ON MEDICINE’S FRONT LINES
The AI Advantage
Clinicians are getting smart new virtual partners to improve care
U .S. News & World Report interviewed
Keith Dreyer, chief data science of-
ficer of Partners HealthCare and vice
chairman of radiology at Massachusetts
General Hospital and Brigham and Women’s
Hospital, to get his perspective on the extraor-
dinary impact artificial intelligence will have
on health care in coming years.
What exactly is artificial intelligence,
and what will it mean to health care?
The formal term we use is data science. That in-
cludes artificial intelligence and machine learning – the science of
getting computers to act without being programmed by humans.
Currently, scientists can pick a specific type of machine-learning
algorithm (basically a step-by-step mathematical process that
tells a computer what to do) and then train it to handle a certain
task. One such algorithm is called a neural network because it
can learn and improve performance on its own like the human
brain, but it can work much faster. Collectively, these powerful
tools will one day help us find disease almost before a patient is
symptomatic, treat it early, and achieve a higher survival rate
with much less patient suffering and at far less cost.
How is AI being used now?
One key way is with diagnostic and imaging tools, like MRIs
and CT and PET scans. Algorithms can be trained, for instance,
to accurately measure all of the lymph nodes from a cancer
patient’s CT scan to see if they’re changing size. It’s a huge
job that algorithms can do much more quickly than humans.
The clinician can then take the results and decide whether
a therapeutic regime is working or needs to be adjusted or
changed. We now also use machine-learning tools in stroke
detection and classification. We can train an algorithm to learn
to assess thousands of data points covering the range of strokes
and how each can be characterized. Over time, the algorithm
learns how to read images with a high degree of accuracy. For
example, the computer might say the patient had a hemor-
rhagic stroke. Then the neuroradiologist and neurologist will
determine whether surgery or medication is needed to treat it.
Where else is data science having an impact?
Population health management is one area. You can look at
28   U.S. NEWS & WORLD REPORT
electronic health records for many thousands of
people and identify biomarkers or other data to
make predictions, for example, about patients’
likelihood of getting a disease. Patients with no
prior history of diabetes, say, might have certain
characteristics that put them on a path to the
disease. So you could steer them to preventa-
tive care. Another area where AI can benefit
patients is precision medicine. For example, it
turns out diabetes has five or more types. With
data science you can tease out a lot of informa-
tion about how people with a specific type might
react to different therapeutics and tailor treatments that will
work best for each patient. Data science will also help in the
laboratory in areas like pathology and genomics – anything that
requires large amounts of data to be analyzed for discovery.
Should doctors and nurses be worried
about their jobs?
You can’t replace the comfort of human-to-human interaction,
but in the near future doctors using AI will win out over those
that don’t in terms of delivering the best care. AI and machine
learning will be critical in helping clinicians by aggregating and
analyzing maybe thousands of data points for a particular patient
(like lab results, genomics, imaging) to identify key conditions
the doctor needs to manage, from pulmonary disease to conges-
tive heart failure. So instead of clinicians being overwhelmed
by data, they now have an AI partner to process and interpret
the information and even advise them on treatment options.
How fast will these changes happen?
Incrementally. To put an algorithm into wide clinical practice,
you have to collect and structure data to train the algorithm.
Then you need to get FDA regulatory approval. Finally you need
to figure out how to deploy that solution in clinical practice to
providers using different electronic health records. And that’s
just one algorithm. We might eventually need thousands in radi-
ology alone. For now, we focus on solving narrow problems like
detecting lung or breast cancers. We’re going to see big successes,
but change won’t seem dramatic at first. People in the field all say
that in time we will no longer talk about artificial intelligence, but
rather a smarter “something” – a smarter cellphone, a smarter
CT scanner, a smarter stethoscope – or a smarter physician. l
COURTESY OF KEITH DREYER
Copyright 2018 the U.S. News & World Report, L.P. All rights reserved.