Ruminations on tech, the digital media, and some golf thrown in for good measure.

Posts Tagged ‘evidence-based medicine

Personalizing Cancer Treatment

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I hate cancer.  I really hate it.

I mean really.  Really really really.

I’ve lost more friends and family to cancer than I care to count.  I’ve lost an uncle to cancer. My two aunts. My grandfather.  My grandmother.


IBM's Watson technology is being put to new use in personalizing cancer treatments in a partnership with world-renowned cancer treatment provider, Memorial Sloan-Kettering Cancer Center.

In the last year, I’ve lost two good friends, and another one before them, several years ago, all wayyy too early (early 30s to mid 40s).

I hate cancer.

So I was pretty stoked about our announcement yesterday where my virtual brother, as Scott and I recently joked with Watson GM Manoj Saxena, is getting another form of unemployment.

First, there was Watson’s gig at Wellpoint, helping doctors with diagnoses.  Then we learned Watson was heading to work at Citibank to help out on Wall Street.

Now Watson is being put to use at the Memorial Sloan-Kettering Cancer Center (MSKCC) in an effort to help oncologists obtain detailed diagnostic and treatment options based on updated research that will help them decide how best to care for an individual patient.

MSKCC’s world-renowned oncologists will assist in developing IBM Watson to use a patient’s medical information and synthesize a vast array of continuously updated and vetted treatment guidelines, published research and insights gleaned from the deep experience of MSKCC clinicians to provide those individualized recommendations to doctors. It will also help provide users with a detailed record of the data and evidence used to reach the recommendations?

You can learn more about this new evidence-based approach to cancer treatment in the video below.

Oncology treatment is a complex arena, and yet cancers are the second most common cause of death in the U.S., second only to heart disease.

In fact, the American Cancer Society projects that 1.6 million new cancer cases will be diagnosed in the U.S. this year with outcomes varying wildly across the country.

Cancer isn’t a single disease with one footprint of cause, but rather, with some having hundreds of sub-types, each with a different genetic fingerprint.

Significant discoveries in molecular biology and genetics in the past two decades have delivered new insights into cancer biology and strategies for targeting specific molecular alterations in tumors. But in the process, these advances have also ratcheted up the complexity of diagnosing and treating each case.

“This comprehensive, evidence-based approach will profoundly enhance cancer care by accelerating the dissemination of practice-changing research at an unprecedented pace,” said Dr. Mark G. Kris, Chief, Thoracic Oncology Service at MSKCC and one of the clinicians leading the development effort. He noted that 85 percent of patients with cancer are not treated at specialized medical centers and it can take years for the latest developments in oncology to reach all practice settings.

Calling Dr. Watson

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What’s Next for Watson?

So now that the matches have all aired, and Watson came out the victor, what does it all mean?

If you missed the hullaballoo, this week, IBM’s Watson computer system competed against Jeopardy!’s most successful contestants, Ken Jennings and Brad Rutter, and ended up running away with victory.

But as amazing as the win was, what hasn’t been celebrated nearly enough in this blogger’s opinion is the practical applications of this technology to solve real problems in the world moving forward across a wide range of industries.

Watson was built by a dedicated team of brilliant IBM Research scientists over the past four years, and represents a breakthrough innovation: a machine that rivals a human’s ability to answer questions posed in natural language – quickly, accurately, confidently.

We saw this demonstrated in full force during the Jeopardy! matches this week.

But today begins the next phase of Watson’s evolution.

Calling Doctor Watson

Today, IBM is announcing that doctors from Columbia University Medical Center and the University of Maryland School of Medicine will work to take the same Jeopardy! playing capabilities of Watson and apply them to medicine in an effort to address some of the healthcare industry’s biggest challenges.

IBM also announced a research agreement with Nuance Communications, Inc., to explore, develop, and apply the Watson computing system to healthcare.

Consider these statistics: Primary care physicians spend an average of only 10.7-18.7 minutes face-to-face with each patient per visit. And approximately 81% average 5 hours or less per month – just over an hour per week – reading medical journals.

This results in an estimated 15% of diagnoses being inaccurate or incomplete.

In today’s healthcare environment, where doctors are often working with limited information and little time, the results can be fragmented care and errors that raise costs and threaten quality.

What doctors need is an assistant who can quickly read and understand massive amounts of information and then provide useful suggestions.

Watson’s ability to deal with natural language across a wide collection of diverse information and make it more digestible for humans holds an enormous potential to transform healthcare effectiveness, efficiency and patient outcomes.

Answer: What Is Watson?

Many have probably wondered through the course of the Jeopardy! matches what, exactly is Watson?

Think of Watson as an analytical computing system that specializes in understanding the meaning of natural human language and provides specific answers to questions across a broad domain of knowledge at lightning speeds.

Those domains could span virtually every industry: as noted already in this post, healthcare, but also media/entertainment, financial services, the public sector, transportation, and more.

Watson’s breakthrough comes in its understanding of natural language, not simply language specifically designed and encoded for computers.  But, rather, language we humans use to naturally capture and communicate knowledge.

Watson evaluates the equivalent of roughly 200 million pages of content (about 1 million books worth) written in natural human language to find correct responses to the Jeopardy! clues.

The system was named after IBM founder Thomas J. Watson, and is powered by 10 racks of IBM POWER 750 servers and runs on the LINUX operating system. Watson contains 15 terabytes of RAM and 2,880 processor cores, and can operate at 80 teraflops – 80 trillion operations per second.

Yes, you read that correctly.  80 trillion.  And yes, I, too, wish I could have that kind of horsepower on my laptop.

Getting A Second Opinion With Watson

As the leading company that helps businesses make sense of data, IBM created Watson to advance our ability to find meaning and knowledge in vast amounts of data.

Watson’s ability to understand the meaning and context of human language, and rapidly process information to find precise answers to questions, holds enormous potential to transform how computers help people accomplish tasks in business and their personal lives.

The fact is, no matter how doctors may try to keep up with the medical literature, it doubles in size every few years and the task of incorporating hundreds of thousands of articles a day into practice and applying them to patient care is difficult and impractical.

Diagnosis, treatment and management of diseases are phenomenally complicated.  For any given chronic disease, there are all sorts of nuances.  One size doesn’t fit all.

Patients with problems like cancer, diabetes, chronic heart or kidney disease are incredibly complex. But much of that is computable. Watson will be able to look at all that and answer profoundly complex questions by analyzing massive amounts of health data and healthcare knowledge.

Doctors understandably tend to diagnose based on their own specialties or experience. A computer system like Watson can also suggest questions that raise alternatives. For instance, doctors may focus on physical issues and forget to investigate whether symptoms could be caused by depression.

It can narrow among a large group of choices and ultimately help doctors pick the right decision — a very necessary advance in the effective and efficient storage, retrieval, analysis and use of biomedical information to improve health.

IBM calls this Deep DDX – deep differential diagnosis.

Now, lest you have fears that R2D2 will start making the rounds, you’re never going to replace a doctor or a nurse.  But, like a good surgical’s assistant, Watson can help inform and advise physicians by creating many hypotheses about a condition then narrowing them down to the one it feels most confident about based on symptoms of the patient, combined with all the information it has received from medical journals, text books, and the like.

Deep QA At Columbia And Maryland

The new research and technology initiative with Nuance will combine IBM’s Deep Question Answering (QA), Natural Language Processing, and Machine Learning capabilities with Nuance’s speech recognition and Clinical Language Understanding (CLU) solutions for the diagnosis and treatment of patients that provide hospitals, physicians, and payers access to critical and timely information.

At Columbia and Maryland School of Medicine, physicians will help identify critical issues in the practice of medicine where the Watson technology may be able to contribute, and to help identify the best way that a technology like Watson could interact with medical practitioners to provide maximum assistance.

Watson’s ability to analyze the meaning and context of human language, and quickly process information to find precise answers can assist decision makers, such as physicians and nurses, unlock important knowledge and facts buried within huge volumes of information, and offer answers they may not have considered to help validate their own ideas or hypotheses.

“Combining our analytics expertise with the experience and technology of Nuance, we can transform the way that healthcare professionals accomplish everyday tasks by enabling them to work smarter and more efficiently,”  said Dr. John E. Kelly III, senior vice president and director of IBM Research. “This initiative demonstrates how we plan to apply Watson’s capabilities into new areas, such as healthcare with Nuance.”

For example, a doctor considering a patient’s diagnosis could use Watson’s analytics technology, in conjunction with Nuance’s voice and clinical language understanding solutions, to rapidly consider all the related texts, reference materials, prior cases, and latest knowledge in journals and medical literature to gain evidence from many more potential sources than previously possible.

You don’t want your doctor to guess.  You want them to have confidence in their answers.

Built into Watson is the idea of confidence in answering. It’s the doctor’s responsibility to make the diagnoses…Watson would only be there to narrow down the options.

As for Watson’s bedside manners…well, on that one we’ll just have to wait and see.

Written by turbotodd

February 17, 2011 at 3:02 pm

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