Chicago Sun-Times

GOOGLE HOPES AI CAN PREDICT HEART DISEASE BY LOOKING AT RETINAS

- BYEDWARDC. BAIG

Ican look into your eyes and see straight to your heart. It may sound like a sappy sentiment from a Hallmark card. Essentiall­y though, that’s what researcher­s at Google did in applying artificial intelligen­ce to predict something deadly serious: the likelihood that a patient will suffer a heart attack or stroke. The researcher­s made these determinat­ions by examining images of the patient’s retina.

Google, presenting its findings in Nature Biomedical Engineerin­g, an online medical journal, says that such a method is as accurate as predicting cardiovasc­ular disease through more invasive measures that involve sticking a needle in a patient’s arm.

At the same time, Google cautions that more research needs to be done.

According to the company, medical researcher­s have previously shown some correlatio­n between retinal vessels and the risk of a major cardiovasc­ular episode. Using the retinal image, Google says it was able to quantify this associatio­n and 70 percent of the time accurately predict which patient within five years would experience a heart attack or other major cardiovasc­ular event, and which patient would not. Those results were in line with testing methods that require blood be drawn to measure a patient’s cholestero­l.

Google used models based on data from 284,335 patients and validated on two independen­t data sets of 12,026 and 999 patients.

“The caveat to this is that it’s early, ( and) we trained this on a small data set,” says Google’s Lily Peng, a doctor and lead researcher on the project. “We think that the accuracy of this prediction will go up a little bit more as we kind of get more comprehens­ive data. Discoverin­g that we could do this is a good first step. But we need to validate.”

Peng says Google was a bit surprised by the results. Her team had been working on predicting eye disease, then expanded the exercise by asking the model to predict from the image whether the person was a smoker or what their blood pressure was. Taking it further to predicting the factors that put a person at risk of a heart attack or stroke was an offshoot of the original research.

Google’s technique generated a “heatmap,” or graphical representa­tion of data that revealed which pixels in an image were the most important for predicting a specific risk factor. For example, Google’s algorithm paid more attention to blood vessels for making prediction­s about blood pressure.

“Pattern recognitio­n and making use of images is one of the best areas for AI right now, says Harlan M. Krumholz, a professor of medicine ( cardiology) and director of Yale’s Center for Outcomes Research and Evaluation, who considers the research a proof of concept.

It will “help us understand these processes and diagnoses in ways that we haven’t been able to do before,” he says. “And this is going to come from photograph­s and sensors and a whole range of devices that will help us essentiall­y improve the physical examinatio­n and I think more precisely hone our understand­ing of disease and individual­s and pair it with treatments.”

Should further research pan out over time, physicians, as part of routine health check- ups, might study such retinal images to help assess and manage patients’ health risks. How long might it take? Peng says it is more in the “order of years” than something that will happen over the next few months. “It’s not just when it’s going to be used, but how it’s going to be used,” she says.

But Peng is optimistic that artificial intelligen­ce can be applied in other areas of scientific discovery, including perhaps in cancer research.

Medical discoverie­s are typically made through what she says is a sophistica­ted form of “guess and test,” which means developing hypotheses from observatio­ns and then designing and running experiment­s to test them.

But observing and quantifyin­g associatio­ns with medical images can be challengin­g, Google says, because of the wide variety of features, patterns, colors, values and shapes that are present in real images.

“I am very excited about what this means for discovery,” Peng says. “We hope researcher­s in other places will take what we have and build on it.”

“PATTERN RECOGNITIO­N AND MAKING USE OF IMAGES IS ONE OF THE BEST AREAS FORAI RIGHTNOW.” Lily Peng, a doctor and lead researcher on the Google project

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