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#434648 The Pediatric AI That Outperformed ...
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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Posted in Human Robots
#434303 Making Superhumans Through Radical ...
Imagine trying to read War and Peace one letter at a time. The thought alone feels excruciating. But in many ways, this painful idea holds parallels to how human-machine interfaces (HMI) force us to interact with and process data today.
Designed back in the 1970s at Xerox PARC and later refined during the 1980s by Apple, today’s HMI was originally conceived during fundamentally different times, and specifically, before people and machines were generating so much data. Fast forward to 2019, when humans are estimated to produce 44 zettabytes of data—equal to two stacks of books from here to Pluto—and we are still using the same HMI from the 1970s.
These dated interfaces are not equipped to handle today’s exponential rise in data, which has been ushered in by the rapid dematerialization of many physical products into computers and software.
Breakthroughs in perceptual and cognitive computing, especially machine learning algorithms, are enabling technology to process vast volumes of data, and in doing so, they are dramatically amplifying our brain’s abilities. Yet even with these powerful technologies that at times make us feel superhuman, the interfaces are still crippled with poor ergonomics.
Many interfaces are still designed around the concept that human interaction with technology is secondary, not instantaneous. This means that any time someone uses technology, they are inevitably multitasking, because they must simultaneously perform a task and operate the technology.
If our aim, however, is to create technology that truly extends and amplifies our mental abilities so that we can offload important tasks, the technology that helps us must not also overwhelm us in the process. We must reimagine interfaces to work in coherence with how our minds function in the world so that our brains and these tools can work together seamlessly.
Embodied Cognition
Most technology is designed to serve either the mind or the body. It is a problematic divide, because our brains use our entire body to process the world around us. Said differently, our minds and bodies do not operate distinctly. Our minds are embodied.
Studies using MRI scans have shown that when a person feels an emotion in their gut, blood actually moves to that area of the body. The body and the mind are linked in this way, sharing information back and forth continuously.
Current technology presents data to the brain differently from how the brain processes data. Our brains, for example, use sensory data to continually encode and decipher patterns within the neocortex. Our brains do not create a linguistic label for each item, which is how the majority of machine learning systems operate, nor do our brains have an image associated with each of these labels.
Our bodies move information through us instantaneously, in a sense “computing” at the speed of thought. What if our technology could do the same?
Using Cognitive Ergonomics to Design Better Interfaces
Well-designed physical tools, as philosopher Martin Heidegger once meditated on while using the metaphor of a hammer, seem to disappear into the “hand.” They are designed to amplify a human ability and not get in the way during the process.
The aim of physical ergonomics is to understand the mechanical movement of the human body and then adapt a physical system to amplify the human output in accordance. By understanding the movement of the body, physical ergonomics enables ergonomically sound physical affordances—or conditions—so that the mechanical movement of the body and the mechanical movement of the machine can work together harmoniously.
Cognitive ergonomics applied to HMI design uses this same idea of amplifying output, but rather than focusing on physical output, the focus is on mental output. By understanding the raw materials the brain uses to comprehend information and form an output, cognitive ergonomics allows technologists and designers to create technological affordances so that the brain can work seamlessly with interfaces and remove the interruption costs of our current devices. In doing so, the technology itself “disappears,” and a person’s interaction with technology becomes fluid and primary.
By leveraging cognitive ergonomics in HMI design, we can create a generation of interfaces that can process and present data the same way humans process real-world information, meaning through fully-sensory interfaces.
Several brain-machine interfaces are already on the path to achieving this. AlterEgo, a wearable device developed by MIT researchers, uses electrodes to detect and understand nonverbal prompts, which enables the device to read the user’s mind and act as an extension of the user’s cognition.
Another notable example is the BrainGate neural device, created by researchers at Stanford University. Just two months ago, a study was released showing that this brain implant system allowed paralyzed patients to navigate an Android tablet with their thoughts alone.
These are two extraordinary examples of what is possible for the future of HMI, but there is still a long way to go to bring cognitive ergonomics front and center in interface design.
Disruptive Innovation Happens When You Step Outside Your Existing Users
Most of today’s interfaces are designed by a narrow population, made up predominantly of white, non-disabled men who are prolific in the use of technology (you may recall The New York Times viral article from 2016, Artificial Intelligence’s White Guy Problem). If you ask this population if there is a problem with today’s HMIs, most will say no, and this is because the technology has been designed to serve them.
This lack of diversity means a limited perspective is being brought to interface design, which is problematic if we want HMI to evolve and work seamlessly with the brain. To use cognitive ergonomics in interface design, we must first gain a more holistic understanding of how people with different abilities understand the world and how they interact with technology.
Underserved groups, such as people with physical disabilities, operate on what Clayton Christensen coined in The Innovator’s Dilemma as the fringe segment of a market. Developing solutions that cater to fringe groups can in fact disrupt the larger market by opening a downward, much larger market.
Learning From Underserved Populations
When technology fails to serve a group of people, that group must adapt the technology to meet their needs.
The workarounds created are often ingenious, specifically because they have not been arrived at by preferences, but out of necessity that has forced disadvantaged users to approach the technology from a very different vantage point.
When a designer or technologist begins learning from this new viewpoint and understanding challenges through a different lens, they can bring new perspectives to design—perspectives that otherwise can go unseen.
Designers and technologists can also learn from people with physical disabilities who interact with the world by leveraging other senses that help them compensate for one they may lack. For example, some blind people use echolocation to detect objects in their environments.
The BrainPort device developed by Wicab is an incredible example of technology leveraging one human sense to serve or compliment another. The BrainPort device captures environmental information with a wearable video camera and converts this data into soft electrical stimulation sequences that are sent to a device on the user’s tongue—the most sensitive touch receptor in the body. The user learns how to interpret the patterns felt on their tongue, and in doing so, become able to “see” with their tongue.
Key to the future of HMI design is learning how different user groups navigate the world through senses beyond sight. To make cognitive ergonomics work, we must understand how to leverage the senses so we’re not always solely relying on our visual or verbal interactions.
Radical Inclusion for the Future of HMI
Bringing radical inclusion into HMI design is about gaining a broader lens on technology design at large, so that technology can serve everyone better.
Interestingly, cognitive ergonomics and radical inclusion go hand in hand. We can’t design our interfaces with cognitive ergonomics without bringing radical inclusion into the picture, and we also will not arrive at radical inclusion in technology so long as cognitive ergonomics are not considered.
This new mindset is the only way to usher in an era of technology design that amplifies the collective human ability to create a more inclusive future for all.
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Posted in Human Robots