Daily Mail - 03.03.2020

Daily Mail, Tuesday, March 3, 2020^ Page 49

H

ealthcare has come

a long way thanks to

human endeavour — but

even occasional human

errors can have disas-

trous consequences.

a misdiagnosis can mean undergoing

unnecessary treatment; a misread scan

can mean a patient is wrongly given the

all-clear. Potentially life-altering or even

life-ending mistakes can be made, even

by excellent doctors.

So the news earlier this year that com-

puter programs can detect breast

tumours better than doctors was hailed

as ‘a huge advance’ by researchers.

the study, published in the journal

Nature, compared the results of

mammograms analysed by doctors with

the same images read by a machine that

had been ‘taught’ to identify tumours.

When the computer was asked to read

images from nearly 29,000 women, the

number of missed cancers — known as

false negatives — fell by 2.7 per cent

compared with when a single doctor

reviewed the scans, while the number of

mammograms incorrectly diagnosed as

abnormal (known as false positives)

decreased by 1.2 per cent.

the machine was as good as two doc-

tors working together — the current

system for reviewing mammograms.

With thousands of women a year mis-

diagnosed in the UK, any improvement

in the reading of scans would be wel-

come — and with an estimated shortage

of more than 1,000 radiologists (doctors

who interpret scans), using technology

to do the work of two doctors could free

up much-needed time for other tasks.

‘this is a huge advance in the poten-

tial for early cancer detection,’ said

study author Dr Mozziyar etemadi, an

assistant professor of anaesthesiology

at Northwestern University in chicago.

however, more research is needed to

work out how such a system could be

introduced, he added.

artificial intelligence (aI) like this —

advanced computer software which not

only carries out tasks but ‘learns’ from

the results — is hailed by some as a pan-

acea for the NhS, which is strained

by increasing patient numbers and

By RACHEL

ELLIS

stalling recruitment and retention

of doctors and nurses.

last year, the Government

announced a £250million aI labo-

ratory that will bring together

research to find solutions to com-

mon healthcare challenges.

‘the idea is that aI can take

some of the workload so that doc-

tors can spend more time with

patients,’ says Sarah Deeny,

assistant director of data analyt-

ics at the independent charity the

health Foundation.

It does look promising, and not

just in the field of breast cancer

diagnosis. research shows aI

could revolutionise diagnostic

testing, predict the most effective

treatments and improve how hos-

pitals are run.

F

or example, it is helping

NhS Blood and transplant

predict how much blood

hospitals will need on any

given day, resulting in 50 per cent

less waste.

a trial, published last year in

Nature, showed aI was better

than specialist doctors at spotting

lung cancer; it also boosted

detection of the cancer by 5 per

cent, while cutting the number of

p e o p l e f a l s e l y d i a g n o s e d b y

1 1 per cent.

It can also identify skin cancers

with the same accuracy as doc-

tors, and was as good as humans

at diagnosing more than 50 eye

conditions in another study.

aI has also been developed to

diagnose atrial fibrillation — an

irregular heartbeat. and last year,

University college hospital in

london came up with an algo-

rithm to flag up patients most

likely to skip appointments. Using

records from 22,000 MrI scan

a p p o i n t m e n t s , t h e p r o g r a m

identified 90 per cent of patients

who would not attend, who could

then be targeted with reminders.

almost eight million appoint-

ments were missed in 2017/18,

according to NhS figures, each

costing the NhS around £120.

addressing the problem could

save almost £1 billion — equiva-

lent to 257,000 hip replacements.

another project by the UK tech

company Brainomix, backed by

pharmaceutical giant Boehringer

Ingelheim, uses aI to interpret

brain scans of people with a sus-

pected stroke — a blockage in the

blood supply to the brain.

By correctly identifying where

the blockage is and the extent of

the damage, patients can be given

clot-busting drugs within the cru-

cial four-and-a-half hour time-

frame, or surgery to restore blood

flow to the brain, to give them the

best chance of recovery.

currently, reading by doctors of

these scans is ‘inconsistent’,

according to Dr George harston,

the company’s chief medical

officer. ‘Problems do get missed,

particularly if a less experienced

doctor is looking at the scan or it

is a non-specialist hospital.’

the Brainomix program analy-

ses ct brain scans in one minute.

this stroke technology has

already been adopted in 20 NhS

hospitals, but in most cases, aI is

not yet widely used in the day-to-

day running of the NhS.

‘We are beginning to see the

benefits of aI in some healthcare

contexts, such as reading scans,’

says Dr rebecca rosen, a GP in

south london and fellow at the

think tank the Nuffield trust.

the key thing which makes

artificial intelligence just that —

intelligent — is it can learn from

the information it receives. But

this creates its own challenges.

‘aI is driven by the data that is

fed into it from which it learns,’

says hugh Whittall, director of

another think tank, the Nuffield

council on Bioethics, which spe-

cialises in the ethical and social

aspects of health policy.

‘If you only have access to data

from a certain population, is that

serving all patients? We know from

facial recognition programs, for

example, that aI is not as good at

recognising the faces of darker-

skinned people, probably because

they are under-represented in the

data used to develop the program,

and that bias is reinforced by the

learning the aI does, making

errors more likely.’

there are also concerns about

p r o t e c t i n g t h e p a t i e n t d a t a

needed to ‘train’ these robots.

In 2017, the royal Free hospital

in london was criticised for shar-

ing 1.6 million patient data records

— including information on men-

tal health history and abortions

— with Google’s aI division, Deep-

Mind, for a trial to monitor and

diagnose acute kidney damage.

T

he Information commis-

sion ruled the hospital had

not done enough to pro-

tect patients’ data.

So, is there a danger that we are

solving one problem with aI, but

creating another? after all, aI is

costly and makes mistakes, too.

‘Because of the human nature of

healthcare, patients want conver-

sations with real doctors, so aI is

most likely to be part of the tech-

nology that helps with diagnosis

and supports decision-making

rather than taking over diagnosis,’

says Mr Whittall.

Sarah Deeny agrees, saying it is

most likely to be helpful for ‘less

high-risk, backroom tasks’ such

as making best use of operating

theatre time so theatres don’t

stand idle, or filing ‘normal’ blood

test results in patient records.

‘You don’t want it to result in

unnecessary extra tests and clini-

cian time,’ she says. ‘For example,

some smartphones can now carry

out pulse checks for an irregular

heartbeat. however, if this tech-

nology were used by the public,

healthy people could be told they

have an irregular pulse when they

don’t. this could result in unnec-

essary additional testing or treat-

ment, and anxiety for patients.

‘Will a highly anxious, risk-averse

patient — or, indeed, any patient

— ever be reassured by a computer

diagnosis? the role of the doctor

is not just to diagnose but to reas-

sure and [guide] patients through

their diagnosis and treatment.’

B u t i t’ s i m p o r t a n t n o t t o

overlook alternative ways of

solving health problems — possibly

e v e n m o r e e f f e c t i v e l y, a d d s

Mr Whittall.

‘there can be a tendency with

new technology to find things for

it to solve,’ he says.

‘take malaria, for example. In

o u r s e a r c h f o r d r u g s a n d

vaccines, there is a danger we

overlook bed nets which can

prevent malaria.

‘there are still many unknowns

about aI, so it is important that

we don’t push this technology

through too quickly.’

As artificial intelligence

proves as effective as

doctors at reading scans...

This week: Emilia

Fox’s arms

Wearing a satin dress that

showed off gym-honed

arms, emilia Fox (right)

oozed elegance on the

red carpet recently.

The 45-year-old actress

is a relatively recent con-

vert to the gym. ‘i run and

lift weights,’ she has said.

‘it makes me feel more

confident, stronger — and

i don’t mean physically.’

WHAT TO TRY: The curl-to-front-press

exercise targets the biceps and shoulder

muscles for all-round toned arms. Hold a

dumbbell in each hand.

Stand with feet hip-width

a p a r t w i t h we i g h t s

against your thighs, palms

facing your body. Bend

your elbows and curl

weights up to shoulder

height. Then stretch

arms straight out in

front so they are level

with shoulders (palms

should be facing the

floor). Keeping your

core muscles engaged, bend the

elbows back in by your sides and lower

back to the start position. repeat 15

times and perform three sets.

How to get the enviable

physiques of the stars

SECRETS OF AN

A-LIST

BODY

Would

you trust

a computer

to diagnose

your illness?

Picture: GeTT y IMaGes/IsTock

PhoTo