How A.I. will liberate doctors from keyboards and basements

Giving A.I. a role in health care can help both doctors and patients.

ERIC TOPOL: Technology can't enhance humanity, that it's depersonalizing, that it's going to detract. I actually think it's just the opposite in medicine, because if we can outsource to machines and technology, we can restore the human bond, which has been eroding for decades. So what I mean by deep medicine is really a three part story: The first is what we call deep phenotyping. And that is a very intensive, comprehensive understanding of each person at every level. So that's the idea of knowing all about their biology, not just their genome, their microbiome, and all the things the different layers of the person, but also their physiology through sensors, their anatomy through scans, their environment through sensors as well, and then traditional data.

So that's deep phenotyping. Now, no human being can process all that data, because it's dynamic, and it's actually quite large to deal with. That's why we have deep learning. That's a type of artificial intelligence which takes all of these inputs and it really crystallizes, distills it all. And that gets us to deep empathy. And the deep empathy is when we have this outsourcing to machines and algorithms. We have all of this data, and we now can get back to the human side of this connection. Well, where deep learning works the best today is with images. And so medical images are especially ideal because it turns out that radiologists miss things in more than 30 percent of scans that are done today. So in order to not miss these things, you can train machines to have vision better than humans. The difference here is that the radiologists can put more context in it, but the machines, they're very complementary.

They can pick up things that radiologists wouldn't see, like a nodule on a chest X-ray or an abnormality on an MRA that would be missed because radiologists read 50 to 100 scans per day. There's many times that we just don't see things. So when you bring the two together, you get the best economy. It doesn't mean we're going to eliminate the need for radiologists. It's going to make the accuracy and the speed much better. And what I project is that we're going to see a time when radiologists move out of the basement in the dark and actually connect with patients, because they want to see patients. They want to be able to share their expertise, and they don't have a vested interest about doing an operation or procedure. They just want to report what they find and communicate that. So I think we're going to see a reshaping of radiology because of this remarkable performance enhancement through AI.

There's a lot of use of AI in the hospital setting, because when patients come in, and trying to predict what's going to happen, we're not so good at that generally in medicine. So almost everything you can think of there have been algorithms tested. One example is sepsis. So what's going to happen? Does the person have sepsis, a serious infection? Are they going to decompensate and possibly die from sepsis? We're not so great at that, it turns out, by algorithm. But what we have learned is that we can use the same machine vision, whether it's nurses, doctors, people who are circulating in a room of a hospital, to see whether or not they're doing appropriate handwashing, and to set off a signal that, no, it wasn't done and needs to be done. So there's lots of things about patient safety with machine vision.

So for example, preventing falls, seeing that someone's walking is unsteady. Another great example is in the intensive care unit. Some people can pull out their breathing tube, and now we have machine vision that can monitor that so that we don't have a nurse that has to be in the room all of the time. Well, the biggest thing that we need down is the gift of time. Rather than to have this AI support? And it's at two levels. So if you can get rid of keyboards, or liberate from keyboards, reestablish face-to-face eye contact, that's a good start. It's going to happen. But also the patients now can have algorithms generating their own data, whether it's their heart rhythm, or their skin rash, or a possible urinary tract infection, they can get that diagnosed now by an algorithm. That frees up, again, doctors to take care of more serious matters, and that's what is so exciting if we grab this opportunity, which I don't know if we'll see it again for generations, if ever, because this technology offers that potential. But it won't happen by accident.

If we're not taking on this, really, activism to promote the gift of time and turning inward, as the medical community, if we don't do this, we're going to see even worse squeeze than we have now. This is an opportunity that we just can't miss.

  • Machines can help doctors by spotting abnormalities in X-rays or MRA scans that the physicians themselves may have missed.
  • A.I. can also help physicians by analyzing data and, through the use of algorithms, produce possible diagnoses.
  • The freed up time, as doctors make their rounds, can help physicians establish better connections with their patients, which in turn can lead to better treatment plans.

An organism found in dirt may lead to an anxiety vaccine, say scientists

Can dirt help us fight off stress? Groundbreaking new research shows how.

University of Colorado Boulder
Surprising Science
  • New research identifies a bacterium that helps block anxiety.
  • Scientists say this can lead to drugs for first responders and soldiers, preventing PTSD and other mental issues.
  • The finding builds on the hygiene hypothesis, first proposed in 1989.

Are modern societies trying too hard to be clean, at the detriment to public health? Scientists discovered that a microorganism living in dirt can actually be good for us, potentially helping the body to fight off stress. Harnessing its powers can lead to a "stress vaccine".

Researchers at the University of Colorado Boulder found that the fatty 10(Z)-hexadecenoic acid from the soil-residing bacterium Mycobacterium vaccae aids immune cells in blocking pathways that increase inflammation and the ability to combat stress.

The study's senior author and Integrative Physiology Professor Christopher Lowry described this fat as "one of the main ingredients" in the "special sauce" that causes the beneficial effects of the bacterium.

The finding goes hand in hand with the "hygiene hypothesis," initially proposed in 1989 by the British scientist David Strachan. He maintained that our generally sterile modern world prevents children from being exposed to certain microorganisms, resulting in compromised immune systems and greater incidences of asthma and allergies.

Contemporary research fine-tuned the hypothesis, finding that not interacting with so-called "old friends" or helpful microbes in the soil and the environment, rather than the ones that cause illnesses, is what's detrimental. In particular, our mental health could be at stake.

"The idea is that as humans have moved away from farms and an agricultural or hunter-gatherer existence into cities, we have lost contact with organisms that served to regulate our immune system and suppress inappropriate inflammation," explained Lowry. "That has put us at higher risk for inflammatory disease and stress-related psychiatric disorders."

University of Colorado Boulder

Christopher Lowry

This is not the first study on the subject from Lowry, who published previous work showing the connection between being exposed to healthy bacteria and mental health. He found that being raised with animals and dust in a rural environment helps children develop more stress-proof immune systems. Such kids were also likely to be less at risk for mental illnesses than people living in the city without pets.

Lowry's other work also pointed out that the soil-based bacterium Mycobacterium vaccae acts like an antidepressant when injected into rodents. It alters their behavior and has lasting anti-inflammatory effects on the brain, according to the press release from the University of Colorado Boulder. Prolonged inflammation can lead to such stress-related disorders as PTSD.

The new study from Lowry and his team identified why that worked by pinpointing the specific fatty acid responsible. They showed that when the 10(Z)-hexadecenoic acid gets into cells, it works like a lock, attaching itself to the peroxisome proliferator-activated receptor (PPAR). This allows it to block a number of key pathways responsible for inflammation. Pre-treating the cells with the acid (or lipid) made them withstand inflammation better.

Lowry thinks this understanding can lead to creating a "stress vaccine" that can be given to people in high-stress jobs, like first responders or soldiers. The vaccine can prevent the psychological effects of stress.

What's more, this friendly bacterium is not the only potentially helpful organism we can find in soil.

"This is just one strain of one species of one type of bacterium that is found in the soil but there are millions of other strains in soils," said Lowry. "We are just beginning to see the tip of the iceberg in terms of identifying the mechanisms through which they have evolved to keep us healthy. It should inspire awe in all of us."

Check out the study published in the journal Psychopharmacology.

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