Artificial Intelligence Needs Doctors As Much As They Need It
In this futuristic medical concept, a doctor assesses a patient with robust machine assistance.
The media loves to hype concerns about artificial intelligence: What if machines become super-intelligent and self-aware? How will humanity compete and survive? But artificial intelligence today is a far cry from a robot takeover. "AI" is a catch-all term that often refers to machine training or machine learning: There is an abundance of data, vastly more than the human mind can assimilate, being tagged, captured and stored. This systematic data processing requires methodologies that can put it in usable form and formats. While these new developments stoke fear in some corners, the ability to predict outcomes is generally seen as a good thing, as it can mitigate risks and even save lives.
We, collectively, want AI even though it is seldom expressed this way.
The prospects and attempts toward artificial intelligence has been with us for decades. Only recently have the underlying technologies and infrastructure--including computer processing, storage, networking speed and advanced software platforms--become omnipresent. These technological advances enabled the implementation of data mining concepts and the subsequent advantages that were not feasible just a decade ago.
AI is fantastical by vision, evolutionary by experience, and disruptive upon reflection. In the world of health care, AI is already transforming research and clinical practice. We, collectively, want AI even though it is seldom expressed this way. What we, the patient population, patient advocates and caregivers, agree on and want is: (1) timely, precise and inexpensive diagnoses of our ailments, injuries and disorders; (2) timely, personalized, highly effective and efficient courses of therapies; and (3) expedited recovery with minimum deficits, complications and recurrence.
"Artificial intelligence and machine learning will impact healthcare as profoundly as the discovery of the microscope."
Implicitly, we all are saying that we want our healthcare systems and clinicians to accomplish truly inhuman feats: to incorporate all sources of structured data (such as published statistics and reports) and unstructured data (including news articles, conversational analysis by care givers, nuances of similar cases, talks at professional societies); to analyze the data sourced and uncover patterns, reveal side effects, define probable success and outcomes; and to present the best personalized course of treatment for the patient that addresses the ailment and mitigates associated risks. It is hard to argue against any of this.
In a recent published interview, Keith J. Dreyer, executive director of the Massachusetts General Hospital and Brigham and Women's Hospital Center for Clinical Data Science, says that "artificial intelligence and machine learning will impact healthcare as profoundly as the discovery of the microscope."
But as AI helps physicians in profound ways, like detecting subtle lesions on scans or distinguishing the symptoms of a stroke from a brain tumor, we humans can't get too complacent. Evolving AI platforms will provide more sophisticated sets of "tools" to address both mundane and complex medical challenges, albeit with humans very much in the mix and routinely at the helm.
Humans do not appear endangered to be replaced anytime soon.
Human beings are capable of a level of nuance and contextual understanding of complex medical scenarios and, consequently, do not appear endangered to be replaced anytime soon. These platforms will do some heavy lifting for sure and provide considerable assistance across the healthcare industry. But human involvement is crucial, as we are best at adaptive learning, cognition, ensuring accuracy of the data, and continually providing feedback to improve the machine learning components of the AI platforms that the health industry will increasingly rely upon.
The human/machine interface is not binary; there is no line in the sand. It is fuzzy and evolutionary, a synchronicity that we all will surely witness and experience. In the future, it may be possible that all recorded knowledge, including genetic, genomic and laboratory data, from structured and unstructured sources, can be at the fingertips of your clinician, and then factored into diagnosing your condition and prescribing your course of treatment. This is precision and personalized medicine on a grand scale applied at the micro level--you!
But none of this will diminish the importance of doctors, nurses and all assortment of care providers. Though they all will undoubtedly become more effective with such awesome AI assistance, their job will always be to heal you with compassion, wisdom, and kindness, for the essence of humanity cannot be automated.
Urinary tract infections account for more than 8 million trips to the doctor each year.
Few things are more painful than a urinary tract infection (UTI). Common in men and women, these infections account for more than 8 million trips to the doctor each year and can cause an array of uncomfortable symptoms, from a burning feeling during urination to fever, vomiting, and chills. For an unlucky few, UTIs can be chronic—meaning that, despite treatment, they just keep coming back.
But new research, presented at the European Association of Urology (EAU) Congress in Paris this week, brings some hope to people who suffer from UTIs.
Clinicians from the Royal Berkshire Hospital presented the results of a long-term, nine-year clinical trial where 89 men and women who suffered from recurrent UTIs were given an oral vaccine called MV140, designed to prevent the infections. Every day for three months, the participants were given two sprays of the vaccine (flavored to taste like pineapple) and then followed over the course of nine years. Clinicians analyzed medical records and asked the study participants about symptoms to check whether any experienced UTIs or had any adverse reactions from taking the vaccine.
The results showed that across nine years, 48 of the participants (about 54%) remained completely infection-free. On average, the study participants remained infection free for 54.7 months—four and a half years.
“While we need to be pragmatic, this vaccine is a potential breakthrough in preventing UTIs and could offer a safe and effective alternative to conventional treatments,” said Gernot Bonita, Professor of Urology at the Alta Bro Medical Centre for Urology in Switzerland, who is also the EAU Chairman of Guidelines on Urological Infections.
The news comes as a relief not only for people who suffer chronic UTIs, but also to doctors who have seen an uptick in antibiotic-resistant UTIs in the past several years. Because UTIs usually require antibiotics, patients run the risk of developing a resistance to the antibiotics, making infections more difficult to treat. A preventative vaccine could mean less infections, less antibiotics, and less drug resistance overall.
“Many of our participants told us that having the vaccine restored their quality of life,” said Dr. Bob Yang, Consultant Urologist at the Royal Berkshire NHS Foundation Trust, who helped lead the research. “While we’re yet to look at the effect of this vaccine in different patient groups, this follow-up data suggests it could be a game-changer for UTI prevention if it’s offered widely, reducing the need for antibiotic treatments.”
MILESTONE: Doctors have transplanted a pig organ into a human for the first time in history
A surgeon at Massachusetts General Hospital prepares a pig organ for transplant.
Surgeons at Massachusetts General Hospital made history last week when they successfully transplanted a pig kidney into a human patient for the first time ever.
The recipient was a 62-year-old man named Richard Slayman who had been living with end-stage kidney disease caused by diabetes. While Slayman had received a kidney transplant in 2018 from a human donor, his diabetes ultimately caused the kidney to fail less than five years after the transplant. Slayman had undergone dialysis ever since—a procedure that uses an artificial kidney to remove waste products from a person’s blood when the kidneys are unable to—but the dialysis frequently caused blood clots and other complications that landed him in the hospital multiple times.
As a last resort, Slayman’s kidney specialist suggested a transplant using a pig kidney provided by eGenesis, a pharmaceutical company based in Cambridge, Mass. The highly experimental surgery was made possible with the Food and Drug Administration’s “compassionate use” initiative, which allows patients with life-threatening medical conditions access to experimental treatments.
The new frontier of organ donation
Like Slayman, more than 100,000 people are currently on the national organ transplant waiting list, and roughly 17 people die every day waiting for an available organ. To make up for the shortage of human organs, scientists have been experimenting for the past several decades with using organs from animals such as pigs—a new field of medicine known as xenotransplantation. But putting an animal organ into a human body is much more complicated than it might appear, experts say.
“The human immune system reacts incredibly violently to a pig organ, much more so than a human organ,” said Dr. Joren Madsen, director of the Mass General Transplant Center. Even with immunosuppressant drugs that suppress the body’s ability to reject the transplant organ, Madsen said, a human body would reject an animal organ “within minutes.”
So scientists have had to use gene-editing technology to change the animal organs so that they would work inside a human body. The pig kidney in Slayman’s surgery, for instance, had been genetically altered using CRISPR-Cas9 technology to remove harmful pig genes and add human ones. The kidney was also edited to remove pig viruses that could potentially infect a human after transplant.
With CRISPR technology, scientists have been able to prove that interspecies organ transplants are not only possible, but may be able to successfully work long term, too. In the past several years, scientists were able to transplant a pig kidney into a monkey and have the monkey survive for more than two years. More recently, doctors have transplanted pig hearts into human beings—though each recipient of a pig heart only managed to live a couple of months after the transplant. In one of the patients, researchers noted evidence of a pig virus in the man’s heart that had not been identified before the surgery and could be a possible explanation for his heart failure.
So far, so good
Slayman and his medical team ultimately decided to pursue the surgery—and the risk paid off. When the pig organ started producing urine at the end of the four-hour surgery, the entire operating room erupted in applause.
Slayman is currently receiving an infusion of immunosuppressant drugs to prevent the kidney from being rejected, while his doctors monitor the kidney’s function with frequent ultrasounds. Slayman is reported to be “recovering well” at Massachusetts General Hospital and is expected to be discharged within the next several days.