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#435196 Avatar Love? New ‘Black Mirror’ ...

This week, the widely-anticipated fifth season of the dystopian series Black Mirror was released on Netflix. The storylines this season are less focused on far-out scenarios and increasingly aligned with current issues. With only three episodes, this season raises more questions than it answers, often leaving audiences bewildered.

The episode Smithereens explores our society’s crippling addiction to social media platforms and the monopoly they hold over our data. In Rachel, Jack and Ashley Too, we see the disruptive impact of technologies on the music and entertainment industry, and the price of fame for artists in the digital world. Like most Black Mirror episodes, these explore the sometimes disturbing implications of tech advancements on humanity.

But once again, in the midst of all the doom and gloom, the creators of the series leave us with a glimmer of hope. Aligned with Pride month, the episode Striking Vipers explores the impact of virtual reality on love, relationships, and sexual fluidity.

*The review contains a few spoilers.*

Striking Vipers
The first episode of the season, Striking Vipers may be one of the most thought-provoking episodes in Black Mirror history. Reminiscent of previous episodes San Junipero and Hang the DJ, the writers explore the potential for technology to transform human intimacy.

The episode tells the story of two old friends, Danny and Karl, whose friendship is reignited in an unconventional way. Karl unexpectedly appears at Danny’s 38th birthday and reintroduces him to the VR version of a game they used to play years before. In the game Striking Vipers X, each of the players is represented by an avatar of their choice in an uncanny digital reality. Following old tradition, Karl chooses to become the female fighter, Roxanne, and Danny takes on the role of the male fighter, Lance. The state-of-the-art VR headsets appear to use an advanced form of brain-machine interface to allow each player to be fully immersed in the virtual world, emulating all physical sensations.

To their surprise (and confusion), Danny and Karl find themselves transitioning from fist-fighting to kissing. Over the course of many games, they continue to explore a sexual and romantic relationship in the virtual world, leaving them confused and distant in the real world. The virtual and physical realities begin to blur, and so do the identities of the players with their avatars. Danny, who is married (in a heterosexual relationship) and is a father, begins to carry guilt and confusion in the real world. They both wonder if there would be any spark between them in real life.

The brain-machine interface (BMI) depicted in the episode is still science fiction, but that hasn’t stopped innovators from pushing the technology forward. Experts today are designing more intricate BMI systems while programming better algorithms to interpret the neural signals they capture. Scientists have already succeeded in enabling paralyzed patients to type with their minds, and are even allowing people to communicate with one another purely through brainwaves.

The convergence of BMIs with virtual reality and artificial intelligence could make the experience of such immersive digital realities possible. Virtual reality, too, is decreasing exponentially in cost and increasing in quality.

The narrative provides meaningful commentary on another tech area—gaming. It highlights video games not necessarily as addictive distractions, but rather as a platform for connecting with others in a deeper way. This is already very relevant. Video games like Final Fantasy are often a tool for meaningful digital connections for their players.

The Implications of Virtual Reality on Love and Relationships
The narrative of Striking Vipers raises many novel questions about the implications of immersive technologies on relationships: could the virtual world allow us a safe space to explore suppressed desires? Can virtual avatars make it easier for us to show affection to those we care about? Can a sexual or romantic encounter in the digital world be considered infidelity?

Above all, the episode explores the therapeutic possibilities of such technologies. While many fears about virtual reality had been raised in previous seasons of Black Mirror, this episode was focused on its potential. This includes the potential of immersive technology to be a source of liberation, meaningful connections, and self-exploration, as well as a tool for realizing our true identities and desires.

Once again, this is aligned with emerging trends in VR. We are seeing the rise of social VR applications and platforms that allow you to hang out with your friends and family as avatars in the virtual space. The technology is allowing for animation movies, such as Coco VR, to become an increasingly social and interactive experience. Considering that meaningful social interaction can alleviate depression and anxiety, such applications could contribute to well-being.

Techno-philosopher and National Geographic host Jason Silva points out that immersive media technologies can be “engines of empathy.” VR allows us to enter virtual spaces that mimic someone else’s state of mind, allowing us to empathize with the way they view the world. Silva said, “Imagine the intimacy that becomes possible when people meet and they say, ‘Hey, do you want to come visit my world? Do you want to see what it’s like to be inside my head?’”

What is most fascinating about Striking Vipers is that it explores how we may redefine love with virtual reality; we are introduced to love between virtual avatars. While this kind of love may seem confusing to audiences, it may be one of the complex implications of virtual reality on human relationships.

In many ways, the title Black Mirror couldn’t be more appropriate, as each episode serves as a mirror to the most disturbing aspects of our psyches as they get amplified through technology. However, what we see in uplifting and thought-provoking plots like Striking Vipers, San Junipero, and Hang The DJ is that technology could also amplify the most positive aspects of our humanity. This includes our powerful capacity to love.

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#435106 Could Artificial Photosynthesis Help ...

Plants are the planet’s lungs, but they’re struggling to keep up due to rising CO2 emissions and deforestation. Engineers are giving them a helping hand, though, by augmenting their capacity with new technology and creating artificial substitutes to help them clean up our atmosphere.

Imperial College London, one of the UK’s top engineering schools, recently announced that it was teaming up with startup Arborea to build the company’s first outdoor pilot of its BioSolar Leaf cultivation system at the university’s White City campus in West London.

Arborea is developing large solar panel-like structures that house microscopic plants and can be installed on buildings or open land. The plants absorb light and carbon dioxide as they photosynthesize, removing greenhouse gases from the air and producing organic material, which can be processed to extract valuable food additives like omega-3 fatty acids.

The idea of growing algae to produce useful materials isn’t new, but Arborea’s pitch seems to be flexibility and affordability. The more conventional approach is to grow algae in open ponds, which are less efficient and open to contamination, or in photo-bioreactors, which typically require CO2 to be piped in rather than getting it from the air and can be expensive to run.

There’s little detail on how the technology deals with issues like nutrient supply and harvesting or how efficient it is. The company claims it can remove carbon dioxide as fast as 100 trees using the surface area of just a single tree, but there’s no published research to back that up, and it’s hard to compare the surface area of flat panels to that of a complex object like a tree. If you flattened out every inch of a tree’s surface it would cover a surprisingly large area.

Nonetheless, the ability to install these panels directly on buildings could present a promising way to soak up the huge amount of CO2 produced in our cities by transport and industry. And Arborea isn’t the only one trying to give plants a helping hand.

For decades researchers have been working on ways to use light-activated catalysts to split water into oxygen and hydrogen fuel, and more recently there have been efforts to fuse this with additional processes to combine the hydrogen with carbon from CO2 to produce all kinds of useful products.

Most notably, in 2016 Harvard researchers showed that water-splitting catalysts could be augmented with bacteria that combines the resulting hydrogen with CO2 to create oxygen and biomass, fuel, or other useful products. The approach was more efficient than plants at turning CO2 to fuel and was built using cheap materials, but turning it into a commercially viable technology will take time.

Not everyone is looking to mimic or borrow from biology in their efforts to suck CO2 out of the atmosphere. There’s been a recent glut of investment in startups working on direct-air capture (DAC) technology, which had previously been written off for using too much power and space to be practical. The looming climate change crisis appears to be rewriting some of those assumptions, though.

Most approaches aim to use the concentrated CO2 to produce synthetic fuels or other useful products, creating a revenue stream that could help improve their commercial viability. But we look increasingly likely to surpass the safe greenhouse gas limits, so attention is instead turning to carbon-negative technologies.

That means capturing CO2 from the air and then putting it into long-term storage. One way could be to grow lots of biomass and then bury it, mimicking the process that created fossil fuels in the first place. Or DAC plants could pump the CO2 they produce into deep underground wells.

But the former would take up unreasonably large amounts of land to make a significant dent in emissions, while the latter would require huge amounts of already scant and expensive renewable power. According to a recent analysis, artificial photosynthesis could sidestep these issues because it’s up to five times more efficient than its natural counterpart and could be cheaper than DAC.

Whether the technology will develop quickly enough for it to be deployed at scale and in time to mitigate the worst effects of climate change remains to be seen. Emissions reductions certainly present a more sure-fire way to deal with the problem, but nonetheless, cyborg plants could soon be a common sight in our cities.

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#435098 Coming of Age in the Age of AI: The ...

The first generation to grow up entirely in the 21st century will never remember a time before smartphones or smart assistants. They will likely be the first children to ride in self-driving cars, as well as the first whose healthcare and education could be increasingly turned over to artificially intelligent machines.

Futurists, demographers, and marketers have yet to agree on the specifics of what defines the next wave of humanity to follow Generation Z. That hasn’t stopped some, like Australian futurist Mark McCrindle, from coining the term Generation Alpha, denoting a sort of reboot of society in a fully-realized digital age.

“In the past, the individual had no power, really,” McCrindle told Business Insider. “Now, the individual has great control of their lives through being able to leverage this world. Technology, in a sense, transformed the expectations of our interactions.”

No doubt technology may impart Marvel superhero-like powers to Generation Alpha that even tech-savvy Millennials never envisioned over cups of chai latte. But the powers of machine learning, computer vision, and other disciplines under the broad category of artificial intelligence will shape this yet unformed generation more definitively than any before it.

What will it be like to come of age in the Age of AI?

The AI Doctor Will See You Now
Perhaps no other industry is adopting and using AI as much as healthcare. The term “artificial intelligence” appears in nearly 90,000 publications from biomedical literature and research on the PubMed database.

AI is already transforming healthcare and longevity research. Machines are helping to design drugs faster and detect disease earlier. And AI may soon influence not only how we diagnose and treat illness in children, but perhaps how we choose which children will be born in the first place.

A study published earlier this month in NPJ Digital Medicine by scientists from Weill Cornell Medicine used 12,000 photos of human embryos taken five days after fertilization to train an AI algorithm on how to tell which in vitro fertilized embryo had the best chance of a successful pregnancy based on its quality.

Investigators assigned each embryo a grade based on various aspects of its appearance. A statistical analysis then correlated that grade with the probability of success. The algorithm, dubbed Stork, was able to classify the quality of a new set of images with 97 percent accuracy.

“Our algorithm will help embryologists maximize the chances that their patients will have a single healthy pregnancy,” said Dr. Olivier Elemento, director of the Caryl and Israel Englander Institute for Precision Medicine at Weill Cornell Medicine, in a press release. “The IVF procedure will remain the same, but we’ll be able to improve outcomes by harnessing the power of artificial intelligence.”

Other medical researchers see potential in applying AI to detect possible developmental issues in newborns. Scientists in Europe, working with a Finnish AI startup that creates seizure monitoring technology, have developed a technique for detecting movement patterns that might indicate conditions like cerebral palsy.

Published last month in the journal Acta Pediatrica, the study relied on an algorithm to extract the movements from a newborn, turning it into a simplified “stick figure” that medical experts could use to more easily detect clinically relevant data.

The researchers are continuing to improve the datasets, including using 3D video recordings, and are now developing an AI-based method for determining if a child’s motor maturity aligns with its true age. Meanwhile, a study published in February in Nature Medicine discussed the potential of using AI to diagnose pediatric disease.

AI Gets Classy
After being weaned on algorithms, Generation Alpha will hit the books—about machine learning.

China is famously trying to win the proverbial AI arms race by spending billions on new technologies, with one Chinese city alone pledging nearly $16 billion to build a smart economy based on artificial intelligence.

To reach dominance by its stated goal of 2030, Chinese cities are also incorporating AI education into their school curriculum. Last year, China published its first high school textbook on AI, according to the South China Morning Post. More than 40 schools are participating in a pilot program that involves SenseTime, one of the country’s biggest AI companies.

In the US, where it seems every child has access to their own AI assistant, researchers are just beginning to understand how the ubiquity of intelligent machines will influence the ways children learn and interact with their highly digitized environments.

Sandra Chang-Kredl, associate professor of the department of education at Concordia University, told The Globe and Mail that AI could have detrimental effects on learning creativity or emotional connectedness.

Similar concerns inspired Stefania Druga, a member of the Personal Robots group at the MIT Media Lab (and former Education Teaching Fellow at SU), to study interactions between children and artificial intelligence devices in order to encourage positive interactions.

Toward that goal, Druga created Cognimates, a platform that enables children to program and customize their own smart devices such as Alexa or even a smart, functional robot. The kids can also use Cognimates to train their own AI models or even build a machine learning version of Rock Paper Scissors that gets better over time.

“I believe it’s important to also introduce young people to the concepts of AI and machine learning through hands-on projects so they can make more informed and critical use of these technologies,” Druga wrote in a Medium blog post.

Druga is also the founder of Hackidemia, an international organization that sponsors workshops and labs around the world to introduce kids to emerging technologies at an early age.

“I think we are in an arms race in education with the advancement of technology, and we need to start thinking about AI literacy before patterns of behaviors for children and their families settle in place,” she wrote.

AI Goes Back to School
It also turns out that AI has as much to learn from kids. More and more researchers are interested in understanding how children grasp basic concepts that still elude the most advanced machine minds.

For example, developmental psychologist Alison Gopnik has written and lectured extensively about how studying the minds of children can provide computer scientists clues on how to improve machine learning techniques.

In an interview on Vox, she described that while DeepMind’s AlpahZero was trained to be a chessmaster, it struggles with even the simplest changes in the rules, such as allowing the bishop to move horizontally instead of vertically.

“A human chess player, even a kid, will immediately understand how to transfer that new rule to their playing of the game,” she noted. “Flexibility and generalization are something that even human one-year-olds can do but that the best machine learning systems have a much harder time with.”

Last year, the federal defense agency DARPA announced a new program aimed at improving AI by teaching it “common sense.” One of the chief strategies is to develop systems for “teaching machines through experience, mimicking the way babies grow to understand the world.”

Such an approach is also the basis of a new AI program at MIT called the MIT Quest for Intelligence.

The research leverages cognitive science to understand human intelligence, according to an article on the project in MIT Technology Review, such as exploring how young children visualize the world using their own innate 3D models.

“Children’s play is really serious business,” said Josh Tenenbaum, who leads the Computational Cognitive Science lab at MIT and his head of the new program. “They’re experiments. And that’s what makes humans the smartest learners in the known universe.”

In a world increasingly driven by smart technologies, it’s good to know the next generation will be able to keep up.

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#434658 The Next Data-Driven Healthtech ...

Increasing your healthspan (i.e. making 100 years old the new 60) will depend to a large degree on artificial intelligence. And, as we saw in last week’s blog, healthcare AI systems are extremely data-hungry.

Fortunately, a slew of new sensors and data acquisition methods—including over 122 million wearables shipped in 2018—are bursting onto the scene to meet the massive demand for medical data.

From ubiquitous biosensors, to the mobile healthcare revolution, to the transformative power of the Health Nucleus, converging exponential technologies are fundamentally transforming our approach to healthcare.

In Part 4 of this blog series on Longevity & Vitality, I expand on how we’re acquiring the data to fuel today’s AI healthcare revolution.

In this blog, I’ll explore:

How the Health Nucleus is transforming “sick care” to healthcare
Sensors, wearables, and nanobots
The advent of mobile health

Let’s dive in.

Health Nucleus: Transforming ‘Sick Care’ to Healthcare
Much of today’s healthcare system is actually sick care. Most of us assume that we’re perfectly healthy, with nothing going on inside our bodies, until the day we travel to the hospital writhing in pain only to discover a serious or life-threatening condition.

Chances are that your ailment didn’t materialize that morning; rather, it’s been growing or developing for some time. You simply weren’t aware of it. At that point, once you’re diagnosed as “sick,” our medical system engages to take care of you.

What if, instead of this retrospective and reactive approach, you were constantly monitored, so that you could know the moment anything was out of whack?

Better yet, what if you more closely monitored those aspects of your body that your gene sequence predicted might cause you difficulty? Think: your heart, your kidneys, your breasts. Such a system becomes personalized, predictive, and possibly preventative.

This is the mission of the Health Nucleus platform built by Human Longevity, Inc. (HLI). While not continuous—that will come later, with the next generation of wearable and implantable sensors—the Health Nucleus was designed to ‘digitize’ you once per year to help you determine whether anything is going on inside your body that requires immediate attention.

The Health Nucleus visit provides you with the following tests during a half-day visit:

Whole genome sequencing (30x coverage)
Whole body (non-contrast) MRI
Brain magnetic resonance imaging/angiography (MRI/MRA)
CT (computed tomography) of the heart and lungs
Coronary artery calcium scoring
Electrocardiogram
Echocardiogram
Continuous cardiac monitoring
Clinical laboratory tests and metabolomics

In late 2018, HLI published the results of the first 1,190 clients through the Health Nucleus. The results were eye-opening—especially since these patients were all financially well-off, and already had access to the best doctors.

Following are the physiological and genomic findings in these clients who self-selected to undergo evaluation at HLI’s Health Nucleus.

Physiological Findings [TG]

Two percent had previously unknown tumors detected by MRI
2.5 percent had previously undetected aneurysms detected by MRI
Eight percent had cardiac arrhythmia found on cardiac rhythm monitoring, not previously known
Nine percent had moderate-severe coronary artery disease risk, not previously known
16 percent discovered previously unknown cardiac structure/function abnormalities
30 percent had elevated liver fat, not previously known

Genomic Findings [TG]

24 percent of clients uncovered a rare (unknown) genetic mutation found on WGS
63 percent of clients had a rare genetic mutation with a corresponding phenotypic finding

In summary, HLI’s published results found that 14.4 percent of clients had significant findings that are actionable, requiring immediate or near-term follow-up and intervention.

Long-term value findings were found in 40 percent of the clients we screened. Long-term clinical findings include discoveries that require medical attention or monitoring but are not immediately life-threatening.

The bottom line: most people truly don’t know their actual state of health. The ability to take a fully digital deep dive into your health status at least once per year will enable you to detect disease at stage zero or stage one, when it is most curable.

Sensors, Wearables, and Nanobots
Wearables, connected devices, and quantified self apps will allow us to continuously collect enormous amounts of useful health information.

Wearables like the Quanttus wristband and Vital Connect can transmit your electrocardiogram data, vital signs, posture, and stress levels anywhere on the planet.

In April 2017, we were proud to grant $2.5 million in prize money to the winning team in the Qualcomm Tricorder XPRIZE, Final Frontier Medical Devices.

Using a group of noninvasive sensors that collect data on vital signs, body chemistry, and biological functions, Final Frontier integrates this data in their powerful, AI-based DxtER diagnostic engine for rapid, high-precision assessments.

Their engine combines learnings from clinical emergency medicine and data analysis from actual patients.

Google is developing a full range of internal and external sensors (e.g. smart contact lenses) that can monitor the wearer’s vitals, ranging from blood sugar levels to blood chemistry.

In September 2018, Apple announced its Series 4 Apple Watch, including an FDA-approved mobile, on-the-fly ECG. Granted its first FDA approval, Apple appears to be moving deeper into the sensing healthcare market.

Further, Apple is reportedly now developing sensors that can non-invasively monitor blood sugar levels in real time for diabetic treatment. IoT-connected sensors are also entering the world of prescription drugs.

Last year, the FDA approved the first sensor-embedded pill, Abilify MyCite. This new class of digital pills can now communicate medication data to a user-controlled app, to which doctors may be granted access for remote monitoring.

Perhaps what is most impressive about the next generation of wearables and implantables is the density of sensors, processing, networking, and battery capability that we can now cheaply and compactly integrate.

Take the second-generation OURA ring, for example, which focuses on sleep measurement and management.

The OURA ring looks like a slightly thick wedding band, yet contains an impressive array of sensors and capabilities, including:

Two infrared LED
One infrared sensor
Three temperature sensors
One accelerometer
A six-axis gyro
A curved battery with a seven-day life
The memory, processing, and transmission capability required to connect with your smartphone

Disrupting Medical Imaging Hardware
In 2018, we saw lab breakthroughs that will drive the cost of an ultrasound sensor to below $100, in a packaging smaller than most bandages, powered by a smartphone. Dramatically disrupting ultrasound is just the beginning.

Nanobots and Nanonetworks
While wearables have long been able to track and transmit our steps, heart rate, and other health data, smart nanobots and ingestible sensors will soon be able to monitor countless new parameters and even help diagnose disease.

Some of the most exciting breakthroughs in smart nanotechnology from the past year include:

Researchers from the École Polytechnique Fédérale de Lausanne (EPFL) and the Swiss Federal Institute of Technology in Zurich (ETH Zurich) demonstrated artificial microrobots that can swim and navigate through different fluids, independent of additional sensors, electronics, or power transmission.

Researchers at the University of Chicago proposed specific arrangements of DNA-based molecular logic gates to capture the information contained in the temporal portion of our cells’ communication mechanisms. Accessing the otherwise-lost time-dependent information of these cellular signals is akin to knowing the tune of a song, rather than solely the lyrics.

MIT researchers built micron-scale robots able to sense, record, and store information about their environment. These tiny robots, about 100 micrometers in diameter (approximately the size of a human egg cell), can also carry out pre-programmed computational tasks.

Engineers at University of California, San Diego developed ultrasound-powered nanorobots that swim efficiently through your blood, removing harmful bacteria and the toxins they produce.

But it doesn’t stop there.

As nanosensor and nanonetworking capabilities develop, these tiny bots may soon communicate with each other, enabling the targeted delivery of drugs and autonomous corrective action.

Mobile Health
The OURA ring and the Series 4 Apple Watch are just the tip of the spear when it comes to our future of mobile health. This field, predicted to become a $102 billion market by 2022, puts an on-demand virtual doctor in your back pocket.

Step aside, WebMD.

In true exponential technology fashion, mobile device penetration has increased dramatically, while image recognition error rates and sensor costs have sharply declined.

As a result, AI-powered medical chatbots are flooding the market; diagnostic apps can identify anything from a rash to diabetic retinopathy; and with the advent of global connectivity, mHealth platforms enable real-time health data collection, transmission, and remote diagnosis by medical professionals.

Already available to residents across North London, Babylon Health offers immediate medical advice through AI-powered chatbots and video consultations with doctors via its app.

Babylon now aims to build up its AI for advanced diagnostics and even prescription. Others, like Woebot, take on mental health, using cognitive behavioral therapy in communications over Facebook messenger with patients suffering from depression.

In addition to phone apps and add-ons that test for fertility or autism, the now-FDA-approved Clarius L7 Linear Array Ultrasound Scanner can connect directly to iOS and Android devices and perform wireless ultrasounds at a moment’s notice.

Next, Healthy.io, an Israeli startup, uses your smartphone and computer vision to analyze traditional urine test strips—all you need to do is take a few photos.

With mHealth platforms like ClickMedix, which connects remotely-located patients to medical providers through real-time health data collection and transmission, what’s to stop us from delivering needed treatments through drone delivery or robotic telesurgery?

Welcome to the age of smartphone-as-a-medical-device.

Conclusion
With these DIY data collection and diagnostic tools, we save on transportation costs (time and money), and time bottlenecks.

No longer will you need to wait for your urine or blood results to go through the current information chain: samples will be sent to the lab, analyzed by a technician, results interpreted by your doctor, and only then relayed to you.

Just like the “sage-on-the-stage” issue with today’s education system, healthcare has a “doctor-on-the-dais” problem. Current medical procedures are too complicated and expensive for a layperson to perform and analyze on their own.

The coming abundance of healthcare data promises to transform how we approach healthcare, putting the power of exponential technologies in the patient’s hands and revolutionizing how we live.

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#434151 Life-or-Death Algorithms: The Black Box ...

When it comes to applications for machine learning, few can be more widely hyped than medicine. This is hardly surprising: it’s a huge industry that generates a phenomenal amount of data and revenue, where technological advances can improve or save the lives of millions of people. Hardly a week passes without a study that suggests algorithms will soon be better than experts at detecting pneumonia, or Alzheimer’s—diseases in complex organs ranging from the eye to the heart.

The problems of overcrowded hospitals and overworked medical staff plague public healthcare systems like Britain’s NHS and lead to rising costs for private healthcare systems. Here, again, algorithms offer a tantalizing solution. How many of those doctor’s visits really need to happen? How many could be replaced by an interaction with an intelligent chatbot—especially if it can be combined with portable diagnostic tests, utilizing the latest in biotechnology? That way, unnecessary visits could be reduced, and patients could be diagnosed and referred to specialists more quickly without waiting for an initial consultation.

As ever with artificial intelligence algorithms, the aim is not to replace doctors, but to give them tools to reduce the mundane or repetitive parts of the job. With an AI that can examine thousands of scans in a minute, the “dull drudgery” is left to machines, and the doctors are freed to concentrate on the parts of the job that require more complex, subtle, experience-based judgement of the best treatments and the needs of the patient.

High Stakes
But, as ever with AI algorithms, there are risks involved with relying on them—even for tasks that are considered mundane. The problems of black-box algorithms that make inexplicable decisions are bad enough when you’re trying to understand why that automated hiring chatbot was unimpressed by your job interview performance. In a healthcare context, where the decisions made could mean life or death, the consequences of algorithmic failure could be grave.

A new paper in Science Translational Medicine, by Nicholson Price, explores some of the promises and pitfalls of using these algorithms in the data-rich medical environment.

Neural networks excel at churning through vast quantities of training data and making connections, absorbing the underlying patterns or logic for the system in hidden layers of linear algebra; whether it’s detecting skin cancer from photographs or learning to write in pseudo-Shakespearean script. They are terrible, however, at explaining the underlying logic behind the relationships that they’ve found: there is often little more than a string of numbers, the statistical “weights” between the layers. They struggle to distinguish between correlation and causation.

This raises interesting dilemmas for healthcare providers. The dream of big data in medicine is to feed a neural network on “huge troves of health data, finding complex, implicit relationships and making individualized assessments for patients.” What if, inevitably, such an algorithm proves to be unreasonably effective at diagnosing a medical condition or prescribing a treatment, but you have no scientific understanding of how this link actually works?

Too Many Threads to Unravel?
The statistical models that underlie such neural networks often assume that variables are independent of each other, but in a complex, interacting system like the human body, this is not always the case.

In some ways, this is a familiar concept in medical science—there are many phenomena and links which have been observed for decades but are still poorly understood on a biological level. Paracetamol is one of the most commonly-prescribed painkillers, but there’s still robust debate about how it actually works. Medical practitioners may be keen to deploy whatever tool is most effective, regardless of whether it’s based on a deeper scientific understanding. Fans of the Copenhagen interpretation of quantum mechanics might spin this as “Shut up and medicate!”

But as in that field, there’s a debate to be had about whether this approach risks losing sight of a deeper understanding that will ultimately prove more fruitful—for example, for drug discovery.

Away from the philosophical weeds, there are more practical problems: if you don’t understand how a black-box medical algorithm is operating, how should you approach the issues of clinical trials and regulation?

Price points out that, in the US, the “21st-Century Cures Act” allows the FDA to regulate any algorithm that analyzes images, or doesn’t allow a provider to review the basis for its conclusions: this could completely exclude “black-box” algorithms of the kind described above from use.

Transparency about how the algorithm functions—the data it looks at, and the thresholds for drawing conclusions or providing medical advice—may be required, but could also conflict with the profit motive and the desire for secrecy in healthcare startups.

One solution might be to screen algorithms that can’t explain themselves, or don’t rely on well-understood medical science, from use before they enter the healthcare market. But this could prevent people from reaping the benefits that they can provide.

Evaluating Algorithms
New healthcare algorithms will be unable to do what physicists did with quantum mechanics, and point to a track record of success, because they will not have been deployed in the field. And, as Price notes, many algorithms will improve as they’re deployed in the field for a greater amount of time, and can harvest and learn from the performance data that’s actually used. So how can we choose between the most promising approaches?

Creating a standardized clinical trial and validation system that’s equally valid across algorithms that function in different ways, or use different input or training data, will be a difficult task. Clinical trials that rely on small sample sizes, such as for algorithms that attempt to personalize treatment to individuals, will also prove difficult. With a small sample size and little scientific understanding, it’s hard to tell whether the algorithm succeeded or failed because it’s bad at its job or by chance.

Add learning into the mix and the picture gets more complex. “Perhaps more importantly, to the extent that an ideal black-box algorithm is plastic and frequently updated, the clinical trial validation model breaks down further, because the model depends on a static product subject to stable validation.” As Price describes, the current system for testing and validation of medical products needs some adaptation to deal with this new software before it can successfully test and validate the new algorithms.

Striking a Balance
The story in healthcare reflects the AI story in so many other fields, and the complexities involved perhaps illustrate why even an illustrious company like IBM appears to be struggling to turn its famed Watson AI into a viable product in the healthcare space.

A balance must be struck, both in our rush to exploit big data and the eerie power of neural networks, and to automate thinking. We must be aware of the biases and flaws of this approach to problem-solving: to realize that it is not a foolproof panacea.

But we also need to embrace these technologies where they can be a useful complement to the skills, insights, and deeper understanding that humans can provide. Much like a neural network, our industries need to train themselves to enhance this cooperation in the future.

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