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#434637 AI Is Rapidly Augmenting Healthcare and ...

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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#434611 This Week’s Awesome Stories From ...

The Rise of the Robot Reporter
Jaclyn Paiser | The New York Times
“In addition to covering company earnings for Bloomberg, robot reporters have been prolific producers of articles on minor league baseball for The Associated Press, high school football for The Washington Post and earthquakes for The Los Angeles Times.”

Penny-Sized Ionocraft Flies With No Moving Parts
Evan Ackerman | IEEE Spectrum
“Electrohydrodynamic (EHD) thrusters, sometimes called ion thrusters, use a high strength electric field to generate a plasma of ionized air. …Magical, right? No moving parts, completely silent, and it flies!”

Making New Drugs With a Dose of Artificial Intelligence
Cade Metz | The New York Times
“…DeepMind won the [protein folding] competition by a sizable margin—it improved the prediction accuracy nearly twice as much as experts expected from the contest winner. DeepMind’s victory showed how the future of biochemical research will increasingly be driven by machines and the people who oversee those machines.”

Nano-Switches Made Out of Graphene Could Make Our Devices Even Smaller
Emerging Technology From the arXiv | MIT Technology Review
“For the first time, physicists have built reliable, efficient graphene nanomachines that can be fabricated on silicon chips. They could lead to even greater miniaturization.”

The Problem With Big DNA
Sarah Zhang | The Atlantic
“It took researchers days to search through thousands of genome sequences. Now it takes just a few seconds. …As sequencing becomes more common, the number of publicly available bacterial and viral genomes has doubled. At the rate this work is going, within a few years multiple millions of searchable pathogen genomes will be available—a library of DNA and disease, spread the world over.”

Fire (and Lots of It): Berkeley Researcher on the Only Way to Fix Cryptocurrency
Dan Goodin | Ars Technica
“Weaver said, there’s no basis for the promises that cryptocurrencies’ decentralized structure and blockchain basis will fundamentally transform commerce or economics. That means the sky-high valuations spawned by those false promises are completely unjustified. …To support that conclusion, Weaver recited an oft-repeated list of supposed benefits of cryptocurrencies and explained why, after closer scrutiny, he believed them to be myths.”

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#434585 This Week’s Awesome Stories From ...

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.”

3D Printing
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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#434544 This Week’s Awesome Stories From ...

DeepMind Beats Pros at Starcraft in Another Triumph for Bots
Tom Simonite | Wired
“DeepMind’s feat is the most complex yet in a long train of contests in which computers have beaten top humans at games. Checkers fell in 1994, chess in 1997, and DeepMind’s earlier bot AlphaGo became the first to beat a champion at the board game Go in 2016. The StarCraft bot is the most powerful AI game player yet; it may also be the least unexpected.”

Complete Axolotl Genome Could Pave the Way Toward Human Tissue Regeneration
George Dvorsky | Gizmodo
“Now that researchers have a near-complete axolotl genome—the new assembly still requires a bit of fine-tuning (more on that in a bit)—they, along with others, can now go about the work of identifying the genes responsible for axolotl tissue regeneration.”

We Analyzed 16,625 Papers to Figure Out Where AI Is Headed Next
Karen Hao | MIT Technology Review
“…though deep learning has singlehandedly thrust AI into the public eye, it represents just a small blip in the history of humanity’s quest to replicate our own intelligence. It’s been at the forefront of that effort for less than 10 years. When you zoom out on the whole history of the field, it’s easy to realize that it could soon be on its way out.”

Apple’s Finger-Controller Patent Is a Glimpse at Mixed Reality’s Future
Mark Sullivan | Fast Company
“[Apple’s] engineers are now looking past the phone touchscreen toward mixed reality, where the company’s next great UX will very likely be built. A recent patent application gives some tantalizing clues as to how Apple’s people are thinking about aspects of that challenge.”

How Do You Govern Machines That Can Learn? Policymakers Are Trying to Figure That Out
Steve Lohr | The New York Times
“Regulation is coming. That’s a good thing. Rules of competition and behavior are the foundation of healthy, growing markets. That was the consensus of the policymakers at MIT. But they also agreed that artificial intelligence raises some fresh policy challenges.”

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#434151 Life-or-Death Algorithms: The Black Box ...

When it comes to applications for machine learning, few can be more widely hyped than medicine. This is hardly surprising: it’s a huge industry that generates a phenomenal amount of data and revenue, where technological advances can improve or save the lives of millions of people. Hardly a week passes without a study that suggests algorithms will soon be better than experts at detecting pneumonia, or Alzheimer’s—diseases in complex organs ranging from the eye to the heart.

The problems of overcrowded hospitals and overworked medical staff plague public healthcare systems like Britain’s NHS and lead to rising costs for private healthcare systems. Here, again, algorithms offer a tantalizing solution. How many of those doctor’s visits really need to happen? How many could be replaced by an interaction with an intelligent chatbot—especially if it can be combined with portable diagnostic tests, utilizing the latest in biotechnology? That way, unnecessary visits could be reduced, and patients could be diagnosed and referred to specialists more quickly without waiting for an initial consultation.

As ever with artificial intelligence algorithms, the aim is not to replace doctors, but to give them tools to reduce the mundane or repetitive parts of the job. With an AI that can examine thousands of scans in a minute, the “dull drudgery” is left to machines, and the doctors are freed to concentrate on the parts of the job that require more complex, subtle, experience-based judgement of the best treatments and the needs of the patient.

High Stakes
But, as ever with AI algorithms, there are risks involved with relying on them—even for tasks that are considered mundane. The problems of black-box algorithms that make inexplicable decisions are bad enough when you’re trying to understand why that automated hiring chatbot was unimpressed by your job interview performance. In a healthcare context, where the decisions made could mean life or death, the consequences of algorithmic failure could be grave.

A new paper in Science Translational Medicine, by Nicholson Price, explores some of the promises and pitfalls of using these algorithms in the data-rich medical environment.

Neural networks excel at churning through vast quantities of training data and making connections, absorbing the underlying patterns or logic for the system in hidden layers of linear algebra; whether it’s detecting skin cancer from photographs or learning to write in pseudo-Shakespearean script. They are terrible, however, at explaining the underlying logic behind the relationships that they’ve found: there is often little more than a string of numbers, the statistical “weights” between the layers. They struggle to distinguish between correlation and causation.

This raises interesting dilemmas for healthcare providers. The dream of big data in medicine is to feed a neural network on “huge troves of health data, finding complex, implicit relationships and making individualized assessments for patients.” What if, inevitably, such an algorithm proves to be unreasonably effective at diagnosing a medical condition or prescribing a treatment, but you have no scientific understanding of how this link actually works?

Too Many Threads to Unravel?
The statistical models that underlie such neural networks often assume that variables are independent of each other, but in a complex, interacting system like the human body, this is not always the case.

In some ways, this is a familiar concept in medical science—there are many phenomena and links which have been observed for decades but are still poorly understood on a biological level. Paracetamol is one of the most commonly-prescribed painkillers, but there’s still robust debate about how it actually works. Medical practitioners may be keen to deploy whatever tool is most effective, regardless of whether it’s based on a deeper scientific understanding. Fans of the Copenhagen interpretation of quantum mechanics might spin this as “Shut up and medicate!”

But as in that field, there’s a debate to be had about whether this approach risks losing sight of a deeper understanding that will ultimately prove more fruitful—for example, for drug discovery.

Away from the philosophical weeds, there are more practical problems: if you don’t understand how a black-box medical algorithm is operating, how should you approach the issues of clinical trials and regulation?

Price points out that, in the US, the “21st-Century Cures Act” allows the FDA to regulate any algorithm that analyzes images, or doesn’t allow a provider to review the basis for its conclusions: this could completely exclude “black-box” algorithms of the kind described above from use.

Transparency about how the algorithm functions—the data it looks at, and the thresholds for drawing conclusions or providing medical advice—may be required, but could also conflict with the profit motive and the desire for secrecy in healthcare startups.

One solution might be to screen algorithms that can’t explain themselves, or don’t rely on well-understood medical science, from use before they enter the healthcare market. But this could prevent people from reaping the benefits that they can provide.

Evaluating Algorithms
New healthcare algorithms will be unable to do what physicists did with quantum mechanics, and point to a track record of success, because they will not have been deployed in the field. And, as Price notes, many algorithms will improve as they’re deployed in the field for a greater amount of time, and can harvest and learn from the performance data that’s actually used. So how can we choose between the most promising approaches?

Creating a standardized clinical trial and validation system that’s equally valid across algorithms that function in different ways, or use different input or training data, will be a difficult task. Clinical trials that rely on small sample sizes, such as for algorithms that attempt to personalize treatment to individuals, will also prove difficult. With a small sample size and little scientific understanding, it’s hard to tell whether the algorithm succeeded or failed because it’s bad at its job or by chance.

Add learning into the mix and the picture gets more complex. “Perhaps more importantly, to the extent that an ideal black-box algorithm is plastic and frequently updated, the clinical trial validation model breaks down further, because the model depends on a static product subject to stable validation.” As Price describes, the current system for testing and validation of medical products needs some adaptation to deal with this new software before it can successfully test and validate the new algorithms.

Striking a Balance
The story in healthcare reflects the AI story in so many other fields, and the complexities involved perhaps illustrate why even an illustrious company like IBM appears to be struggling to turn its famed Watson AI into a viable product in the healthcare space.

A balance must be struck, both in our rush to exploit big data and the eerie power of neural networks, and to automate thinking. We must be aware of the biases and flaws of this approach to problem-solving: to realize that it is not a foolproof panacea.

But we also need to embrace these technologies where they can be a useful complement to the skills, insights, and deeper understanding that humans can provide. Much like a neural network, our industries need to train themselves to enhance this cooperation in the future.

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