James Fleck: Anticancerweb 24(02), 2019
Since the beginning of the XXI century we are testifying a buddy-buddy connection between Medicine and Technology (M&T). It’s a natural consequence of a world dominated by the Internet-of Things (IoT). The concept behind this scenario is the growing network of smart devices able to share internet data. There are already around 4 billions smartphone connected around the world. In the next few years connected devices will expand to nearly 30 billions. Overcoming privacy and security natural concerns, IoT will quickly find a central role in health care. Growing knowledge in genomics and oncology has been combined in personalized new treatment strategies. International cooperative clinical trials and widespread acceptance of surrogates, speeding the approval of new interventions, have made it nearly impossible for a physician to keep up-to-date with new standards.The physician has always been educated to provide the best recommendation to the patient. Eventually, delay could be responsible for mixed feelings. The gap might be solved with a well-designed M&T interaction.
Five years ago, IBM launched a supercomputer called Watson. The name came after Thomas J Watson, first chairman and CEO of IBM between 1914 and 1956. Watson is one of the best examples of a useful vertical machine learning. The supercomputer working with big data, is able to process almost immediately multiple new information gathered from medical journals, clinical trials and actionable genomics. The attached video shows how Watson works.
In 2011, Watson database, competing with the champions of quiz show Jeopardy, won the first prize. In fact, human brain had provided vertical storage of huge number of categorized information. But, only input of information is not enough. IBM Watson high-level system generated hypothesis should be verified using a source of uploaded scoring evidence, increasing the confidence level of the answer provided. In 2013, Watson embarked in its first health care application working in the management of lung cancer treatment decision-making at the Memorial Sloan Kettering Cancer Center in New York. In 2016, a double-blind study presented at San Antonio Breast Cancer Symposium reveled a high concordance in breast cancer treatment recommendation provided either by Manipal interdisciplinary tumor board and IBM supercomputer. Additional worldwide validation should be pursued.
Watson is a new cognitive computing system, based on natural language processing, structured information retrieval and automated reasoning. It is a promising device, following the same strategy used by clinical oncologists in search of knowledge, but with greater speed. After acquittance, the median time taken to collect and enter patient data is only 12 minutes. However, artificial intelligence should recognize the importance of a human medical approach, sustained by a well-tuned doctor-patient relationship. Without this magical touch, a comprehensive view of patient’s needs would never be achieved. Multidimensional Integrative Medicine will never be replaced by machine. Machines have no feeling, no emotions, no ability to integrate multiple professionals with different personalities. They will not understand patient’s expectations, will not be able to work on patient and family emotional dynamics, as well as ethical concerns.
In health care, man and machine are not competitive or mutually exclusive. They need to cooperate by exploiting complementary skills. Nowadays, IoT are mapping market behavior, anticipating individual trends. The strategy could be useful for commodities, but is still far away from the needs in health care. Human brain has an uncounted number of neurons, followed by an even higher number of synapses. M&T should continue cooperating to uncover the mysteries of the human central nervous system, better understanding patterns of memory, judgment, mood and orientation. By now, human unpredictability is the major challenge to be overcome by artificial intelligence.
Watson Supercomputer You-tube Link: https://www.youtube.com/watch?v=idp55-2kMc8
Somashekhar SP, Kumarc R, Rauthan A, Arun KR, Patil P, Ramya YE. Double blinded validation study to assess performance of IBM artificial intelligence platform, Watson for oncology in comparison with Manipal multidisciplinary tumour board – First study of 638 breast cancer cases [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016