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#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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#432467 Dungeons and Dragons, Not Chess and Go: ...
Everyone had died—not that you’d know it, from how they were laughing about their poor choices and bad rolls of the dice. As a social anthropologist, I study how people understand artificial intelligence (AI) and our efforts towards attaining it; I’m also a life-long fan of Dungeons and Dragons (D&D), the inventive fantasy roleplaying game. During a recent quest, when I was playing an elf ranger, the trainee paladin (or holy knight) acted according to his noble character, and announced our presence at the mouth of a dragon’s lair. The results were disastrous. But while success in D&D means “beating the bad guy,” the game is also a creative sandbox, where failure can count as collective triumph so long as you tell a great tale.
What does this have to do with AI? In computer science, games are frequently used as a benchmark for an algorithm’s “intelligence.” The late Robert Wilensky, a professor at the University of California, Berkeley and a leading figure in AI, offered one reason why this might be. Computer scientists “looked around at who the smartest people were, and they were themselves, of course,” he told the authors of Compulsive Technology: Computers as Culture (1985). “They were all essentially mathematicians by training, and mathematicians do two things—they prove theorems and play chess. And they said, hey, if it proves a theorem or plays chess, it must be smart.” No surprise that demonstrations of AI’s “smarts” have focused on the artificial player’s prowess.
Yet the games that get chosen—like Go, the main battlefield for Google DeepMind’s algorithms in recent years—tend to be tightly bounded, with set objectives and clear paths to victory or defeat. These experiences have none of the open-ended collaboration of D&D. Which got me thinking: do we need a new test for intelligence, where the goal is not simply about success, but storytelling? What would it mean for an AI to “pass” as human in a game of D&D? Instead of the Turing test, perhaps we need an elf ranger test?
Of course, this is just a playful thought experiment, but it does highlight the flaws in certain models of intelligence. First, it reveals how intelligence has to work across a variety of environments. D&D participants can inhabit many characters in many games, and the individual player can “switch” between roles (the fighter, the thief, the healer). Meanwhile, AI researchers know that it’s super difficult to get a well-trained algorithm to apply its insights in even slightly different domains—something that we humans manage surprisingly well.
Second, D&D reminds us that intelligence is embodied. In computer games, the bodily aspect of the experience might range from pressing buttons on a controller in order to move an icon or avatar (a ping-pong paddle; a spaceship; an anthropomorphic, eternally hungry, yellow sphere), to more recent and immersive experiences involving virtual-reality goggles and haptic gloves. Even without these add-ons, games can still produce biological responses associated with stress and fear (if you’ve ever played Alien: Isolation you’ll understand). In the original D&D, the players encounter the game while sitting around a table together, feeling the story and its impact. Recent research in cognitive science suggests that bodily interactions are crucial to how we grasp more abstract mental concepts. But we give minimal attention to the embodiment of artificial agents, and how that might affect the way they learn and process information.
Finally, intelligence is social. AI algorithms typically learn through multiple rounds of competition, in which successful strategies get reinforced with rewards. True, it appears that humans also evolved to learn through repetition, reward and reinforcement. But there’s an important collaborative dimension to human intelligence. In the 1930s, the psychologist Lev Vygotsky identified the interaction of an expert and a novice as an example of what became called “scaffolded” learning, where the teacher demonstrates and then supports the learner in acquiring a new skill. In unbounded games, this cooperation is channelled through narrative. Games of It among small children can evolve from win/lose into attacks by terrible monsters, before shifting again to more complex narratives that explain why the monsters are attacking, who is the hero, and what they can do and why—narratives that aren’t always logical or even internally compatible. An AI that could engage in social storytelling is doubtless on a surer, more multifunctional footing than one that plays chess; and there’s no guarantee that chess is even a step on the road to attaining intelligence of this sort.
In some ways, this failure to look at roleplaying as a technical hurdle for intelligence is strange. D&D was a key cultural touchstone for technologists in the 1980s and the inspiration for many early text-based computer games, as Katie Hafner and Matthew Lyon point out in Where Wizards Stay up Late: The Origins of the Internet (1996). Even today, AI researchers who play games in their free time often mention D&D specifically. So instead of beating adversaries in games, we might learn more about intelligence if we tried to teach artificial agents to play together as we do: as paladins and elf rangers.
This article was originally published at Aeon and has been republished under Creative Commons.
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