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Training a doctor takes years of grueling work in universities and hospitals. Building a doctor may be as easy as teaching an AI how to read.
Artificial intelligence has taken another step towards becoming an integral part of 21st-century medicine. New research out of Guangzhou, China, published February 11th in Nature Medicine Letters, has demonstrated a natural-language processing AI that is capable of out-performing rookie pediatricians in diagnosing common childhood ailments.
The massive study examined the electronic health records (EHR) from nearly 600,000 patients over an 18-month period at the Guangzhou Women and Children’s Medical Center and then compared AI-generated diagnoses against new assessments from physicians with a range of experience.
The verdict? On average, the AI was noticeably more accurate than junior physicians and nearly as reliable as the more senior ones. These results are the latest demonstration that artificial intelligence is on the cusp of becoming a healthcare staple on a global scale.
Less Like a Computer, More Like a Person
To outshine human doctors, the AI first had to become more human. Like IBM’s Watson, the pediatric AI leverages natural language processing, in essence “reading” written notes from EHRs not unlike how a human doctor would review those same records. But the similarities to human doctors don’t end there. The AI is a machine learning classifier (MLC), capable of placing the information learned from the EHRs into categories to improve performance.
Like traditionally-trained pediatricians, the AI broke cases down into major organ groups and infection areas (upper/lower respiratory, gastrointestinal, etc.) before breaking them down even further into subcategories. It could then develop associations between various symptoms and organ groups and use those associations to improve its diagnoses. This hierarchical approach mimics the deductive reasoning human doctors employ.
Another key strength of the AI developed for this study was the enormous size of the dataset collected to teach it: 1,362,559 outpatient visits from 567,498 patients yielded some 101.6 million data points for the MLC to devour on its quest for pediatric dominance. This allowed the AI the depth of learning needed to distinguish and accurately select from the 55 different diagnosis codes across the various organ groups and subcategories.
When comparing against the human doctors, the study used 11,926 records from an unrelated group of children, giving both the MLC and the 20 humans it was compared against an even playing field. The results were clear: while cohorts of senior pediatricians performed better than the AI, junior pediatricians (those with 3-15 years of experience) were outclassed.
Helping, Not Replacing
While the research used a competitive analysis to measure the success of the AI, the results should be seen as anything but hostile to human doctors. The near future of artificial intelligence in medicine will see these machine learning programs augment, not replace, human physicians. The authors of the study specifically call out augmentation as the key short-term application of their work. Triaging incoming patients via intake forms, performing massive metastudies using EHRs, providing rapid ‘second opinions’—the applications for an AI doctor that is better-but-not-the-best are as varied as the healthcare industry itself.
That’s only considering how artificial intelligence could make a positive impact immediately upon implementation. It’s easy to see how long-term use of a diagnostic assistant could reshape the way modern medical institutions approach their work.
Look at how the MLC results fit snugly between the junior and senior physician groups. Essentially, it took nearly 15 years before a physician could consistently out-diagnose the machine. That’s a decade and a half wherein an AI diagnostic assistant would be an invaluable partner—both as a training tool and a safety measure. Likewise, on the other side of the experience curve you have physicians whose performance could be continuously leveraged to improve the AI’s effectiveness. This is a clear opportunity for a symbiotic relationship, with humans and machines each assisting the other as they mature.
Closer to Us, But Still Dependent on Us
No matter the ultimate application, the AI doctors of the future are drawing nearer to us step by step. This latest research is a demonstration that artificial intelligence can mimic the results of human deductive reasoning even in some of the most complex and important decision-making processes. True, the MLC required input from humans to function; both the initial data points and the cases used to evaluate the AI depended on EHRs written by physicians. While every effort was made to design a test schema that removed any indication of the eventual diagnosis, some “data leakage” is bound to occur.
In other words, when AIs use human-created data, they inherit human insight to some degree. Yet the progress made in machine imaging, chatbots, sensors, and other fields all suggest that this dependence on human input is more about where we are right now than where we could be in the near future.
Data, and More Data
That near future may also have some clear winners and losers. For now, those winners seem to be the institutions that can capture and apply the largest sets of data. With a rapidly digitized society gathering incredible amounts of data, China has a clear advantage. Combined with their relatively relaxed approach to privacy, they are likely to continue as one of the driving forces behind machine learning and its applications. So too will Google/Alphabet with their massive medical studies. Data is the uranium in this AI arms race, and everyone seems to be scrambling to collect more.
In a global community that seems increasingly aware of the potential problems arising from this need for and reliance on data, it’s nice to know there’ll be an upside as well. The technology behind AI medical assistants is looking more and more mature—even if we are still struggling to find exactly where, when, and how that technology should first become universal.
Yet wherever we see the next push to make AI a standard tool in a real-world medical setting, I have little doubt it will greatly improve the lives of human patients. Today Doctor AI is performing as well as a human colleague with more than 10 years of experience. By next year or so, it may take twice as long for humans to be competitive. And in a decade, the combined medical knowledge of all human history may be a tool as common as a stethoscope in your doctor’s hands.
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We’ve long used the brain as inspiration for computers, but the SpiNNaker supercomputer, switched on this month, is probably the closest we’ve come to recreating it in silicon. Now scientists hope to use the supercomputer to model the very thing that inspired its design.
The brain is the most complex machine in the known universe, but that complexity comes primarily from its architecture rather than the individual components that make it up. Its highly interconnected structure means that relatively simple messages exchanged between billions of individual neurons add up to carry out highly complex computations.
That’s the paradigm that has inspired the ‘Spiking Neural Network Architecture” (SpiNNaker) supercomputer at the University of Manchester in the UK. The project is the brainchild of Steve Furber, the designer of the original ARM processor. After a decade of development, a million-core version of the machine that will eventually be able to simulate up to a billion neurons was switched on earlier this month.
The idea of splitting computation into very small chunks and spreading them over many processors is already the leading approach to supercomputing. But even the most parallel systems require a lot of communication, and messages may have to pack in a lot of information, such as the task that needs to be completed or the data that needs to be processed.
In contrast, messages in the brain consist of simple electrochemical impulses, or spikes, passed between neurons, with information encoded primarily in the timing or rate of those spikes (which is more important is a topic of debate among neuroscientists). Each neuron is connected to thousands of others via synapses, and complex computation relies on how spikes cascade through these highly-connected networks.
The SpiNNaker machine attempts to replicate this using a model called Address Event Representation. Each of the million cores can simulate roughly a million synapses, so depending on the model, 1,000 neurons with 1,000 connections or 100 neurons with 10,000 connections. Information is encoded in the timing of spikes and the identity of the neuron sending them. When a neuron is activated it broadcasts a tiny packet of data that contains its address, and spike timing is implicitly conveyed.
By modeling their machine on the architecture of the brain, the researchers hope to be able to simulate more biological neurons in real time than any other machine on the planet. The project is funded by the European Human Brain Project, a ten-year science mega-project aimed at bringing together neuroscientists and computer scientists to understand the brain, and researchers will be able to apply for time on the machine to run their simulations.
Importantly, it’s possible to implement various different neuronal models on the machine. The operation of neurons involves a variety of complex biological processes, and it’s still unclear whether this complexity is an artefact of evolution or central to the brain’s ability to process information. The ability to simulate up to a billion simple neurons or millions of more complex ones on the same machine should help to slowly tease out the answer.
Even at a billion neurons, that still only represents about one percent of the human brain, so it’s still going to be limited to investigating isolated networks of neurons. But the previous 500,000-core machine has already been used to do useful simulations of the Basal Ganglia—an area affected in Parkinson’s disease—and an outer layer of the brain that processes sensory information.
The full-scale supercomputer will make it possible to study even larger networks previously out of reach, which could lead to breakthroughs in our understanding of both the healthy and unhealthy functioning of the brain.
And while neurological simulation is the main goal for the machine, it could also provide a useful research tool for roboticists. Previous research has already shown a small board of SpiNNaker chips can be used to control a simple wheeled robot, but Furber thinks the SpiNNaker supercomputer could also be used to run large-scale networks that can process sensory input and generate motor output in real time and at low power.
That low power operation is of particular promise for robotics. The brain is dramatically more power-efficient than conventional supercomputers, and by borrowing from its principles SpiNNaker has managed to capture some of that efficiency. That could be important for running mobile robotic platforms that need to carry their own juice around.
This ability to run complex neural networks at low power has been one of the main commercial drivers for so-called neuromorphic computing devices that are physically modeled on the brain, such as IBM’s TrueNorth chip and Intel’s Loihi. The hope is that complex artificial intelligence applications normally run in massive data centers could be run on edge devices like smartphones, cars, and robots.
But these devices, including SpiNNaker, operate very differently from the leading AI approaches, and its not clear how easy it would be to transfer between the two. The need to adopt an entirely new programming paradigm is likely to limit widespread adoption, and the lack of commercial traction for the aforementioned devices seems to back that up.
At the same time, though, this new paradigm could potentially lead to dramatic breakthroughs in massively parallel computing. SpiNNaker overturns many of the foundational principles of how supercomputers work that make it much more flexible and error-tolerant.
For now, the machine is likely to be firmly focused on accelerating our understanding of how the brain works. But its designers also hope those findings could in turn point the way to more efficient and powerful approaches to computing.
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