Tag Archives: treatment

#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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#431427 Why the Best Healthcare Hacks Are the ...

Technology has the potential to solve some of our most intractable healthcare problems. In fact, it’s already doing so, with inventions getting us closer to a medical Tricorder, and progress toward 3D printed organs, and AIs that can do point-of-care diagnosis.
No doubt these applications of cutting-edge tech will continue to push the needle on progress in medicine, diagnosis, and treatment. But what if some of the healthcare hacks we need most aren’t high-tech at all?
According to Dr. Darshak Sanghavi, this is exactly the case. In a talk at Singularity University’s Exponential Medicine last week, Sanghavi told the audience, “We often think in extremely complex ways, but I think a lot of the improvements in health at scale can be done in an analog way.”
Sanghavi is the chief medical officer and senior vice president of translation at OptumLabs, and was previously director of preventive and population health at the Center for Medicare and Medicaid Innovation, where he oversaw the development of large pilot programs aimed at improving healthcare costs and quality.
“How can we improve health at scale, not for only a small number of people, but for entire populations?” Sanghavi asked. With programs that benefit a small group of people, he explained, what tends to happen is that the average health of a population improves, but the disparities across the group worsen.
“My mantra became, ‘The denominator is everybody,’” he said. He shared details of some low-tech but crucial fixes he believes could vastly benefit the US healthcare system.
1. Regulatory Hacking
Healthcare regulations are ultimately what drive many aspects of patient care, for better or worse. Worse because the mind-boggling complexity of regulations (exhibit A: the Affordable Care Act is reportedly about 20,000 pages long) can make it hard for people to get the care they need at a cost they can afford, but better because, as Sanghavi explained, tweaking these regulations in the right way can result in across-the-board improvements in a given population’s health.
An adjustment to Medicare hospitalization rules makes for a relevant example. The code was updated to state that if people who left the hospital were re-admitted within 30 days, that hospital had to pay a penalty. The result was hospitals taking more care to ensure patients were released not only in good health, but also with a solid understanding of what they had to do to take care of themselves going forward. “Here, arguably the writing of a few lines of regulatory code resulted in a remarkable decrease in 30-day re-admissions, and the savings of several billion dollars,” Sanghavi said.
2. Long-Term Focus
It’s easy to focus on healthcare hacks that have immediate, visible results—but what about fixes whose benefits take years to manifest? How can we motivate hospitals, regulators, and doctors to take action when they know they won’t see changes anytime soon?
“I call this the reality TV problem,” Sanghavi said. “Reality shows don’t really care about who’s the most talented recording artist—they care about getting the most viewers. That is exactly how we think about health care.”
Sanghavi’s team wanted to address this problem for heart attacks. They found they could reliably determine someone’s 10-year risk of having a heart attack based on a simple risk profile. Rather than monitoring patients’ cholesterol, blood pressure, weight, and other individual factors, the team took the average 10-year risk across entire provider panels, then made providers responsible for controlling those populations.
“Every percentage point you lower that risk, by hook or by crook, you get some people to stop smoking, you get some people on cholesterol medication. It’s patient-centered decision-making, and the provider then makes money. This is the world’s first predictive analytic model, at scale, that’s actually being paid for at scale,” he said.
3. Aligned Incentives
If hospitals are held accountable for the health of the communities they’re based in, those hospitals need to have the right incentives to follow through. “Hospitals have to spend money on community benefit, but linking that benefit to a meaningful population health metric can catalyze significant improvements,” Sanghavi said.
Darshak Sanghavi speaking at Singularity University’s 2017 Exponential Medicine Summit in San Diego, CA.
He used smoking cessation as an example. His team designed a program where hospitals were given a score (determined by the Centers for Disease Control and Prevention) based on the smoking rate in the counties where they’re located, then given monetary incentives to improve their score. Improving their score, in turn, resulted in better health for their communities, which meant fewer patients to treat for smoking-related health problems.
4. Social Determinants of Health
Social determinants of health include factors like housing, income, family, and food security. The answer to getting people to pay attention to these factors at scale, and creating aligned incentives, Sanghavi said, is “Very simple. We just have to measure it to start with, and measure it universally.”
His team was behind a $157 million pilot program called Accountable Health Communities that went live this year. The program requires all Medicare and Medicaid beneficiaries get screened for various social determinants of health. With all that data being collected, analysts can pinpoint local trends, then target funds to address the underlying problem, whether it’s job training, drug use, or nutritional education. “You’re then free to invest the dollars where they’re needed…this is how we can improve health at scale, with very simple changes in the incentive structures that are created,” he said.
5. ‘Securitizing’ Public Health
Sanghavi’s final point tied back to his discussion of aligning incentives. As misguided as it may seem, the reality is that financial incentives can make a huge difference in healthcare outcomes, from both a patient and a provider perspective.
Sanghavi’s team did an experiment in which they created outcome benchmarks for three major health problems that exist across geographically diverse areas: smoking, adolescent pregnancy, and binge drinking. The team proposed measuring the baseline of these issues then creating what they called a social impact bond. If communities were able to lower their frequency of these conditions by a given percent within a stated period of time, they’d get paid for it.
“What that did was essentially say, ‘you have a buyer for this outcome if you can achieve it,’” Sanghavi said. “And you can try to get there in any way you like.” The program is currently in CMS clearance.
AI and Robots Not Required
Using robots to perform surgery and artificial intelligence to diagnose disease will undoubtedly benefit doctors and patients around the US and the world. But Sanghavi’s talk made it clear that our healthcare system needs much more than this, and that improving population health on a large scale is really a low-tech project—one involving more regulatory and financial innovation than technological innovation.
“The things that get measured are the things that get changed,” he said. “If we choose the right outcomes to predict long-term benefit, and we pay for those outcomes, that’s the way to make progress.”
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#430814 The Age of Cyborgs Has Arrived

How many cyborgs did you see during your morning commute today? I would guess at least five. Did they make you nervous? Probably not; you likely didn’t even realize they were there.
In a presentation titled “Biohacking and the Connected Body” at Singularity University Global Summit, Hannes Sjoblad informed the audience that we’re already living in the age of cyborgs. Sjoblad is co-founder of the Sweden-based biohacker network Bionyfiken, a chartered non-profit that unites DIY-biologists, hackers, makers, body modification artists and health and performance devotees to explore human-machine integration.
Sjoblad said the cyborgs we see today don’t look like Hollywood prototypes; they’re regular people who have integrated technology into their bodies to improve or monitor some aspect of their health. Sjoblad defined biohacking as applying hacker ethic to biological systems. Some biohackers experiment with their biology with the goal of taking the human body’s experience beyond what nature intended.
Smart insulin monitoring systems, pacemakers, bionic eyes, and Cochlear implants are all examples of biohacking, according to Sjoblad. He told the audience, “We live in a time where, thanks to technology, we can make the deaf hear, the blind see, and the lame walk.” He is convinced that while biohacking could conceivably end up having Brave New World-like dystopian consequences, it can also be leveraged to improve and enhance our quality of life in multiple ways.
The field where biohacking can make the most positive impact is health. In addition to pacemakers and insulin monitors, several new technologies are being developed with the goal of improving our health and simplifying access to information about our bodies.
Ingestibles are a type of smart pill that use wireless technology to monitor internal reactions to medications, helping doctors determine optimum dosage levels and tailor treatments to different people. Your body doesn’t absorb or process medication exactly as your neighbor’s does, so shouldn’t you each have a treatment that works best with your unique system? Colonoscopies and endoscopies could one day be replaced by miniature pill-shaped video cameras that would collect and transmit images as they travel through the digestive tract.
Singularity University Global Summit is the culmination of the Exponential Conference Series and the definitive place to witness converging exponential technologies and understand how they’ll impact the world.
Security is another area where biohacking could be beneficial. One example Sjoblad gave was personalization of weapons: an invader in your house couldn’t fire your gun because it will have been matched to your fingerprint or synced with your body so that it only responds to you.
Biohacking can also simplify everyday tasks. In an impressive example of walking the walk rather than just talking the talk, Sjoblad had an NFC chip implanted in his hand. The chip contains data from everything he used to have to carry around in his pockets: credit and bank card information, key cards to enter his office building and gym, business cards, and frequent shopper loyalty cards. When he’s in line for a morning coffee or rushing to get to the office on time, he doesn’t have to root around in his pockets or bag to find the right card or key; he just waves his hand in front of a sensor and he’s good to go.
Evolved from radio frequency identification (RFID)—an old and widely distributed technology—NFC chips are activated by another chip, and small amounts of data can be transferred back and forth. No wireless connection is necessary. Sjoblad sees his NFC implant as a personal key to the Internet of Things, a simple way for him to talk to the smart, connected devices around him.
Sjoblad isn’t the only person who feels a need for connection.

When British science writer Frank Swain realized he was going to go deaf, he decided to hack his hearing to be able to hear Wi-Fi. Swain developed software that tunes into wireless communication fields and uses an inbuilt Wi-Fi sensor to pick up router name, encryption modes and distance from the device. This data is translated into an audio stream where distant signals click or pop, and strong signals sound their network ID in a looped melody. Swain hears it all through an upgraded hearing aid.
Global datastreams can also become sensory experiences. Spanish artist Moon Ribas developed and implanted a chip in her elbow that is connected to the global monitoring system for seismographic sensors; each time there’s an earthquake, she feels it through vibrations in her arm.
You can feel connected to our planet, too: North Sense makes a “standalone artificial sensory organ” that connects to your body and vibrates whenever you’re facing north. It’s a built-in compass; you’ll never get lost again.
Biohacking applications are likely to proliferate in the coming years, some of them more useful than others. But there are serious ethical questions that can’t be ignored during development and use of this technology. To what extent is it wise to tamper with nature, and who gets to decide?
Most of us are probably ok with waiting in line an extra 10 minutes or occasionally having to pull up a maps app on our phone if it means we don’t need to implant computer chips into our forearms. If it’s frightening to think of criminals stealing our wallets, imagine them cutting a chunk of our skin out to have instant access to and control over our personal data. The physical invasiveness and potential for something to go wrong seems to far outweigh the benefits the average person could derive from this technology.
But that may not always be the case. It’s worth noting the miniaturization of technology continues at a quick rate, and the smaller things get, the less invasive (and hopefully more useful) they’ll be. Even today, there are people already sensibly benefiting from biohacking. If you look closely enough, you’ll spot at least a couple cyborgs on your commute tomorrow morning.
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#430649 Robotherapy for children with autism

New Robotherapy for children with autism could reduce patient supervision by therapists.
Autism treatments and therapies routinely make headlines. With robot enhanced therapies on the rise, often overlooked though, is the mental stress and physical toll the procedures take on therapists. As autism treatments can be taxing on both patient and therapists, few realize the stress and workload of those working with autistic patients.
It is against this backdrop, that researchers from the Vrije Universiteit Brussel are pioneering a new technology to aid behavioural therapy, and one with a very deliberate aspect: they are using robots to boost the basic social learning skills of children with ASD and while doing so, they hope to make the therapists’ job substantially easier.
A study, just published in PALADYN – Journal of Behavioural Robotics examines the use of social robots as tools in clinical situations by addressing the challenge of increasing robot autonomy.
The growing deployment of robot-assisted therapies in recent decades means children with Autism Spectrum Disorder (ASD) can develop and nurture social behaviour and cognitive skills. Learning skills that hold out in real life is the first and foremost goal of all autism therapies, including the Robot-Assisted Therapy (RAT), with effectiveness always considered a key concern. However, this time round the scientists have set off on the additional mission to take the load off the human therapists by letting parts of the intervention be taken over by the supervised yet autonomous robots.
The researchers developed a complete system of robot-enhanced therapy (RET) for children with ASD. The therapy works by teaching behaviours during repeated sessions of interactive games. Since the individuals with ASD tend to be more responsive to feedback coming from an interaction with technology, robots are often used for this therapy. In this approach, the social robot acts as a mediator and typically remains remote-controlled by a human operator. The technique, called Wizard of Oz, requires the robot to be operated by an additional person and the robot is not recording the performance during the therapy. In order to reduce operator workload, authors introduced a system with a supervised autonomous robot – which is able to understand the psychological disposition of the child and use it to select actions appropriate to the current state of the interaction.
Admittedly, robots with supervised autonomy can substantially benefit behavioural therapy for children with ASD – diminishing the therapist workload on the one hand, and achieving more objective measurements of therapy outcomes on the other. Yet, complex as it is, this therapy requires a multidisciplinary approach, as RET provides mixed effectiveness for primary tasks: the turn-taking, joint attention and imitation task comparing to Standard Human Treatment (SHT).
Results are likely to prompt a further development of the robot assisted therapy with increasing robot’s autonomy. With many outstanding conceptual and technical issues yet to tackle –it is definitely the ethical questions that pose one of the major challenges as far as the potential and maximal degree of robot autonomy is concerned.
The article is fully available in open access to read, download and share on De Gruyter Online.
Research was conducted as a part of DREAM (Development of Robot-Enhanced therapy for children with Autism spectrum disorders) project.
DOI: 10.1515/pjbr-2017-0002
Image credit: P.G. Esteban
About the Journal: PALADYN – Journal of Behavioural Robotics is a fully peer-reviewed, electronic-only journal that publishes original, high-quality research on topics broadly related to neuronally and psychologically inspired robots and other behaving autonomous systems.
About De Gruyter Open: De Gruyter Open is a leading publisher of Open Access academic content. Publishing in all major disciplines, De Gruyter Open is home to more than 500 scholarly journals and over 100 books. The company is part of the De Gruyter Group (www.degruyter.com) and a member of the Association of Learned and Professional Society Publishers (ALPSP). De Gruyter Open’s book and journal programs have been endorsed by the international research community and some of the world’s top scientists, including Nobel laureates. The company’s mission is to make the very best in academic content freely available to scholars and lay readers alike.
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