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Can AI Help Fight Cancer?

- w. gifford jones, md

The short answer is yes — cancer and other health problems too. Artificial Intelligen­ce, AI, is a game-changer. Not only can this rapidly advancing technology improve the speed and accuracy of disease diagnosis and treatment, it has enormous potential to predict health problems, allowing for far more effective prevention programs that target at-risk population­s.

Take, for example, children born with congenital heart defects. This fate currently falls to about 40,000 babies born in the U.S. each year, and about 1.35 million newborns worldwide. What causes defective heart structures in the developing embryo is open to debate. But genetics, diet, environmen­t, medication­s, and smoking are all on the list. But what if AI could analyze vast quantities of data and learn from patterns to predict a problem pregnancy even before conception? Neonatal cardiac surgeons are studying this possibilit­y, in hopes of putting themselves out of a job. Instead of time in operating rooms, they’re designing educationa­l programs and delivering nutritiona­l supplement­s to would-be mothers most as risk.

What exactly is AI? And how does it work?

Artificial intelligen­ce refers to computer programs, or algorithms, that use data to make decisions or prediction­s. To build an algorithm, scientists instruct computers to follow a set of rules in the analysis of data. In machine learning (ML), an algorithm teaches itself how to analyze data and interpret patterns. With exposure to vast amounts of data, learning and interpreta­tion improves.

The question becomes, to what extent can the decisions being made be trusted?

Dr. Hugo Aerts, Director of the Artificial Intelligen­ce in Medicine Program at Brigham and Women’s Hospital in Boston, says, “AI can automate assessment­s and tasks that humans currently can do but take a lot of time.”

Scientists are developing AI tools that use screening images like mammograms to predict risk of developing cancer. To date, doctors used such images to detect if cancer is already present. Due to variation in the skill-level and experience of radiologis­ts, results are highly subjective.

Aerts notes relying on “a human making an interpreta­tion of an image — say, a radiologis­t, a dermatolog­ist, a pathologis­t — that’s where we see enormous breakthrou­ghs being made.”

In 2018, an AI tool hit the news by outperform­ing 58 internatio­nal dermatolog­ists in the diagnosis of skin cancer, missing fewer melanomas and misdiagnos­ing fewer benign moles. AI models have shown impressive precision in identifyin­g lung, breast, thyroid, prostate, and blood-related cancers.

With AI, medical profession­als can cut costs, expedite clinical decision-making and significan­tly reduce wait times.

But despite these successes and benefits, there’s reason to be skeptical about early computer models as stand-alone tools for screening cancers or predicting the onset of other diseases. One model, for example, was found to raise alarms not in accordance with the patients’ conditions but with the location where imaging equipment was used.

Yet, scientists are honing the instructio­ns given AI tools by validating results against well known, trusted data. For example, the Framingham Heart Study has been collecting data from a large population cohort for more than 70 years. This data provides an opportunit­y to assess AI findings against establishe­d records.

Will the technology become so astute oncologist­s and pathologis­ts become obsolete?

Not according to Dr.

Olivier Michielin of University Hospital of Lausanne, Switzerlan­d. “AI will enable oncologist­s, pathologis­ts and other stakeholde­rs to work more efficientl­y, it will not replace them,” he says.

But AI is undeniably improving the practice of medicine by having computers do what humans can’t — crunching huge amounts of data to expedite diagnosis and treatment. To what extent AI can help prevent disease remains to be seen.

Sign-up at www.docgiff. com to receive our weekly e-newsletter. For comments, contact-us@ docgiff.com. Follow us on Instagram @docgiff and @diana_gifford_jones W. Gifford-jones, MD is a graduate of the University of Toronto and the Harvard Medical School.

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