Artificial Intelligence in Medicine/Healthcare

1. AI: complex algorithms that analyse large amounts of data 1

2. Helps doctors obtain solutions by providing access to a large database 2;
informing healthcare decisions3
a. Computers can crunch numbers and identify patterns (i.e. deeplearning4)
b. But this data doesnt capture patients full-range of symptoms or
even their treatments. Images, radiology reports, and the notes
doctors write about each patient can be more useful. Thats
unstructured data, and computers are less savvy at handling it
because it requires making inferences and a certain understanding
of context and intent.
c. CHALLENGE: tremendous expense and difficulty of gaining access to
high-quality data; a comprehensive reservoir of medical
information; as most electronical medical record-keeping systems
are not compatible with each other.
i. Systems are not hooked up to the internet (privacy fulfilled,
though)/cloud, and available worldwide
ii. 5Past incidents may make people wary, e.g. Edward Snowden
leak
iii. Data can be bought (scary!!); but they have already been
anonymised what else will you do with the data, anyway?
for the greater good?
d. CHALLENGE: develop smart models and train them to pick up
patterns
3. Speeding up the selection of targets for drug development 6

1 Hernandez, D. (2014, June 2). Artificial Intelligence Is Now Telling Doctors How
to Treat You. Retrieved 21 September, 2015, from
http://www.wired.com/2014/06/ai-healthcare/
2 Ibid
3 Baum, S. (2015, February 14). 4 ways healthcare is putting artificial
intelligence, machine learning to use. Retrieved 21 September, 2015, from
http://medcitynews.com/2015/02/4-ways-healthcare-putting-artificialintelligence-machine-learning-use/
4 McMillan, R., and Dwoskin, E. (2015, August 11). IBM Crafts a Role for Artificial
Intelligence in Medicine. Retrieved 21 September 2015,
http://www.wsj.com/articles/ibm-crafts-a-role-for-artificial-intelligence-inmedicine-1439265840
5 http://medcitynews.com/2015/02/4-ways-healthcare-putting-artificialintelligence-machine-learning-use/
6 Ibid

CATEGORIES of systems7

iPhone-like pop-up notifications that appear in records; alerts and

reminders
a. medication reminders
b. encourage healthy behaviour
Diagnostic help; creation of new medical knowledge 8
Formulating treatment plans specific to individuals
Information retrieval
Image interpretation
Drug development9

SPECIFIC machines/systems

IBMs Watson supercomputer

The PUFF system for automatic interpretation of pulmonary function tests
has been sold in its commercial form to hundreds of sites world-wide. PUFF
can diagnose the presence and severity of lung disease and produce
reports for the patient's file. PUFF went into production at Pacific
Presbyterian Medical Centre in San Francisco in 1977, making it one of the
very earliest medical expert systems in use. Many thousands of cases
later, it is still in routine use.
http://www.openclinical.org/aisp_germwatcher.html
GermWatcher is an expert system that monitors microbiology culture data
from a hospital's laboratory system, identifies those cultures which
represent nosocomial infections and reports them to the US National
Centers for Disease Control and Prevention (CDC). GermWatcher checks
for hospital-acquired (nosocomial) infections, which represent a significant
cause of prolonged inpatient days and additional hospital charges (Kahn et
al.,1993). Microbiology culture data from the hospital's laboratory system
are monitored by GermWatcher, using a rule-base containing a
combination of national criteria and local hospital infection control policy.
http://www.openclinical.org/aisp_peirs.html
PEIRS (Pathology Expert Interpretative Reporting System) appends
interpretative comments to pathology reports. The knowledge aqusition
strategy is the Ripple Down Rules method, which has allowed a pathologist
to build over 2300 rules without knowledge engineering or programming
support. During it period of operation, PEIRS interpreted about 80-100
reports a day with a diagnostic accuracy of about 95%. It accounted for
about which 20% of all the reports generated by the hospital's Chemical
Pathology Department. PEIRS reported on thyroid function tests, arterial
blood gases, urine and plasma catecholamines, hCG (human chorionic

7 Kannan, P. V. (n.d.). Artificial intelligence: applications in healthcare. Retrieved

22 September, 2015, from http://www.asianhhm.com/technologyequipment/artificial-intelligence
8 <not done up> http://www.openclinical.org/aiinmedicine.html
9 http://medcitynews.com/2015/02/4-ways-healthcare-putting-artificialintelligence-machine-learning-use/

gonadotrophin) and AFP (alpha fetoprotein), glucose tolerance tests,

cortisol, gastrin, cholinesterase phenotypes and parathyroid hormone
related peptide (PTH-RP). http://www.openclinical.org/aisp_puff.html

Why? Motivation for AI in healthcare.

4. A push to improve outcomes and reduce costs by leveraging new
technologies10
5. Shift from hospital-centric model to a patient- and personalised medical
model11
6. Companies can get a slice of the healthcare expenditure (!!!) 12
a. CHALLENGE: prevent excessive profiteering? Commercialisation?
i. Arrival of IBM shakes up the industry/provides support for
smaller companies looking to do the same thing then it
becomes commercialised??? Ack, the horrors
ii. The move to spread Watson throughout the globe is just
another way IBM is attempting to make Watson a big
business. While IBM is clearly pushing Watson hard, it
currently doesnt generate as much cash when compared to
the companys other services. 13
iii. Will IBM give up the information/share it with others, so that
everyone can advance for the betterment of humankind?
Hur.14

Other ethical dilemmas

7. Using patients as test subjects???
8. Trial-end-error? Misdiagnosis how do you know if you gave the correct
diagnosis
9. Deprive patients of emotional rapport; do not fit naturally into a system of
care, and require additional time from already-busy doctors 15
10 http://www.wired.com/2014/06/ai-healthcare/
11 Poulard, C. (2015, May 25). Artificial Intelligence & Healthcare: in between
fear and excitement. Retrieved 21 September, 2015,
fromhttp://www.ersinnovation.com/biotechnologies/artificial-intelligencehealthcare-in-between-fear-and-excitement/
12 http://www.wsj.com/articles/ibm-crafts-a-role-for-artificial-intelligence-inmedicine-1439265840
13 Vanian, J. (2015, July 14). IBM's Watson supercomputer is learning Arabic in
move to Middle East. Retrieved 21 September, 2015, from
http://fortune.com/2015/07/14/ibm-watson-home-middle-east/
14 <not done up> http://whatis.techtarget.com/definition/IBM-Watsonsupercomputer

10.Do doctors certifications then become useless? Even surgeons have

mechanical arms. BUT THEN AGAIN, it can help those rural areas where
medical expertise is limited

Other dilemmas
11.Computer illiteracy

Questions about the role of computers vs doctors

12.Computers might dilute the value of being a doctor? Everyone can become
a doctor then!
a. Question of how fare computers should encroach on a doctors turf
i. The line between making RECOMMENDATIONS and making
DECISIONS has to be drawn clearly but might become murky
(over time)
b. For now: not diagnostic tools, but information banks; they dont
claim to practice medicine
13.Concerns seem to emerge from worst case scenarios and assume that
even though AI can be used for beneficial purposes, what if the technology
is turned against us?
a. (side point: even famous people are wary/cautious/against it. Maybe
having such influential people voice it out keeps us on our toes?
Spreads awareness about the dangers?16)
b. We only fear what we dont know17
14.But computers cannot replace doctors
a. They are not sentient beings. Intelligence =/= autonomy 18
b. Most, if not all, articles have been careful to coin them as with the
insight of expert physicianstools19

15 Health informatics. (2015). Artificial intelligence in medicine. Retrieved 22

September, 2015,
https://healthinformatics.wikispaces.com/Artificial+Intelligence+in+Medicine
16 http://www.ersinnovation.com/biotechnologies/artificial-intelligencehealthcare-in-between-fear-and-excitement/
17 Etzioni, O. (2014, December 9). Its time to intelligently discuss artificial
intelligence. Retrieved 22 September, 2015, from
https://medium.com/backchannel/ai-wont-exterminate-us-it-will-empower-us5b7224735bf3
18 Ibid
19 <not done up>
https://healthinformatics.wikispaces.com/Artificial+Intelligence+in+Medicine

Current challenges: data access, picking up subtle patterns

Medium-term challenges: profiteering/commercialisation of such services; it
becomes a business
Long-term: role of doctors vs supercomputers (general conclusion) + dumbing
of the human race? (Hahahaha, or creating a super small specialised group of
superdoctors) + over-reliance

Specific examples

Medcitynews
Ersinnovation
(categories) http://epia2015.dei.uc.pt/artificial-intelligence-in-medicine/