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When it comes to the future of healthcare, perhaps the only technology more powerful than CRISPR is artificial intelligence.
Over the past five years, healthcare AI startups around the globe raised over $4.3 billion across 576 deals, topping all other industries in AI deal activity.
During this same period, the FDA has given 70 AI healthcare tools and devices ‘fast-tracked approval’ because of their ability to save both lives and money.
The pace of AI-augmented healthcare innovation is only accelerating.
In Part 3 of this blog series on longevity and vitality, I cover the different ways in which AI is augmenting our healthcare system, enabling us to live longer and healthier lives.
In this blog, I’ll expand on:
Machine learning and drug design
Artificial intelligence and big data in medicine
Healthcare, AI & China
Let’s dive in.
Machine Learning in Drug Design
What if AI systems, specifically neural networks, could predict the design of novel molecules (i.e. medicines) capable of targeting and curing any disease?
Imagine leveraging cutting-edge artificial intelligence to accomplish with 50 people what the pharmaceutical industry can barely do with an army of 5,000.
And what if these molecules, accurately engineered by AIs, always worked? Such a feat would revolutionize our $1.3 trillion global pharmaceutical industry, which currently holds a dismal record of 1 in 10 target drugs ever reaching human trials.
It’s no wonder that drug development is massively expensive and slow. It takes over 10 years to bring a new drug to market, with costs ranging from $2.5 billion to $12 billion.
This inefficient, slow-to-innovate, and risk-averse industry is a sitting duck for disruption in the years ahead.
One of the hottest startups in digital drug discovery today is Insilico Medicine. Leveraging AI in its end-to-end drug discovery pipeline, Insilico Medicine aims to extend healthy longevity through drug discovery and aging research.
Their comprehensive drug discovery engine uses millions of samples and multiple data types to discover signatures of disease, identify the most promising protein targets, and generate perfect molecules for these targets. These molecules either already exist or can be generated de novo with the desired set of parameters.
In late 2018, Insilico’s CEO Dr. Alex Zhavoronkov announced the groundbreaking result of generating novel molecules for a challenging protein target with an unprecedented hit rate in under 46 days. This included both synthesis of the molecules and experimental validation in a biological test system—an impressive feat made possible by converging exponential technologies.
Underpinning Insilico’s drug discovery pipeline is a novel machine learning technique called Generative Adversarial Networks (GANs), used in combination with deep reinforcement learning.
Generating novel molecular structures for diseases both with and without known targets, Insilico is now pursuing drug discovery in aging, cancer, fibrosis, Parkinson’s disease, Alzheimer’s disease, ALS, diabetes, and many others. Once rolled out, the implications will be profound.
Dr. Zhavoronkov’s ultimate goal is to develop a fully-automated Health-as-a-Service (HaaS) and Longevity-as-a-Service (LaaS) engine.
Once plugged into the services of companies from Alibaba to Alphabet, such an engine would enable personalized solutions for online users, helping them prevent diseases and maintain optimal health.
Insilico, alongside other companies tackling AI-powered drug discovery, truly represents the application of the 6 D’s. What was once a prohibitively expensive and human-intensive process is now rapidly becoming digitized, dematerialized, demonetized and, perhaps most importantly, democratized.
Companies like Insilico can now do with a fraction of the cost and personnel what the pharmaceutical industry can barely accomplish with thousands of employees and a hefty bill to foot.
As I discussed in my blog on ‘The Next Hundred-Billion-Dollar Opportunity,’ Google’s DeepMind has now turned its neural networks to healthcare, entering the digitized drug discovery arena.
In 2017, DeepMind achieved a phenomenal feat by matching the fidelity of medical experts in correctly diagnosing over 50 eye disorders.
And just a year later, DeepMind announced a new deep learning tool called AlphaFold. By predicting the elusive ways in which various proteins fold on the basis of their amino acid sequences, AlphaFold may soon have a tremendous impact in aiding drug discovery and fighting some of today’s most intractable diseases.
Artificial Intelligence and Data Crunching
AI is especially powerful in analyzing massive quantities of data to uncover patterns and insights that can save lives. Take WAVE, for instance. Every year, over 400,000 patients die prematurely in US hospitals as a result of heart attack or respiratory failure.
Yet these patients don’t die without leaving plenty of clues. Given information overload, however, human physicians and nurses alone have no way of processing and analyzing all necessary data in time to save these patients’ lives.
Enter WAVE, an algorithm that can process enough data to offer a six-hour early warning of patient deterioration.
Just last year, the FDA approved WAVE as an AI-based predictive patient surveillance system to predict and thereby prevent sudden death.
Another highly valuable yet difficult-to-parse mountain of medical data comprises the 2.5 million medical papers published each year.
For some time, it has become physically impossible for a human physician to read—let alone remember—all of the relevant published data.
To counter this compounding conundrum, Johnson & Johnson is teaching IBM Watson to read and understand scientific papers that detail clinical trial outcomes.
Enriching Watson’s data sources, Apple is also partnering with IBM to provide access to health data from mobile apps.
One such Watson system contains 40 million documents, ingesting an average of 27,000 new documents per day, and providing insights for thousands of users.
After only one year, Watson’s successful diagnosis rate of lung cancer has reached 90 percent, compared to the 50 percent success rate of human doctors.
But what about the vast amount of unstructured medical patient data that populates today’s ancient medical system? This includes medical notes, prescriptions, audio interview transcripts, and pathology and radiology reports.
In late 2018, Amazon announced a new HIPAA-eligible machine learning service that digests and parses unstructured data into categories, such as patient diagnoses, treatments, dosages, symptoms and signs.
Taha Kass-Hout, Amazon’s senior leader in health care and artificial intelligence, told the Wall Street Journal that internal tests demonstrated that the software even performs as well as or better than other published efforts.
On the heels of this announcement, Amazon confirmed it was teaming up with the Fred Hutchinson Cancer Research Center to evaluate “millions of clinical notes to extract and index medical conditions.”
Having already driven extraordinary algorithmic success rates in other fields, data is the healthcare industry’s goldmine for future innovation.
Healthcare, AI & China
In 2017, the Chinese government published its ambitious national plan to become a global leader in AI research by 2030, with healthcare listed as one of four core research areas during the first wave of the plan.
Just a year earlier, China began centralizing healthcare data, tackling a major roadblock to developing longevity and healthcare technologies (particularly AI systems): scattered, dispersed, and unlabeled patient data.
Backed by the Chinese government, China’s largest tech companies—particularly Tencent—have now made strong entrances into healthcare.
Just recently, Tencent participated in a $154 million megaround for China-based healthcare AI unicorn iCarbonX.
Hoping to develop a complete digital representation of your biological self, iCarbonX has acquired numerous US personalized medicine startups.
Considering Tencent’s own Miying healthcare AI platform—aimed at assisting healthcare institutions in AI-driven cancer diagnostics—Tencent is quickly expanding into the drug discovery space, participating in two multimillion-dollar, US-based AI drug discovery deals just this year.
China’s biggest, second-order move into the healthtech space comes through Tencent’s WeChat. In the course of a mere few years, already 60 percent of the 38,000 medical institutions registered on WeChat allow patients to digitally book appointments through Tencent’s mobile platform. At the same time, 2,000 Chinese hospitals accept WeChat payments.
Tencent has additionally partnered with the U.K.’s Babylon Health, a virtual healthcare assistant startup whose app now allows Chinese WeChat users to message their symptoms and receive immediate medical feedback.
Similarly, Alibaba’s healthtech focus started in 2016 when it released its cloud-based AI medical platform, ET Medical Brain, to augment healthcare processes through everything from diagnostics to intelligent scheduling.
As Nvidia CEO Jensen Huang has stated, “Software ate the world, but AI is going to eat software.” Extrapolating this statement to a more immediate implication, AI will first eat healthcare, resulting in dramatic acceleration of longevity research and an amplification of the human healthspan.
Next week, I’ll continue to explore this concept of AI systems in healthcare.
Particularly, I’ll expand on how we’re acquiring and using the data for these doctor-augmenting AI systems: from ubiquitous biosensors, to the mobile healthcare revolution, and finally, to the transformative power of the health nucleus.
As AI and other exponential technologies increase our healthspan by 30 to 40 years, how will you leverage these same exponential technologies to take on your moonshots and live out your massively transformative purpose?
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The World’s Fastest Supercomputer Breaks an AI Record
Tom Simonite | Wired
“Summit, which occupies an area equivalent to two tennis courts, used more than 27,000 powerful graphics processors in the project. It tapped their power to train deep-learning algorithms, the technology driving AI’s frontier, chewing through the exercise at a rate of a billion billion operations per second, a pace known in supercomputing circles as an exaflop.”
iRobot Finally Announces Awesome New Terra Robotic Lawnmower
Evan Ackerman | IEEE Spectrum
“Since the first Roomba came out in 2002, it has seemed inevitable that one day iRobot would develop a robotic lawn mower. After all, a robot mower is basically just a Roomba that works outside, right? Of course, it’s not nearly that simple, as iRobot has spent the last decade or so discovering, but they’ve finally managed to pull it off.”
Watch This Super Speedy 3D Printer Make Objects Suddenly Appear
Erin Winick | MIT Technology Review
“The new machine—which the team nicknamed the ‘replicator’ after the machine from Star Trek—instead forms the entire item all in one go. It does this by shining light onto specific spots in a rotating resin that solidifies when exposed to a certain light level.”
The DIY Designer Baby Project Funded With Bitcoin
Antonio Regalado | MIT Technology Review
“i‘Is DIY bio anywhere close to making a CRISPR baby? No, not remotely,’ David Ishee says. ‘But if some rich guy pays a scientist to do the work, it’s going to happen.’ He adds: ‘What you are reporting on isn’t Bryan—it’s the unseen middle space, a layer of gray-market biotech and freelance science where people with resources can get things done.’i”
The Complete Cancer Cure Story Is Both Bogus and Tragic
Megan Molteni | Wired
“You’d think creators and consumers of news would have learned their lesson by now. But the latest version of the fake cancer cure story is even more flagrantly flawed than usual. The public’s cancer cure–shaped amnesia, and media outlets’ willingness to exploit it for clicks, are as bottomless as ever. Hope, it would seem, trumps history.”
An AI Reading List—From Practical Primers to Sci-Fi Short Stories
James Vincent | The Verge
“The Verge has assembled a reading list: a brief but diverse compendium of books, short stories, and blogs, all chosen by leading figures in the AI world to help you better understand artificial intelligence.”
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Scarcely a day goes by without another headline about neural networks: some new task that deep learning algorithms can excel at, approaching or even surpassing human competence. As the application of this approach to computer vision has continued to improve, with algorithms capable of specialized recognition tasks like those found in medicine, the software is getting closer to widespread commercial use—for example, in self-driving cars. Our ability to recognize patterns is a huge part of human intelligence: if this can be done faster by machines, the consequences will be profound.
Yet, as ever with algorithms, there are deep concerns about their reliability, especially when we don’t know precisely how they work. State-of-the-art neural networks will confidently—and incorrectly—classify images that look like television static or abstract art as real-world objects like school-buses or armadillos. Specific algorithms could be targeted by “adversarial examples,” where adding an imperceptible amount of noise to an image can cause an algorithm to completely mistake one object for another. Machine learning experts enjoy constructing these images to trick advanced software, but if a self-driving car could be fooled by a few stickers, it might not be so fun for the passengers.
These difficulties are hard to smooth out in large part because we don’t have a great intuition for how these neural networks “see” and “recognize” objects. The main insight analyzing a trained network itself can give us is a series of statistical weights, associating certain groups of points with certain objects: this can be very difficult to interpret.
Now, new research from UCLA, published in the journal PLOS Computational Biology, is testing neural networks to understand the limits of their vision and the differences between computer vision and human vision. Nicholas Baker, Hongjing Lu, and Philip J. Kellman of UCLA, alongside Gennady Erlikhman of the University of Nevada, tested a deep convolutional neural network called VGG-19. This is state-of-the-art technology that is already outperforming humans on standardized tests like the ImageNet Large Scale Visual Recognition Challenge.
They found that, while humans tend to classify objects based on their overall (global) shape, deep neural networks are far more sensitive to the textures of objects, including local color gradients and the distribution of points on the object. This result helps explain why neural networks in image recognition make mistakes that no human ever would—and could allow for better designs in the future.
In the first experiment, a neural network was trained to sort images into 1 of 1,000 different categories. It was then presented with silhouettes of these images: all of the local information was lost, while only the outline of the object remained. Ordinarily, the trained neural net was capable of recognizing these objects, assigning more than 90% probability to the correct classification. Studying silhouettes, this dropped to 10%. While human observers could nearly always produce correct shape labels, the neural networks appeared almost insensitive to the overall shape of the images. On average, the correct object was ranked as the 209th most likely solution by the neural network, even though the overall shapes were an exact match.
A particularly striking example arose when they tried to get the neural networks to classify glass figurines of objects they could already recognize. While you or I might find it easy to identify a glass model of an otter or a polar bear, the neural network classified them as “oxygen mask” and “can opener” respectively. By presenting glass figurines, where the texture information that neural networks relied on for classifying objects is lost, the neural network was unable to recognize the objects by shape alone. The neural network was similarly hopeless at classifying objects based on drawings of their outline.
If you got one of these right, you’re better than state-of-the-art image recognition software. Image Credit: Nicholas Baker, Hongjing Lu, Gennady Erlikhman, Philip J. Kelman. “Deep convolutional networks do not classify based on global object shape.” Plos Computational Biology. 12/7/18. / CC BY 4.0
When the neural network was explicitly trained to recognize object silhouettes—given no information in the training data aside from the object outlines—the researchers found that slight distortions or “ripples” to the contour of the image were again enough to fool the AI, while humans paid them no mind.
The fact that neural networks seem to be insensitive to the overall shape of an object—relying instead on statistical similarities between local distributions of points—suggests a further experiment. What if you scrambled the images so that the overall shape was lost but local features were preserved? It turns out that the neural networks are far better and faster at recognizing scrambled versions of objects than outlines, even when humans struggle. Students could classify only 37% of the scrambled objects, while the neural network succeeded 83% of the time.
Humans vastly outperform machines at classifying object (a) as a bear, while the machine learning algorithm has few problems classifying the bear in figure (b). Image Credit: Nicholas Baker, Hongjing Lu, Gennady Erlikhman, Philip J. Kelman. “Deep convolutional networks do not classify based on global object shape.” Plos Computational Biology. 12/7/18. / CC BY 4.0
“This study shows these systems get the right answer in the images they were trained on without considering shape,” Kellman said. “For humans, overall shape is primary for object recognition, and identifying images by overall shape doesn’t seem to be in these deep learning systems at all.”
Naively, one might expect that—as the many layers of a neural network are modeled on connections between neurons in the brain and resemble the visual cortex specifically—the way computer vision operates must necessarily be similar to human vision. But this kind of research shows that, while the fundamental architecture might resemble that of the human brain, the resulting “mind” operates very differently.
Researchers can, increasingly, observe how the “neurons” in neural networks light up when exposed to stimuli and compare it to how biological systems respond to the same stimuli. Perhaps someday it might be possible to use these comparisons to understand how neural networks are “thinking” and how those responses differ from humans.
But, as yet, it takes a more experimental psychology to probe how neural networks and artificial intelligence algorithms perceive the world. The tests employed against the neural network are closer to how scientists might try to understand the senses of an animal or the developing brain of a young child rather than a piece of software.
By combining this experimental psychology with new neural network designs or error-correction techniques, it may be possible to make them even more reliable. Yet this research illustrates just how much we still don’t understand about the algorithms we’re creating and using: how they tick, how they make decisions, and how they’re different from us. As they play an ever-greater role in society, understanding the psychology of neural networks will be crucial if we want to use them wisely and effectively—and not end up missing the woods for the trees.
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2018 was bonkers for science.
From a woman who gave birth using a transplanted uterus, to the infamous CRISPR baby scandal, to forensics adopting consumer-based genealogy test kits to track down criminals, last year was a factory churning out scientific “whoa” stories with consequences for years to come.
With CRISPR still in the headlines, Britain ready to bid Europe au revoir, and multiple scientific endeavors taking off, 2019 is shaping up to be just as tumultuous.
Here are the science and health stories that may blow up in the new year. But first, a note of caveat: predicting the future is tough. Forecasting is the lovechild between statistics and (a good deal of) intuition, and entire disciplines have been dedicated to the endeavor. But January is the perfect time to gaze into the crystal ball for wisps of insight into the year to come. Last year we predicted the widespread approval of gene therapy products—on the most part, we nailed it. This year we’re hedging our bets with multiple predictions.
Gene Drives Used in the Wild
The concept of gene drives scares many, for good reason. Gene drives are a step up in severity (and consequences) from CRISPR and other gene-editing tools. Even with germline editing, in which the sperm, egg, or embryos are altered, gene editing affects just one genetic line—one family—at least at the beginning, before they reproduce with the general population.
Gene drives, on the other hand, have the power to wipe out entire species.
In a nutshell, they’re little bits of DNA code that help a gene transfer from parent to child with almost 100 percent perfect probability. The “half of your DNA comes from dad, the other comes from mom” dogma? Gene drives smash that to bits.
In other words, the only time one would consider using a gene drive is to change the genetic makeup of an entire population. It sounds like the plot of a supervillain movie, but scientists have been toying around with the idea of deploying the technology—first in mosquitoes, then (potentially) in rodents.
By releasing just a handful of mutant mosquitoes that carry gene drives for infertility, for example, scientists could potentially wipe out entire populations that carry infectious scourges like malaria, dengue, or Zika. The technology is so potent—and dangerous—the US Defense Advances Research Projects Agency is shelling out $65 million to suss out how to deploy, control, counter, or even reverse the effects of tampering with ecology.
Last year, the U.N. gave a cautious go-ahead for the technology to be deployed in the wild in limited terms. Now, the first release of a genetically modified mosquito is set for testing in Burkina Faso in Africa—the first-ever field experiment involving gene drives.
The experiment will only release mosquitoes in the Anopheles genus, which are the main culprits transferring disease. As a first step, over 10,000 male mosquitoes are set for release into the wild. These dudes are genetically sterile but do not cause infertility, and will help scientists examine how they survive and disperse as a preparation for deploying gene-drive-carrying mosquitoes.
Hot on the project’s heels, the nonprofit consortium Target Malaria, backed by the Bill and Melinda Gates foundation, is engineering a gene drive called Mosq that will spread infertility across the population or kill out all female insects. Their attempt to hack the rules of inheritance—and save millions in the process—is slated for 2024.
A Universal Flu Vaccine
People often brush off flu as a mere annoyance, but the infection kills hundreds of thousands each year based on the CDC’s statistical estimates.
The flu virus is actually as difficult of a nemesis as HIV—it mutates at an extremely rapid rate, making effective vaccines almost impossible to engineer on time. Scientists currently use data to forecast the strains that will likely explode into an epidemic and urge the public to vaccinate against those predictions. That’s partly why, on average, flu vaccines only have a success rate of roughly 50 percent—not much better than a coin toss.
Tired of relying on educated guesses, scientists have been chipping away at a universal flu vaccine that targets all strains—perhaps even those we haven’t yet identified. Often referred to as the “holy grail” in epidemiology, these vaccines try to alert our immune systems to parts of a flu virus that are least variable from strain to strain.
Last November, a first universal flu vaccine developed by BiondVax entered Phase 3 clinical trials, which means it’s already been proven safe and effective in a small numbers and is now being tested in a broader population. The vaccine doesn’t rely on dead viruses, which is a common technique. Rather, it uses a small chain of amino acids—the chemical components that make up proteins—to stimulate the immune system into high alert.
With the government pouring $160 million into the research and several other universal candidates entering clinical trials, universal flu vaccines may finally experience a breakthrough this year.
In-Body Gene Editing Shows Further Promise
CRISPR and other gene editing tools headed the news last year, including both downers suggesting we already have immunity to the technology and hopeful news of it getting ready for treating inherited muscle-wasting diseases.
But what wasn’t widely broadcasted was the in-body gene editing experiments that have been rolling out with gusto. Last September, Sangamo Therapeutics in Richmond, California revealed that they had injected gene-editing enzymes into a patient in an effort to correct a genetic deficit that prevents him from breaking down complex sugars.
The effort is markedly different than the better-known CAR-T therapy, which extracts cells from the body for genetic engineering before returning them to the hosts. Rather, Sangamo’s treatment directly injects viruses carrying the edited genes into the body. So far, the procedure looks to be safe, though at the time of reporting it was too early to determine effectiveness.
This year the company hopes to finally answer whether it really worked.
If successful, it means that devastating genetic disorders could potentially be treated with just a few injections. With a gamut of new and more precise CRISPR and other gene-editing tools in the works, the list of treatable inherited diseases is likely to grow. And with the CRISPR baby scandal potentially dampening efforts at germline editing via regulations, in-body gene editing will likely receive more attention if Sangamo’s results return positive.
Neuralink and Other Brain-Machine Interfaces
Neuralink is the stuff of sci fi: tiny implanted particles into the brain could link up your biological wetware with silicon hardware and the internet.
But that’s exactly what Elon Musk’s company, founded in 2016, seeks to develop: brain-machine interfaces that could tinker with your neural circuits in an effort to treat diseases or even enhance your abilities.
Last November, Musk broke his silence on the secretive company, suggesting that he may announce something “interesting” in a few months, that’s “better than anyone thinks is possible.”
Musk’s aspiration for achieving symbiosis with artificial intelligence isn’t the driving force for all brain-machine interfaces (BMIs). In the clinics, the main push is to rehabilitate patients—those who suffer from paralysis, memory loss, or other nerve damage.
2019 may be the year that BMIs and neuromodulators cut the cord in the clinics. These devices may finally work autonomously within a malfunctioning brain, applying electrical stimulation only when necessary to reduce side effects without requiring external monitoring. Or they could allow scientists to control brains with light without needing bulky optical fibers.
Cutting the cord is just the first step to fine-tuning neurological treatments—or enhancements—to the tune of your own brain, and 2019 will keep on bringing the music.
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