impact factor

- RCT transparency

- data hacking

- p hacking

- GBM

(These are black boxes in EBM, and there are more.. I am not counting market manipulation, kickbacks etc. As they are not part of EBM at its core..).. 

My question to @Dr. RB sir is

how useless/harmful/dangerous EBM is to the retail investor/trader (patients).. (Subjective question and any subjective answer/opinion will be very helpful to get idea about how to think).. 


Blackboxes - guidance to retailers to utilize but big pharma/ bulls use it against retailers to make own benefits..



RB - None of the quoted black boxes are true EBM and simply reflect what EBM shouldn't be 🙂


Avi - But when they are being misused as EBM (must not be) I am trying to understand what is the magnitude of disaster (Miscommunicated and misguided as ebm)


RB - That's really a great research area with so much happening for the taking



Avi - For some research in this area.. Covid evidence misuse/wrong use (bad EBM) may be best present possibility.. A questionnaire based survey to covid recovered patients may be good beginning..




In terms of $ the opioid epidemic is 1$ trillian for 2017..there can be more aspects as qaly, daly, and even very simple as just the over expenses..

RB - It would be very simple to understand if you were working with us daily. We see this everyday. Essentially making data transparent accountable and triangulated.

RB - Yes one can focus on  one drug and progress on pointing out all one at a time.






Trading and Medicine analogy (complexity, uncertainity, technology) - part 5




Custom, self made, Trading Decision Support System.. work in progress.. found it easy to prepare in google sheets than any paid tools, also haven't analyzed much in paid tools, but while preparing the cdss/tdss i realize that how its(evidence basis)  made and how its used (evidence appraisal and application) matter more than how feature full and advance algorithm  or high computation it have...


Common tip - Listen everyone but never follow them, as following experts is a sure shot strategy for destruction. Experts are also frequently wrong and worst of all is they have COI. So can listen but always analyse yourself and make your own decisions.


Stop loss - a pre-set point to exit on a loosing trade to prevent any further/major loss.. It's one of the most important aspect in trading for minimising risk, which ultimately helps better profit in the long run by minimising losses. There are low hanging fruits in medicine as stop loss by having communication with the patient , if not directly then with a student or patient advocate or even a patient  app where we can find the harm/adr/low effect of a drug easily and quickly. Even sharing information like patient leaflets or links to patient education website can be useful same way. A precise monitoring of therapeutic and adverse effect of drugs are other possibilities ahead.


while its cool to notice analogies and experiment with them explore about decision making, there are two big differences between trading and clinical decision making. First is the common patterns to note are similar to the common diagnosis found in real practice but the less common ones are also must to not miss in clinics while also keeping an open eye for the rare ones, whereas in trading the less common and rare patterns are found only by machines i think and that to not always explainable due to heavy use of machine learning/AI. Second major difference is in clinics we always have to look at complex inter-relationships to some significant depth for making any decisions and may be in much depth when facing challenges, but in trading we don't look much at logically explainable inter-relationships when doing it manually, but with help of machines it starts to some extent.. this makes a trader life's easy and to make it more easy to play game for being more successful, the strategy is specializing. Master one thing and do very well and as the market keep changing, keep updating your techniques. (this is like clinically applicable ebm updates)


RB - It's a breakthrough analogy 👏👏👏  Try reviewing the literature to see if anyone has had this analogy idea before.


Avi - Thanks a lot sir 🙏🙏 . I am having this thought since a few days that may be it becomes an educational strategy someday as checklists became from airline industry correlation.  

no such literature sir. its commonly said that trading is like medical decision making as a wrong decision may destroy whole capital(like can kill a human)... but nothing more than that.. but here the discussion is from medical perspective, there is zero literature in pubmed and i didn't find also in gray literature.

RB - It will become better than that 👏

Avi - very happy to be able to do it sir! all medicine concepts learn't helped me understand better while i was reading/studying heavily in 65 days. My dedicated heavy effort ended 5 days back and i am happy to be a successful beginner. There is a rule of 90/90/90 i.e. 90% traders loose 90% of money in 90 days, but luckily i recovered back from -20% to approx 0% in the first month and then to 10% profit in the 2nd month. Its not best learning in a bullish (going high) market as it is now because we don't discover our mistakes easily which are very important in learning journey, but I feel lucky that it helped me lesser losses while take time for dedicated effort to learn well. (The profit matched  my monthly expenses and that is my target & need for coming months).

human body is self healing, like a bullish market and may be that's why we don't see the medical science inefficiencies easily, and due to very high interconnectivity among concepts, it's tough to figure out meaningful correlations and understand its causations.

there are 3 kind of trading decisions -> gambling, investing, and speculation. they based on logic applied and risk applicable. medicine have minimalist, the real trader may be doing a combination of these and depending on his/her risk appetite, as in medicine there are minimalists and maximalists utilizing evidence of efficacy in varying ranges as weak to strong quality of evidence..

as i have some confidence now on profit making, now i am trying to look into optimizing the workflow , automating it and maximizing the profit https://www.elearnmarkets.com/blog/nr4-and-nr7-trading-strategy-setup/    ,  so for this when i started experimenting, i made a loss of 1% of the capital i have as risk increased when i entered into new territory, learning happened less by practice and more by analyzing the outcomes of practise so can say that is a catalyst when we move ahead on the learning curve, and the TDSS i made showed something already known and similar existing as terms which are not very well known to newbies and hobbyists (NR4 and NR7 are the terms) 

the way optimizing and maximizing profit learning is going on is by 1) finding more objective ways of doing the things i was trying to do subjectively but also avoiding overfitting of objective/quantities on subjective approach/qualities 2) finding the right tools 3) going deeper towards interelationships


RB - 1 and 3 👏👏



Trading and Medicine analogy (complexity, uncertainity, technology) - part 4

Avoiding complexity - they are paralyzing to navigate through, and even the little data available is highly fragmented and conclusions based on that are not very reliable. Exploring complexity is surely fun and helps figure out imprecision in various day to day used techniques but it doesn't help significantly & neither frequently to get more precision. So avoiding complexity itself is a way to stay more correct generally and so the concepts of Commons are common in medicine and the insight is that they are not as bad as considered because of lack of precision, rather they are best of what all we have.

Important to explore complexity to be better at decision making as it helps understand limitations of all tools and techniques available, and if explored frequently and data used to improve the indicators then surely there will be progress giving an edge. Complexity is not necessarily tough, mostly when exploring we will find something or other useful insight due to our limitations of knowledge absorbing and recall capacity, but it's also fact that it's easy to hit the dead end when we try to keep asking what/why/how...

Edge is the small incremental improvement but they can be of high help. For not missing those edges which are low hanging fruits, there should be curiosity/interest & training. 

Another benefit of complexity exploration is the tiny incremental gain in knowledge which helps acquire low hanging fruits/edges quickly and better to be a better decision maker. Like in investment /money, Knowledge will also grow similarly as the theory of compounding works. 

100 invested, 0.05% gained daily by knowledge gain by exploring complexity then in 20 years it will be 3843.96

If total knowledge learnt in 5 years of mbbs is 100% , then 100/ ( 5*365) = 0.05% daily.. 

But after mbbs we are more into experiential learning and less into didactic so even more impact per day in learning.. This high gain may not reflect in quantity of knowledge as no. Of pages read but will surely reflect in ability to perform better for healing the patient by the accumulation of edges by continued learning with curiosity/interest into complexity

This is totally hypothetical to explain the logic.


-> KISS but don't KISS too https://en.m.wikipedia.org/wiki/KISS_principle


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image seems like concept of epidemiology


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RB - When we reach a point of not getting answers to our research questions we have reached the edge or the fringes where new methods and insights are likely to be born. I like this new perspective on edge 👍





Trading and Medicine analogy (complexity, uncertainity, technology) - part 3

Hitting the ceiling - as a retail trader I am playing with strategies that are too old and not best in current market but still profitable to a good extent if done right. I get to see the data every minute I.e. minute candle but those having high resources have milliseconds level. Resources eg. Big capital, super smart quantitative strategies (quant) and access to high performance systems.. 


On Milliseconds data they don't only use it as an edge but also in quant trading they use even stock specific strategy which to be used for only one stock/scrip/company/symbol and that too frequently adjusted and even replaced after some time as a strategy may not work always and not just this but there may be even ensemble of strategies for a single stock and giving an extra edge by use of machine learning and neural networks along with all the smart statistics.. The quant traders are not only the players against retail traders but also can make a huge dent on algo traders profits and there is one way even more intensive and that is high frequency trading.. I have hit the ceiling because though I can have access to tools to learn and even to some extent also possible to do it (quant) myself as an individual trader (cloudquant software company brings money where we can bring in strategies)  but neither I have bandwidth to learn that much nor that suits to my future plans, life goals, or in short to my personality.. In all these different variations I have discussed above till today, each of them have pros and cons and capability to make profit and best suitability in different scenario and people are not only recommend to focus on specializing by practice for maximize profits and in best suitable way for the person but also to find and edge which helps to perform even better and adapt according to the market scenario.. It's easy to know any of these to be dangerous enough (burning all capital while trying to profit) but it's very difficult to master any of those as an art , as same as the art of medicine is. Be it 10000  hours of practice or regular incremental improvement or goal to be a performer like Beethoven or mozart, it's all about the art..


RB - Let's utilize this learning analogy to further the field of medicine 👏


Avi - About performance - not the high performing traders in the high resource settings make the most impact (own earning), a low performing retail trader doing consistent work for long time may be more or equally impactful.. Same applies to the community health workers (doctors , quacks, anyone) , given the condition that they do right thing. they must be guided towards doing the right things while enabling them with good useful technology.


RB - Yes and the earnings are in terms of patient outcomes


Avi - when the data is there having no meaning and full of uncertainity and everyone having some general and some person view on market (understanding).. Utilizing techniques to help make better decision makings are important. Historical data (womb to tomb), Backtesting (past medicine effect), sample testing (challenge test / n= 1 trial), etc. Are important , and also all other data in detail as social, environmental, even political etc. Become important (lockdown -> lonliness and depression).. And combining all to analyze together is a possibility which is being made a reality in stocks with help of advance statitsivs and ai. 


(Not just the diagnostic data but also therapeutic data - allopathy ayurveda ayush placebopathy naturopathy hypnosis talking listening therapy faith etc..)



And they are also coming to Medicine too.. Covid was great example as google had gps data from phone and it was showing lots of useful data on a separate dashboard.. More coming ahead soon hopefully

Conclusion - "Let students be part of decision making".

RB - Integration is a piece of swiss cheese if not cake 👏






Trading and Medicine analogy (complexity, uncertainity, technology) - part 2





This graph shows a phenomenon called BTC dominance.. The way BTC graph moves (mid top)  will decide the way all other move making a similar pattern during fall but during rise they may not match so precisely though the effect remain in that too, only a few rarely at different time point show variation from this and there is mostly any external factor causing that variations. 

So if we consider all as course of intervention of various drugs eg. Anti-Hypertensive agents, the graph at center too which will be having dominance over all interventions effect will be "Lifestyle Intervention/modification"..

------------

The composite man , equivalent of big pharma in stock market (composite man is not necessarily bad or against a trader, its just another player with you in the market, playing for his/her own profit).. Luckily stock market have ways to understand it's game play, same as we have EBM combined with critical appraisal for understanding the real effect/benefit.


"Wyckoff created the idea of the Composite Man (or Composite Operator) as an imaginary identity of the market. He proposed that investors and traders should study the stock market as if a single entity was controlling it. This would make it easier for them to go along the market trends. In essence, the Composite Man represents the biggest players (market makers), such as wealthy individuals and institutional investors. It always acts in his own best interest to ensure he can buy low and sell high. The Composite Man’s behavior is the opposite of the majority of retail investors, which Wyckoff often observed losing money. But according to Wyckoff, the Composite Man uses a somewhat predictable strategy, from which investors can learn from." https://academy.binance.com/en/articles/the-wyckoff-method-explained


It's very interesting to notice that if someone focuses on very few stocks which have good fundamentals, they may make small but consistent profit, it's like the experienced doctor analogy who uses very few drugs for wide range of disease and still seen successful. Are they really successful? Or they are keeping safe way (for the patient) by giving small but sure profit than giving sometimes high gains and sometimes high losses.. In terms of investing they are successful as an important mantra is "never loose money", and same way in medicine too that "do no harm". When we become greedy wanting best possible there is scope of high benefit but high loss too.. 

Btw be it identifying wykoff method on a chart 📊 or critical appraisal for drug effects.. "We only see what we know"..


RB - 👏you are opening a new way of looking at medicine and it is just at the right place at the right time


Avi - Thanks sir!🙏

RB- Entering covid ICU and thinking of the stock options in the humans lying in front of me. The market stakes have come down since last two weeks with less people crashing (during the peak of 2nd phase of covid in India when delta variant created havoc.)


RB - Govt policy driven interventions (lockdown effect) to bring the market stakes down? 🤔


Avi - Better to say Swiss cheese model impact where govt. Is one among many factors.

RB - Integrative interventions 👏

RB - But what would be the analogy in terms of stock share trading?


Avi - As you are looking at population level, the analogy will also come at population level data and that is nifty / nifty 50 / sensex etc. Which are affected by overall effect on all stocks considered under these and also on how the market performs globally I.e. Dow, sgx (other countries)  etc. 

And the event at population level is a rare event of surge of cases of a particular disease in your facility and same seen globally and that may be analogous to a black Swan event... A black Swan event is a rare event that can not be predicted (a few say it can be sometimes) and they may lead to crash of a market , local / global and even at a smaller subset of local like your facility..but these rare events may happen in case of individual stocks or humans journey also eg. Mucoromycosis (not black swan technically in such case, just the system is an individual level).

"A black swan is an unpredictable event that is beyond what is normally expected of a situation and has potentially severe consequences. Black swan events are characterized by their extreme rarity, severe impact, and the widespread insistence they were obvious in hindsight." https://www.investopedia.com/articles/trading/11/black-swan-events-investing.asp

The covid pandemic may be a good example of black Swan event but not all Swiss cheese model failure based event may be black Swan.. Because black swans are rare events where are swiss cheese model also applies on common events eg. All Medical errors (they are very common)

One cool thing is, after the black Swan event happen and we analyse data in backdate it's easily possible to notice, but never possible to predict in future. Same happening in covid case hypes.. We easily point to crowded gathering events etc which lead to superspreader events..

The equivalent to medical errors in stocks can be, not analysing the data enough or well or not doing that with sufficient speed for decision making, not applying safety measures eg. Diversification, hedging, stop loss etc.. Not keeping personal psychology in control and away from bias, greed, fear.. And also the biases that are inbuilt in the analysis methods.

Sometimes it becomes important to break a few rules, sometimes being greedy may become useful.. Also misusing the safety Strategies are also a danger as putting stop losses too tight or too far, over diversifying etc. 

So right thing at right time in right quantity is important.. It's tough to be so right always so we loose alot in stock market... But if win rate is higher than loose rate by even 1% or exactly same then it's success because in first case there is some profit and in second there is no loss so profit may be in future.. But in Medicine we hide failures, they are not accepted easily as errors and so everyone only know success stories but nobody knows success rates..  

Interestingly in stocks if win rate is very less compared to loose rate but just keep check to keep loss sizes small and win sizes bigger then also its a profit overall.


RB - 👏 A large part of the literature in stock trade borrows from statistical theory. Good insights building up with this analogy 👏


Avi - [11:00 AM, 5/31/2021] Avinash Kumar Gupta: Yes sir. The winner and looser both apply stats and they both think they are right and it's even possible that the looser have better technology than the winner but when we see ratio, the lowest resource settings have win rate of approx 2% and rest 98% are small fishes to be eaten by the bigger ones, those having high resources. 

Various strategies and instruments are there in stocks and using some are very safe but low profit, some very risky but high profit and some in between and the resources required vary for them.. One aspect of such resources is capital -> For a good safety and good profit strategy the capital required is huge, for a high profit high risk the capital needed can be smallest size also but they wins may be very very less.. 

Having high resources brings different set of challenges that may never occur in case of small resource setups (retail investors) so not having high resources as mainly enough capital is a challenge but then more/ better skills, analytical capabilities, speed , etc comes into picture.. Procedural skills which are again learnt by doing both theory and practice.


Trading and Medicine analogy (complexity, uncertainity, technology) - part 1

 Avi - 




My Cryptocurrency trading setup.. When I used a  profitable + generalizable strategy (eg. RSI overbought and oversold cutoff) and let it run free 24*7 on fully automated basis, it gave some profits but when I use same strategy and add some personalization / precision (same RSI based but sell only if it's in profit, and also when noticed bitcoin dominance then choosing high volatile tokens where percent change is more on both sides up/down) then profit increases drastically and also losses reduces drastically too. Are we missing the drastic/tremendous benefits of drugs because of not having the right information and analytics on top of it?  Or we are just loosing a lil.? 


May be we are loosing in ratio of NNT, as if More precise and beautiful action of a drug, better optimization and  benefit scope and may be we are doing fine without optimization as we haven't seen how much gap is there in the approaches.. 

Probably looking at evidence into cancer care will give info on variations in impact of drugs by following personalization strategies as they are most advance in that afaik.


( I had just begun algo-trading using ActionScript and google sheets that i made over a weekend)




these values and terms I made myself with some analytics, not sure if they are defined and exist already, must be I guess.


RB - Good question and hypothesis.  The big question is how do we test it.


Avi - It's recommended to develop own strategy and keep modifying and improving it. No strategy can perform best/optimal in all markets (different time in a year or even a week sometimes).. I created my own based on freely available knowledge base that i could study and some hypothetical experiments tested later with practical experiments in real market. 

Here in the excel sheet I have programmed to fetch real-time data and developed my own indicator named co-efficient, it is probably similar or in relationship to B (beta).. Now having a quick look at this sheet helps me make better choices for faster profit. It doesn't help choose profit/loss, but whatever happens will happen at a faster pace in the chosen token based on co-efficient values.. A programmed script also analyzes the real time data as I would do manually and sends me alerts as mobile msgs so I don't need to keep looking at data, rather just check when there is a buy alert and decide to go ahead or not.. 

In a human the algorithms may analyzes objective and subjective data generated by human body (sensors) and a doctor may only give permission to execute a best possible chosen Rx/Tx..  But there are a scope for a few errors and combined together they may create havoc.. 

1) population level data - algorithm ( all data in a range +/- and we go right way or wrong way makes us get small/big error) 

2) human level - algorithm input (sensors - natural and artificial) 

3) decision maker - algorithm+human analytics based output/decision (doctor's choice/decision)


Avi - So now how do we test it/ minimize errors? 

1) by making corrections before it's too late. By Making smaller corrections to keep the course of therapy more precise to the desired outcome without loosing too much against uncertainty

2) developing sensors and their analytics to make the first point a reality. 

The point 2 reminds of a line @Dr. RB sir repeated a few times during electives - we need micro level sensors data and macro level data and merge together to decide best possible way ahead.


RB - Is this what every individual doctor currently does in his own self styled intuitive manner?


Yes sir.. But intuitive is not a more of data focused approach neither the outcome tested and corrected in real-time.. 

(For a system realtime may be also every Nano-second, and may be even hours, we just need to zoom-in to the right ratio).. 

(Idk if the real-time term use is technically correct here).

(Intution is data based - much subjectively, less objectively)

So corrections are not non-existent but not as high precision as we are thinking as possibility by the hifi system.. 

Q - do we need such high end precision? Given the facts that 1/3rd medical error deaths, 85% dx healed even without any intervention, most tx are emperical, etc.

RB - We could reduce overtesting and overtreatment in those 85%?

Avi - Answer - Yes need precision

Not just on optimizing tx but also finding better tx and finding better dx and most importantly ensuring their access because if this exist only in ivory towers then non-existent is the real reality of world.

Yes sir.. That can be reduced with only all the data we have now openly freely accessible, just need to be used without even any need for anymore fancy tool other than any Wikipedia or blogger like cdss or tech enabled cdss or at least a conversational cdss


RB - Intuition could be data in quantum reality?

Avi - Anything having the term quantum is very difficult for me to understand..  This term have so many meanings in so many different contexts and so many explanation on web which are unrelated to each other..

RB - Yes it's a theory of everything



recovering from another tough episode, which lasted shorter duration

De-identified writeup from client in his own words, published with consent. The client is self-learning psychology. In psychology its better to call client and not a patient afaik.


There is no better medicine than will power to come out from depression. But medicine are extremely important, all we loose is taking a month or 2 to find what suits and a few more month of continuation of a medication but what it helps is that may prevent from the extremes i.e. suicide.

depression changes the view of a person and force them to avoid seeing and appreciating the positives in life. But this is what most important to change to fight against , and even small small steps matter a lot.

sometimes people have questions like "why me" why this happened to me? or why not me, why something good didn't happened to me? and there is no answer to such questions except that all happen for some good and that good happen by being courageous, making plans and then efforts to make the good a reality.




long time back i had big troubles, and since then something like this has been my life track, I wish I had monitored it somehow but overall can generalize to this graph where the recent depressive state passed yesterday and i am hopeful to be in a good state for now and probably always.





(images taken from google image search)




Later update - on a psychiatrist visit

patient refused RFT and to continue any medication. sent this document for education - https://www.mind.org.uk/media-a/2966/bpd-2018.pdf






https://en.wikipedia.org/wiki/Dialectical_behavior_therapy








Thursday 8 July 2021

30 minute DIY app for patient's health monitoring

I have been working with an IBS patient who started following FODMAP diet and lifestyle modification to get relief from her 10+ years old IBS issues. Started helping her in health and data monitoring and understanding basic medical queries she was getting, and that's where simple tool like google sheets became very useful to record data and visualize. Later patient herself switched to taking data on paper and update it very rarely to the sheets, and I also realized updating an excel/google sheet was not the easiest way so tried developing an app.

Recently I also completed designing a framework for a community health project which is being executed by a small dedicated team on the ground somewhere in villages. Having the challenge to empower them with the right tools for delivering cost-effective evidence-based and well planned healthcare services with limited resources and technology-enabled ways, I got to experiment the same app development process and outcome is a beautiful and agile technique, sharing step by step tutorial below.


1) Use google forms to create a form having data that patients wish to monitor (data that matter for the patient) and also the data you as a care provider (family, friend, doctor) wish to monitor (and best to be evidence-based and if suitable then also a minimalist on this part).  ( 10 min. ) 

2) Create the google sheet with the form to collect responses and then go to google data studio and connect the sheet as a data source https://datastudio.google.com/  ( 2 min. )

3) Copy the code from github https://github.com/avi33tbtt/DIY-Med-App for a basic webview based android app and import project to android studio, and in the source file / java code just change the URL to your google form URL (avoid using shortened URL). ( 5 min. )

4) Build project and check on your device if it works then send apk to the patient. ( 2 min. )

5) when some data available, experiment with google studio to design your dashboard to help you visualize latest data in interactive way and even in real time. ( 11 min. )



App Screenshot






Dashboard Screenshot





contact me for any technical help to create yours or for any feedback to improve.
Avinash Kumar
avi33tbtt@gmail.com



*Data in the above image is shared with consent.

- Good to explore AppScript for creating web app using excel sheets for getting more power and be able to develop better DIY Tools and even capable to send data to a fhir server/EHR/EMR/PHR.

- These techniques are good for small scale implementation and I believe it to have capability of being highly patient-centric.

- Enable collect emails in form setting and filtering in the google studio dashboard for using same app for multiple users having similar requirements.