Tag Archives: treatment

#433828 Using Big Data to Give Patients Control ...

Big data, personalized medicine, artificial intelligence. String these three buzzphrases together, and what do you have?

A system that may revolutionize the future of healthcare, by bringing sophisticated health data directly to patients for them to ponder, digest, and act upon—and potentially stop diseases in their tracks.

At Singularity University’s Exponential Medicine conference in San Diego this week, Dr. Ran Balicer, director of the Clalit Research Institute in Israel, painted a futuristic picture of how big data can merge with personalized healthcare into an app-based system in which the patient is in control.

Dr. Ran Balicer at Exponential Medicine
Picture this: instead of going to a physician with your ailments, your doctor calls you with some bad news: “Within six hours, you’re going to have a heart attack. So why don’t you come into the clinic and we can fix that.” Crisis averted.

Following the treatment, you’re at home monitoring your biomarkers, lab test results, and other health information through an app with a clean, beautiful user interface. Within the app, you can observe how various health-influencing life habits—smoking, drinking, insufficient sleep—influence your chance of future cardiovascular disease risks by toggling their levels up or down.

There’s more: you can also set a health goal within the app—for example, stop smoking—which automatically informs your physician. The app will then suggest pharmaceuticals to help you ditch the nicotine and automatically sends the prescription to your local drug store. You’ll also immediately find a list of nearby support groups that can help you reach your health goal.

With this hefty dose of AI, you’re in charge of your health—in fact, probably more so than under current healthcare systems.

Sound fantastical? In fact, this type of preemptive care is already being provided in some countries, including Israel, at a massive scale, said Balicer. By mining datasets with deep learning and other powerful AI tools, we can predict the future—and put it into the hands of patients.

The Israeli Advantage
In order to apply big data approaches to medicine, you first need a giant database.

Israel is ahead of the game in this regard. With decades of electronic health records aggregated within a central warehouse, Israel offers a wealth of health-related data on the scale of millions of people and billions of data points. The data is incredibly multiplex, covering lab tests, drugs, hospital admissions, medical procedures, and more.

One of Balicer’s early successes was an algorithm that predicts diabetes, which allowed the team to notify physicians to target their care. Clalit has also been busy digging into data that predicts winter pneumonia, osteoporosis, and a long list of other preventable diseases.

So far, Balicer’s predictive health system has only been tested on a pilot group of patients, but he is expecting to roll out the platform to all patients in the database in the next few months.

Truly Personalized Medicine
To Balicer, whatever a machine can do better, it should be welcomed to do. AI diagnosticians have already enjoyed plenty of successes—but their collaboration remains mostly with physicians, at a point in time when the patient is already ill.

A particularly powerful use of AI in medicine is to bring insights and trends directly to the patient, such that they can take control over their own health and medical care.

For example, take the problem of tailored drug dosing. Current drug doses are based on average results conducted during clinical trials—the dosing is not tailored for any specific patient’s genetic and health makeup. But what if a doctor had already seen millions of other patients similar to your case, and could generate dosing recommendations more relevant to you based on that particular group of patients?

Such personalized recommendations are beyond the ability of any single human doctor. But with the help of AI, which can quickly process massive datasets to find similarities, doctors may soon be able to prescribe individually-tailored medications.

Tailored treatment doesn’t stop there. Another issue with pharmaceuticals and treatment regimes is that they often come with side effects: potentially health-threatening reactions that may, or may not, happen to you based on your biometrics.

Back in 2017, the New England Journal of Medicine launched the SPRINT Data Analysis Challenge, which urged physicians and data analysts to identify novel clinical findings using shared clinical trial data.

Working with Dr. Noa Dagan at the Clalit Research Institute, Balicer and team developed an algorithm that recommends whether or not a patient receives a particularly intensive treatment regime for hypertension.

Rather than simply looking at one outcome—normalized blood pressure—the algorithm takes into account an individual’s specific characteristics, laying out the treatment’s predicted benefits and harms for a particular patient.

“We built thousands of models for each patient to comprehensively understand the impact of the treatment for the individual; for example, a reduced risk for stroke and cardiovascular-related deaths could be accompanied by an increase in serious renal failure,” said Balicer. “This approach allows a truly personalized balance—allowing patients and their physicians to ultimately decide if the risks of the treatment are worth the benefits.”

This is already personalized medicine at its finest. But Balicer didn’t stop there.

We are not the sum of our biologics and medical stats, he said. A truly personalized approach needs to take a patient’s needs and goals and the sacrifices and tradeoffs they’re willing to make into account, rather than having the physician make decisions for them.

Balicer’s preventative system adds this layer of complexity by giving weights to different outcomes based on patients’ input of their own health goals. Rather than blindly following big data, the system holistically integrates the patient’s opinion to make recommendations.

Balicer’s system is just one example of how AI can truly transform personalized health care. The next big challenge is to work with physicians to further optimize these systems, in a way that doctors can easily integrate them into their workflow and embrace the technology.

“Health systems will not be replaced by algorithms, rest assured,” concluded Balicer, “but health systems that don’t use algorithms will be replaced by those that do.”

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#432563 This Week’s Awesome Stories From ...

ARTIFICIAL INTELLIGENCE
Pedro Domingos on the Arms Race in Artificial Intelligence
Christoph Scheuermann and Bernhard Zand | Spiegel Online
“AI lowers the cost of knowledge by orders of magnitude. One good, effective machine learning system can do the work of a million people, whether it’s for commercial purposes or for cyberespionage. Imagine a country that produces a thousand times more knowledge than another. This is the challenge we are facing.”

BIOTECHNOLOGY
Gene Therapy Could Free Some People From a Lifetime of Blood Transfusions
Emily Mullin | MIT Technology Review
“A one-time, experimental treatment for an inherited blood disorder has shown dramatic results in a small study. …[Lead author Alexis Thompson] says the effect on patients has been remarkable. ‘They have been tied to this ongoing medical therapy that is burdensome and expensive for their whole lives,’ she says. ‘Gene therapy has allowed people to have aspirations and really pursue them.’ ”

ENVIRONMENT
The Revolutionary Giant Ocean Cleanup Machine Is About to Set Sail
Adele Peters | Fast Company
“By the end of 2018, the nonprofit says it will bring back its first harvest of ocean plastic from the North Pacific Gyre, along with concrete proof that the design works. The organization expects to bring 5,000 kilograms of plastic ashore per month with its first system. With a full fleet of systems deployed, it believes that it can collect half of the plastic trash in the Great Pacific Garbage Patch—around 40,000 metric tons—within five years.”

ROBOTICS
Autonomous Boats Will Be on the Market Sooner Than Self-Driving Cars
Tracey Lindeman | Motherboard
“Some unmanned watercraft…may be at sea commercially before 2020. That’s partly because automating all ships could generate a ridiculous amount of revenue. According to the United Nations, 90 percent of the world’s trade is carried by sea and 10.3 billion tons of products were shipped in 2016.”

DIGITAL CULTURE
Style Is an Algorithm
Kyle Chayka | Racked
“Confronting the Echo Look’s opaque statements on my fashion sense, I realize that all of these algorithmic experiences are matters of taste: the question of what we like and why we like it, and what it means that taste is increasingly dictated by black-box robots like the camera on my shelf.”

COMPUTING
How Apple Will Use AR to Reinvent the Human-Computer Interface
Tim Bajarin | Fast Company
“It’s in Apple’s DNA to continually deliver the ‘next’ major advancement to the personal computing experience. Its innovation in man-machine interfaces started with the Mac and then extended to the iPod, the iPhone, the iPad, and most recently, the Apple Watch. Now, get ready for the next chapter, as Apple tackles augmented reality, in a way that could fundamentally transform the human-computer interface.”

SCIENCE
Advanced Microscope Shows Cells at Work in Incredible Detail
Steve Dent | Engadget
“For the first time, scientists have peered into living cells and created videos showing how they function with unprecedented 3D detail. Using a special microscope and new lighting techniques, a team from Harvard and the Howard Hughes Medical Institute captured zebrafish immune cell interactions with unheard-of 3D detail and resolution.”

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#432027 We Read This 800-Page Report on the ...

The longevity field is bustling but still fragmented, and the “silver tsunami” is coming.

That is the takeaway of The Science of Longevity, the behemoth first volume of a four-part series offering a bird’s-eye view of the longevity industry in 2017. The report, a joint production of the Biogerontology Research Foundation, Deep Knowledge Life Science, Aging Analytics Agency, and Longevity.International, synthesizes the growing array of academic and industry ventures related to aging, healthspan, and everything in between.

This is huge, not only in scale but also in ambition. The report, totally worth a read here, will be followed by four additional volumes in 2018, covering topics ranging from the business side of longevity ventures to financial systems to potential tensions between life extension and religion.

And that’s just the first step. The team hopes to publish updated versions of the report annually, giving scientists, investors, and regulatory agencies an easy way to keep their finger on the longevity pulse.

“In 2018, ‘aging’ remains an unnamed adversary in an undeclared war. For all intents and purposes it is mere abstraction in the eyes of regulatory authorities worldwide,” the authors write.

That needs to change.

People often arrive at the field of aging from disparate areas with wildly diverse opinions and strengths. The report compiles these individual efforts at cracking aging into a systematic resource—a “periodic table” for longevity that clearly lays out emerging trends and promising interventions.

The ultimate goal? A global framework serving as a road map to guide the burgeoning industry. With such a framework in hand, academics and industry alike are finally poised to petition the kind of large-scale investments and regulatory changes needed to tackle aging with a unified front.

Infographic depicting many of the key research hubs and non-profits within the field of geroscience.
Image Credit: Longevity.International
The Aging Globe
The global population is rapidly aging. And our medical and social systems aren’t ready to handle this oncoming “silver tsunami.”

Take the medical field. Many age-related diseases such as Alzheimer’s lack effective treatment options. Others, including high blood pressure, stroke, lung or heart problems, require continuous medication and monitoring, placing enormous strain on medical resources.

What’s more, because disease risk rises exponentially with age, medical care for the elderly becomes a game of whack-a-mole: curing any individual disease such as cancer only increases healthy lifespan by two to three years before another one hits.

That’s why in recent years there’s been increasing support for turning the focus to the root of the problem: aging. Rather than tackling individual diseases, geroscience aims to add healthy years to our lifespan—extending “healthspan,” so to speak.

Despite this relative consensus, the field still faces a roadblock. The US FDA does not yet recognize aging as a bona fide disease. Without such a designation, scientists are banned from testing potential interventions for aging in clinical trials (that said, many have used alternate measures such as age-related biomarkers or Alzheimer’s symptoms as a proxy).

Luckily, the FDA’s stance is set to change. The promising anti-aging drug metformin, for example, is already in clinical trials, examining its effect on a variety of age-related symptoms and diseases. This report, and others to follow, may help push progress along.

“It is critical for investors, policymakers, scientists, NGOs, and influential entities to prioritize the amelioration of the geriatric world scenario and recognize aging as a critical matter of global economic security,” the authors say.

Biomedical Gerontology
The causes of aging are complex, stubborn, and not all clear.

But the report lays out two main streams of intervention with already promising results.

The first is to understand the root causes of aging and stop them before damage accumulates. It’s like meddling with cogs and other inner workings of a clock to slow it down, the authors say.

The report lays out several treatments to keep an eye on.

Geroprotective drugs is a big one. Often repurposed from drugs already on the market, these traditional small molecule drugs target a wide variety of metabolic pathways that play a role in aging. Think anti-oxidants, anti-inflammatory, and drugs that mimic caloric restriction, a proven way to extend healthspan in animal models.

More exciting are the emerging technologies. One is nanotechnology. Nanoparticles of carbon, “bucky-balls,” for example, have already been shown to fight viral infections and dangerous ion particles, as well as stimulate the immune system and extend lifespan in mice (though others question the validity of the results).

Blood is another promising, if surprising, fountain of youth: recent studies found that molecules in the blood of the young rejuvenate the heart, brain, and muscles of aged rodents, though many of these findings have yet to be replicated.

Rejuvenation Biotechnology
The second approach is repair and maintenance.

Rather than meddling with inner clockwork, here we force back the hands of a clock to set it back. The main example? Stem cell therapy.

This type of approach would especially benefit the brain, which harbors small, scattered numbers of stem cells that deplete with age. For neurodegenerative diseases like Alzheimer’s, in which neurons progressively die off, stem cell therapy could in theory replace those lost cells and mend those broken circuits.

Once a blue-sky idea, the discovery of induced pluripotent stem cells (iPSCs), where scientists can turn skin and other mature cells back into a stem-like state, hugely propelled the field into near reality. But to date, stem cells haven’t been widely adopted in clinics.

It’s “a toolkit of highly innovative, highly invasive technologies with clinical trials still a great many years off,” the authors say.

But there is a silver lining. The boom in 3D tissue printing offers an alternative approach to stem cells in replacing aging organs. Recent investment from the Methuselah Foundation and other institutions suggests interest remains high despite still being a ways from mainstream use.

A Disruptive Future
“We are finally beginning to see an industry emerge from mankind’s attempts to make sense of the biological chaos,” the authors conclude.

Looking through the trends, they identified several technologies rapidly gaining steam.

One is artificial intelligence, which is already used to bolster drug discovery. Machine learning may also help identify new longevity genes or bring personalized medicine to the clinic based on a patient’s records or biomarkers.

Another is senolytics, a class of drugs that kill off “zombie cells.” Over 10 prospective candidates are already in the pipeline, with some expected to enter the market in less than a decade, the authors say.

Finally, there’s the big gun—gene therapy. The treatment, unlike others mentioned, can directly target the root of any pathology. With a snip (or a swap), genetic tools can turn off damaging genes or switch on ones that promote a youthful profile. It is the most preventative technology at our disposal.

There have already been some success stories in animal models. Using gene therapy, rodents given a boost in telomerase activity, which lengthens the protective caps of DNA strands, live healthier for longer.

“Although it is the prospect farthest from widespread implementation, it may ultimately prove the most influential,” the authors say.

Ultimately, can we stop the silver tsunami before it strikes?

Perhaps not, the authors say. But we do have defenses: the technologies outlined in the report, though still immature, could one day stop the oncoming tidal wave in its tracks.

Now we just have to bring them out of the lab and into the real world. To push the transition along, the team launched Longevity.International, an online meeting ground that unites various stakeholders in the industry.

By providing scientists, entrepreneurs, investors, and policy-makers a platform for learning and discussion, the authors say, we may finally generate enough drive to implement our defenses against aging. The war has begun.

Read the report in full here, and watch out for others coming soon here. The second part of the report profiles 650 (!!!) longevity-focused research hubs, non-profits, scientists, conferences, and literature. It’s an enormously helpful resource—totally worth keeping it in your back pocket for future reference.

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#431907 The Future of Cancer Treatment Is ...

In an interview at Singularity University’s Exponential Medicine in San Diego, Richard Wender, chief cancer control officer at the American Cancer Society, discussed how technology has changed cancer care and treatment in recent years.
Just a few years ago, microscopes were the primary tool used in cancer diagnoses, but we’ve come a long way since.
“We still look at a microscope, we still look at what organ the cancer started in,” Wender said. “But increasingly we’re looking at the molecular signature. It’s not just the genomics, and it’s not just the genes. It’s also the cellular environment around that cancer. We’re now targeting our therapies to the mutations that are found in that particular cancer.”
Cancer treatments in the past have been largely reactionary, but they don’t need to be. Most cancer is genetic, which means that treatment can be preventative. This is one reason why newer cancer treatment techniques are searching for actionable targets in the specific gene before the cancer develops.

When asked how artificial intelligence and machine learning technologies are reshaping clinical trials, Wender acknowledged that how clinical trials have been run in the past won’t work moving forward.
“Our traditional ways of learning about cancer were by finding a particular cancer type and conducting a long clinical trial that took a number of years enrolling patients from around the country. That is not how we’re going to learn to treat individual patients in the future.”
Instead, Wender emphasized the need for gathering as much data as possible, and from as many individual patients as possible. This data should encompass clinical, pathological, and molecular data and should be gathered from a patient all the way through their final outcome. “Literally every person becomes a clinical trial of one,” Wender said.
For the best cancer treatment and diagnostics, Wender says the answer is to make the process collaborative by pulling in resources from organizations and companies that are both established and emerging.
It’s no surprise to hear that the best solutions come from pairing together uncommon partners to innovate.
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#431839 The Hidden Human Workforce Powering ...

The tech industry touts its ability to automate tasks and remove slow and expensive humans from the equation. But in the background, a lot of the legwork training machine learning systems, solving problems software can’t, and cleaning up its mistakes is still done by people.
This was highlighted recently when Expensify, which promises to automatically scan photos of receipts to extract data for expense reports, was criticized for sending customers’ personally identifiable receipts to workers on Amazon’s Mechanical Turk (MTurk) crowdsourcing platform.
The company uses text analysis software to read the receipts, but if the automated system falls down then the images are passed to a human for review. While entrusting this job to random workers on MTurk was maybe not so wise—and the company quickly stopped after the furor—the incident brought to light that this kind of human safety net behind AI-powered services is actually very common.
As Wired notes, similar services like Ibotta and Receipt Hog that collect receipt information for marketing purposes also use crowdsourced workers. In a similar vein, while most users might assume their Facebook newsfeed is governed by faceless algorithms, the company has been ramping up the number of human moderators it employs to catch objectionable content that slips through the net, as has YouTube. Twitter also has thousands of human overseers.
Humans aren’t always witting contributors either. The old text-based reCAPTCHA problems Google used to use to distinguish humans from machines was actually simultaneously helping the company digitize books by getting humans to interpret hard-to-read text.
“Every product that uses AI also uses people,” Jeffrey Bigham, a crowdsourcing expert at Carnegie Mellon University, told Wired. “I wouldn’t even say it’s a backstop so much as a core part of the process.”
Some companies are not shy about their use of crowdsourced workers. Startup Eloquent Labs wants to insert them between customer service chatbots and human agents who step in when the machines fail. Many times the AI is pretty certain what particular work means, and an MTurk worker can step in and quickly classify them faster and cheaper than a service agent.
Fashion retailer Gilt provides “pre-emptive shipping,” which uses data analytics to predict what people will buy to get products to them faster. The company uses MTurk workers to provide subjective critiques of clothing that feed into their models.
MTurk isn’t the only player. Companies like Cloudfactory and Crowdflower provide crowdsourced human manpower tailored to particular niches, and some companies prefer to maintain their own communities of workers. Unlabel uses an army of 50,000 humans to check and edit the translations its artificial intelligence system produces for customers.
Most of the time these human workers aren’t just filling in the gaps, they’re also helping to train the machine learning component of these companies’ services by providing new examples of how to solve problems. Other times humans aren’t used “in-the-loop” with AI systems, but to prepare data sets they can learn from by labeling images, text, or audio.
It’s even possible to use crowdsourced workers to carry out tasks typically tackled by machine learning, such as large-scale image analysis and forecasting.
Zooniverse gets citizen scientists to classify images of distant galaxies or videos of animals to help academics analyze large data sets too complex for computers. Almanis creates forecasts on everything from economics to politics with impressive accuracy by giving those who sign up to the website incentives for backing the correct answer to a question. Researchers have used MTurkers to power a chatbot, and there’s even a toolkit for building algorithms to control this human intelligence called TurKit.
So what does this prominent role for humans in AI services mean? Firstly, it suggests that many tools people assume are powered by AI may in fact be relying on humans. This has obvious privacy implications, as the Expensify story highlighted, but should also raise concerns about whether customers are really getting what they pay for.
One example of this is IBM’s Watson for oncology, which is marketed as a data-driven AI system for providing cancer treatment recommendations. But an investigation by STAT highlighted that it’s actually largely driven by recommendations from a handful of (admittedly highly skilled) doctors at Memorial Sloan Kettering Cancer Center in New York.
Secondly, humans intervening in AI-run processes also suggests AI is still largely helpless without us, which is somewhat comforting to know among all the doomsday predictions of AI destroying jobs. At the same time, though, much of this crowdsourced work is monotonous, poorly paid, and isolating.
As machines trained by human workers get better at all kinds of tasks, this kind of piecemeal work filling in the increasingly small gaps in their capabilities may get more common. While tech companies often talk about AI augmenting human intelligence, for many it may actually end up being the other way around.
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