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Saturday, October 20, 2012

Paging Dr. Watson

I did watch Watson defeat the best Jeopardy players in the world, when - last year or so - and of course as an eHealth student, I knew this would be a fantastic machine to program for medicine, in particular, diagnosis.  I knew about other attempts at artificial intelligence for diagnosis like Isabel.  Isabel is one of the leading "differential clinical decision support" tools for physicians.  There were many early experiments in artificial intelligence for medicine, and I believe the editor our our Biomedical Informatics textbook, Edward H. Shortliffe, was also an early pioneer, as the chapter would attest. The writer on this article on "Paging Dr. Watson" mentions a book called "How Doctors Think".  I read it, and it is excellent.  Another book that is relevent is "Every Patient Tells a Story" by Lisa Sanders, who advised on the House TV series.  One theme of the book is the loss of skill in the physical exam by physicians and the over reliance on technology for diagnosis.  I am just saying. 



Paging Dr. Watson: artificial intelligence as a prescription for health care

October 18, 2012

(Credit: IBM)
“It’s not humanly possible to practice the best possible medicine. We need machines,” said Herbert Chase, a professor of clinical medicine at Columbia University and member of IBM’s Watson Healthcare Advisory Board, Wired Science reports.
“A machine like [IBM's Watson], with massively parallel processing, is like 500,000 of me sitting at Google and Pubmed, trying to find the right information.”
Yet though Watson is clearly a powerful tool, doctors like physician Mark Graber, a former chief of the Veterans Administration hospital in Northport, New York,  wonder if it’s the right tool. “Watson may solve the small fraction of cases where inadequate knowledge is the issue,” he said. “But medical school works. Doctors have enough knowledge. They struggle because they don’t have enough time, because they didn’t get a second opinion.”
According to Chase, doesn’t fully appreciate Watson’s value in bias-free second opinions. “The machine says, you thought of 10 things. Here are the other five,” he said. “You’ve probably seen Jerome Groopman’s book, How Doctors Think, about the mistakes doctors make. A simple one is anchoring: You get stuck to some diagnosis. We’ve all had that experience. A machine can change its diagnostic profile on a dime based on new information. One of the things a machine is not is biased.”
Graber warned that doctors will need to guard against a new source of bias: over-reliance on Watson. “When I use my GPS too much, I never really learn the layout of a new city,” Graber said. “Same story.”
He and Chase also disagree on the implications for health costs. Chase sees Watson helping doctors and patients reduce eliminate unnecessary tests and treatments, whichnow cost $750 billion per year. Graber fears that Watson’s ability to identify many possible diagnoses will encourage patients to ask for even more tests and procedures, setting off a cost-inflating “diagnostic cascade.”  …