Some fellow in his pajamas, home sick with bronchitis and complaining online about it, could soon be contributing to a digital collection of medical information designed to help speed diagnoses and treatments.
A doctor who is helping to prepare IBM’s Watson computer system for work as a medical tool says such blog entries may be included in Watson’s database.
Watson is best known for handily defeating the world’s best Jeopardy players on the TV quiz show earlier this year. IBM says Watson, with its ability to understand plain language, can digest questions about a person’s symptoms and medical history and quickly suggest diagnoses and treatments.
The company is still perhaps two years from marketing a medical Watson, and it says no prices have been established. However, it envisions several uses, including a doctor simply speaking into a handheld device to get answers at a patient’s bedside.
Watson won’t be the first such product on the medical market, however, and one rival company says it isn’t impressed.
At a recent demonstration, Watson was gradually given information about a fictional patient with an eye problem. As more clues were unveiled — blurred vision, family history of arthritis, Connecticut residence — Watson’s suggested diagnoses evolved from uveitis to Behcet’s disease to Lyme disease. It gave the final diagnosis a 73 percent confidence rating.
“You do get eye problems in Lyme disease, but it’s not common,” Columbia University medical school professor Herbert Chase said. “You can’t fool Watson.”
For Jeopardy Watson was fed encyclopedias, dictionaries, books, news and movie scripts. For health care, it’s on a diet of medical textbooks and journals. It could also link to the electronic health records that the federal government wants hospitals to maintain. Medical students are peppering it with sample questions to help train it.
Chase said anecdotal information — such as personal blogs from medical Web sites — may also be included.
“What people say about their treatment ... it’s not to be ignored just because it’s anecdotal,” Chase said. “We certainly listen when our patients talk to us and that’s anecdotal.”
Chase and other experts say cramming Watson with the latest medical information would help with a major problem in modern health care: information overload.
“For at least 30 years it’s been clear that it’s not possible for us to know everything,” he said. “Every day, doctors have questions they can’t find the answers to. Even if you sit down at a search engine, it’s so labor intensive and it takes so long to find answers.”
Carl Kesselman, director of the Health Informatics Center at the University of Southern California, said the “deluge of information” is a significant problem.
“Advances in medicine are increasing rapidly: genomics, specialized drugs, off-label uses, increasingly finer-grained classifications of disease,” said Kesselman, who is not involved with the Watson project. “The ability to ask Jeopardy-style questions and get that kind of information retrieval, to sort through all the stuff out there and point you to the latest literature, would be of potentially huge value.”
Michael Yuan, chief scientist at Ringful Health, a medical consulting company in Austin, Texas, that has worked with IBM, cited a 1999 study of 103 doctors that found they fielded more than 1,100 questions a day, of which 64 percent were never answered.
“That’s a huge potential for people to make mistakes,” he said. “Watson is the type of solution that can really reduce that.”
In Jeopardy Watson was asked for one correct answer, whether it was answering questions about Sir Christopher Wren, the Lion of Nimrud or the Church Lady from Saturday Night Live.
However, in its medical guise, when presented a set of symptoms, Watson offers several possible diagnoses, ranked in order of its confidence.
“In medicine, we don’t want one answer, we want a list of options,” Chase said.
Kesselman said having options might help doctors accept a computer’s findings.
“Will a physician ever blindly accept a diagnosis coming out of a computer? I don’t think that will happen anytime soon,” he said.
Chase said seeing more than one choice might also help doctors move away from what he called “anchoring,” or getting too attached to a diagnosis.
“If a person has a 95 percent chance of having disease X, there’s still a one-in-20 chance that they have something else,” he said. “We often forget what’s in that 5 percent, but Watson won’t.”
The treatment application works much like the diagnosis application. In the demonstration, Watson first suggested the antibiotic doxycycline for treating Lyme disease, then switched to cefuroxime when told the patient was pregnant and allergic to penicillin.
Chase said Watson would know the latest treatment guidelines — which are complex and often updated — “and can see if they’re not being met.”
“You have to match the right treatment with each unique patient,” Chase said. “You can’t treat everybody with high blood pressure the same way — a 75-year-old man with prostate cancer who felt dizzy last week and a 32-year-old woman.”
Yuan said Watson’s influence would depend on “how widely it is adopted.”
“You have to wonder if a hospital is going to plunk down a couple of million dollars,” he said.
IBM’s Dan Pelino, general manager for global health care, said clients wouldn’t have to buy a complete Watson system. He said possible future uses include:
‧ Allowing a doctor to connect to Watson’s database by speaking into a hand-held device, using speech-recognition technology and cloud computing;
‧ Serving as a repository for the most advanced research in cancer or other fields;
‧ Providing an always-available second opinion.
“You can imagine someone asking Watson a question on an iPad as they’re walking down the hall,” Chase said. “It might get updates like a GPS.”
An existing private medical database known as Isabel is already used by some multi-hospital health systems. Co-founder Jason Maude of Isabel Healthcare said that from what he’s heard about IBM’s plans for Watson, “it’s kind of what we’ve had for about 10 years.”
An online demonstration of Isabel showed similarities to the Watson model — symptoms are entered and the computer searches through a database for a possible diagnosis. Maude, who named Isabel for a daughter who escaped a serious misdiagnosis as a child, says Isabel’s database has been “tuned and honed” over time.
He said prices for using Isabel range from a few thousand US dollars a year for a family practice to as much as US$400,000 for a health system.
Pelino said Watson is much faster while Chase said Watson is better at understanding non--medical terms.
“Watson knows that ‘difficulty swallowing’ is ‘dysphagia,’” he said.
Isabel has been used at the Orlando Health hospital network in Florida since last fall, and “has had its successes,” said Jay Falk, chief academic medical officer.
He said less experienced doctors use it under the guidance of senior clinicians “who can make some judgments about the likelihood of what’s given on the list of diagnoses.”
“There’s no question that there’s a need for a tool that will help in this regard,” Falk said. “Whether Isabel itself is the answer is unclear.”
Overall, he said, “We’re enjoying learning with it.”
IBM said Watson could answer some medical questions in the same few moments it took on Jeopardy and Yuan said studies have shown that “if it takes more than two minutes, it won’t get used.”
As on Jeopardy — where Watson identified Toronto as a US city and Picasso as an art period — the computer occasionally bungles a medical question.
“I think once we were asking what type of drug we should use and the answer was a person’s name,” Chase said. “In fairness, I think it was a person associated with the drug.”
And of course there are things Watson cannot do. It won’t know a patient’s appetite for risk, for example, or feelings about end-of-life treatment.
“That’s why you have to emphasize that the decisions aren’t coming from the computer, they’re coming from the patient,” Chase said.
Chase’s suggestion that medical blogs be included may have something to do with his own medical history.
Several years ago, fighting a cholesterol problem, he took Lipitor and was soon plagued with insomnia. He suspected a connection, but found nothing in textbooks or journals.
“I go to the blogosphere, and it was like, ‘You moron, don’t take Lipitor before you go to bed because you’ll never sleep again!” he said. “Now it’s five years later, and if you Google Lipitor and insomnia, it’s all over the place.”
Stephen Garrett, a 27-year-old graduate student, always thought he would study in China, but first the country’s restrictive COVID-19 policies made it nearly impossible and now he has other concerns. The cost is one deterrent, but Garrett is more worried about restrictions on academic freedom and the personal risk of being stranded in China. He is not alone. Only about 700 American students are studying at Chinese universities, down from a peak of nearly 25,000 a decade ago, while there are nearly 300,000 Chinese students at US schools. Some young Americans are discouraged from investing their time in China by what they see
MAJOR DROP: CEO Tim Cook, who is visiting Hanoi, pledged the firm was committed to Vietnam after its smartphone shipments declined 9.6% annually in the first quarter Apple Inc yesterday said it would increase spending on suppliers in Vietnam, a key production hub, as CEO Tim Cook arrived in the country for a two-day visit. The iPhone maker announced the news in a statement on its Web site, but gave no details of how much it would spend or where the money would go. Cook is expected to meet programmers, content creators and students during his visit, online newspaper VnExpress reported. The visit comes as US President Joe Biden’s administration seeks to ramp up Vietnam’s role in the global tech supply chain to reduce the US’ dependence on China. Images on
New apartments in Taiwan’s major cities are getting smaller, while old apartments are increasingly occupied by older people, many of whom live alone, government data showed. The phenomenon has to do with sharpening unaffordable property prices and an aging population, property brokers said. Apartments with one bedroom that are two years old or older have gained a noticeable presence in the nation’s six special municipalities as well as Hsinchu county and city in the past five years, Evertrust Rehouse Co (永慶房產集團) found, citing data from the government’s real-price transaction platform. In Taipei, apartments with one bedroom accounted for 19 percent of deals last
US CONSCULTANT: The US Department of Commerce’s Ursula Burns is a rarely seen US government consultant to be put forward to sit on the board, nominated as an independent director Taiwan Semiconductor Manufacturing Co (TSMC, 台積電), the world’s largest contract chipmaker, yesterday nominated 10 candidates for its new board of directors, including Ursula Burns from the US Department of Commerce. It is rare that TSMC has nominated a US government consultant to sit on its board. Burns was nominated as one of seven independent directors. She is vice chair of the department’s Advisory Council on Supply Chain Competitiveness. Burns is to stand for election at TSMC’s annual shareholders’ meeting on June 4 along with the rest of the candidates. TSMC chairman Mark Liu (劉德音) was not on the list after in December last