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IBM Says Watson Health's AI Is Getting Really Good at Diagnosing Cancer (fastcompany.com)

An anonymous reader shares a report: In deciding on cancer treatment, doctors often get together in a "tumor board" to go over the options. IBM's Watson now sits in on those meetings in a few hospitals, such as in South Korea and India -- and it generally makes the same calls that a human expert would. So says IBM in a series of studies it's presenting this weekend at the ASCO cancer treatment conference in Chicago. "It's not making a diagnosis. That's not what we set out to do," says Andrew Norden of IBM's Watson Health division. "They will run Watson Oncology in a tumor board and sort of get another external opinion." Watson's "concordance rate" -- the degree to which it agrees with human doctors -- ranged from 73% to 96%, depending on the type of cancer (such as colon cancer) and the particular hospital where the study was done (in India, South Korea, and Thailand).

51 comments

  1. Mixed Messages by Anonymous Coward · · Score: 4, Informative

    Title: "IBM Says Watson Health's AI Is Getting Really Good at Diagnosing Cancer "
    Summary: "It's not making a diagnosis. That's not what we set out to do," says Andrew Norden of IBM's Watson Health division"

    1. Re:Mixed Messages by hey! · · Score: 4, Informative

      Well, that's the headline editor's fault. As I understand it, a tumor board doesn't diagnose; it makes treatment plan decisions.

      Well, that's the headline writer. My understanding is that a tumor board isn't about making a diagnosis, it's about deciding between alternative modes of treatment. If your doctor happens to be a surgical oncologist, a multidisciplinary board is less likely to have a systematic bias toward surgery over chemotherapy.

      --
      Post may contain irony: discontinue use if experiencing mood swings, nausea or elevated blood pressure.
    2. Re:Mixed Messages by Anonymous Coward · · Score: 0

      Well stated... Attending tumor boards, greater than 99% of the discussion revolves around tumors already diagnosed as cancer. The discussion is treatment.
      Sitting in there saying that looks like cancer 73-96% of the time is not impressive when the population being input is biased towards being diagnosed for cancer.
      You could hit those numbers with 2-3 facts, age of the patient, size of the lesion, and symptoms. The difficulty is the 4-27% including outliers to the typical demographics.

  2. Comment removed by account_deleted · · Score: 2, Interesting

    Comment removed based on user account deletion

  3. Put can it cure cancer? by Anonymous Coward · · Score: 0

    Let me know when.

    Meanwhile, power on, Trump. Don't let the haters get you down. You won't be around that much longer, anyway.

    1. Re:Put can it cure cancer? by Anonymous Coward · · Score: 0

      But with cancer, knowing is half the battle. Isn't it?

    2. Re:Put can it cure cancer? by Anonymous Coward · · Score: 0

      Zappa would agree. Jobs would not.

    3. Re:Put can it cure cancer? by hey! · · Score: 2

      AI could help cure cancer by making better treatment decisions. This might especially be useful in situations where a patient doesn't have access to the full range of medical expertise found in a major teaching hospital.

      There are a lot of under-served areas even in the US. Over the last decade there has been a movement of American hospitals out of low-income areas to places with healthier, more affluent patients. In the past five years rural areas have been especially strongly hit, particularly in states that rejected Medicaid expansion. The five hardest hit states were Alabama (5 rural hospitals closed), Georgia (6), Mississippi (5), Tennessee (8), and Texas (13).

      The US in aggregate has recovered from the Great Recession, but if you break the country down by rural/small town vs. metro areas, the recovery never happened in most rural areas.

      The disparities are frankly shocking. Massachusetts has 315 doctors 100,000 population and 95.6% of residents have health insurance. Georgia has 180 doctors/ 100,000 and an insurance rate of 80.3%. In Texas 24% of the population is uninsured which probably accounts for the horrific rate of rural hospital closures there.

      Well before this kind of technology is something you'd ever consider relying on this in a place like New York City, there are plenty places where people are lucky to have access to an oncologist, much less a tumor board.

      --
      Post may contain irony: discontinue use if experiencing mood swings, nausea or elevated blood pressure.
  4. don't care if... by Anonymous Coward · · Score: 0

    Don't care if Watson agrees with the experts, I want Watson to give the right diagnosis.

  5. Who is right? by manu0601 · · Score: 4, Interesting

    Watson agrees with humans in 73% to 96% of the cases. But who is right when it disagrees, the human doctor or Watson?

    1. Re:Who is right? by PatientZero · · Score: 2

      AlphaGo.

      --
      Freedom to fear. Freedom from thought. Freedom to kill.
      I guess the War on Terror really is about freedom!
    2. Re:Who is right? by SharpFang · · Score: 3, Funny

      Cancer.

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      45 5F E1 04 22 CA 29 C4 93 3F 95 05 2B 79 2A B2
    3. Re:Who is right? by Daniel+Dvorkin · · Score: 2

      And maybe more importantly, if it disagrees with the humans, can we figure out why? This is a problem with a lot of machine learning applications, but there aren't many where understanding the decision-making process is more vital than it is here.

      --
      The correlation between ignorance of statistics and using "correlation is not causation" as an argument is close to 1.
    4. Re:Who is right? by AHuxley · · Score: 1

      Depends on a nations skills at producing experts who can read results and the people they educate over the decades.
      If a nation has poor quality staff and poor tracking of results per doctor, lacks tracking and peer review, a system will sell as been better.
      A human who writes the books, book chapters and teaches decades of new staff will have the skills with their colleagues.
      Teaching hospital vs a lab that has limits and finds staff that can do the job to some standard.

      --
      Domestic spying is now "Benign Information Gathering"
    5. Re:Who is right? by Anonymous Coward · · Score: 0

      Then you get a second opinion. It's a cue for the humans to take a more careful look at the case.

    6. Re:Who is right? by AHuxley · · Score: 1

      Few nations want to fund or do the real epidemiology. It usually shows pollution, issues with mil/gov or private sector production lines, maintenance, substances once passed as been safe, lack of filters, lack of expected gov inspections going back decades.
      No government wants heavy metal issues talked about in public and tracked back to some weapon production line or that aircraft repair issues resulted in sick workers.
      Unions and employers did nothing as workers got sick. Governments wanted jobs and a person in work getting sick was still a person in work and not adding to unemployment numbers.
      The average labs and doctors don't like decades of average work been peer reviewed by real experts. Private hospitals don't like mistakes been made public.
      Mil and gov officials don't like people talking about metals and substances they used in the 1950-90's that might have made generations of once very secret workers very sick.
      Ship, railway maintenance, aircraft work, mining, chemical production all add to issues most governments over decades would like to forget.
      The why is simple. Nations don't fund or hire or educate enough really smart experts and then give them all the data and access they need.
      Once doctors start requesting tests, suggesting tests, more public health spending is needed.
      Dont fund epidemiology, pathology and nothing is found that needs funding or new spending.
      So skills are lost, doctors just work within the system they have and know only a limited amount of experts will ever look at a nations health care system.
      Private hospitals don't want peer reviews, lots of expensive tests, slides been shared with outside experts.
      Bureaucrats that sit between the health care system and private insurance want to find fraud but not open up all kinds of new spending on public health issues.
      Private insurance wants to know if a doctor did something very wrong or if a hospital has bad conditions that needed more spending but thats not help looking at a nations wider public health for free.
      Some nations also import a lot of 'experts" to help with medical jobs in their nation. Due to a lack of university education in the nation or party policy, some nations have a health experts from other nations with average results. Getting peer reviews on such "experts" would expose the accreditation as been useless and the policy of using other nations doctors as been flawed. So a lot of people in power have a lot of reasons to hide the "why".
      All computers show is a lack of experts. Want to fix issues? Fund the best doctors and experts in the best teaching hospitals and let them do their work.
      Some nations just don't want the lack of spending to be found. Why have rescue helicopters, ambulances, expert staff at the front end and peer review of every result?
      No peer review and less spending is needed as everything is within a national average.
      All computers do is show a nation has issues and should spend a lot more on their own experts over generations.

      --
      Domestic spying is now "Benign Information Gathering"
    7. Re:Who is right? by ceoyoyo · · Score: 1

      This is a bigger problem with non-machine learning algorithms. People have a great deal of difficulty figuring out how they know what they know. Sometimes they're honest and say they don't know, sometimes they're happy to make something up.

      There have been studies on physicians specifically. The students tend to follow diagnostic criteria. Once you get good at it, you don't anymore.

      With the machine learning algorithms you can crack them open and poke around to your heart's content. And the "it's a black box" is more of a sound bite: it takes a little more work to figure out what it's doing when you didn't explicitly program it. People get very pissed off when you try and do the same thing with their heads.

  6. Compare to Truth Not Doctors by Roger+W+Moore · · Score: 2

    Why are they worried about making the same calls as doctors? What they should be doing is (obviously after the fact) comparing it to whether the patient actually had cancer. Nobody cares that Watson might only agree with doctors 73-96% of the time if, overall, it catches more cancers.

    In fact, even if it has a comparable success rate but disagrees with doctors that's great because it means it is catching cancers that doctors are likely to miss.

    1. Re:Compare to Truth Not Doctors by Anonymous Coward · · Score: 0

      This reminds me of the nursing home cat that would predict death by jumping up on a patient's bed, and staying, when the patient's death was near. Eventually the staff noticed this and would use this as a cue to call a patient's family (while there was still time). One day a doctor saw the cat jump off the bed of a patient that he, the doctor, was sure was about to die. He concluded that the cat's predictive streak was snapped.

      The patient lived longer than the doctor expected, and the cat later came back to jump up on the bed again, before the end. Cat 1, Doctor 0.

      I don't know if anyone figured out how the cat did it. Speculation is that the dying patients smelled a bit differently at the end, and that this particular cat not only noticed the difference, but for whatever reason, decided to do something about it.

    2. Re:Compare to Truth Not Doctors by Anonymous Coward · · Score: 0

      This is not about diagnosing cancer despite the article's title. It says it quite clearly in the actual article. It's about deciding treatment. Right now the gold standard is the tumor board that Watson is on and the consensus of the humans involved. In order to prove that Watson was better than the tumor board a study would have to be done to prove that patient outcomes were better with Watson than the board. It would not be a difficult study to design but would take time to prove -- possibly on the order of five year. It could be iterative because Watson will learn over time so even if the first study was in favor of the tumor board I'm willing to bet that at some point Watson will be the gold standard.

  7. Watson has achieved self-awareness by turkeydance · · Score: 1

    it agrees with those who control the power to disconnect it.

  8. I play a doctor, but not on TV by rmdingler · · Score: 1
    Despite the inevitable point that a computer surpasses human ability to diagnose and treat ailments and disease,

    might there not still be a place for humans as middlemen to broker the information to a fellow human?

    --
    Happiness in intelligent people is the rarest thing I know.

    Ernest Hemingway

    1. Re:I play a doctor, but not on TV by ceoyoyo · · Score: 1

      Yes. Nursing has a not-so-dim future, for the rich people who can afford it.

  9. Re:Where does it end? by known_coward_69 · · Score: 1

    star trek had doctors and they had better tech than we do now. someone has to make treatment decisions

  10. False positive rate also matters by Anonymous Coward · · Score: 0

    I know how to diagnose 100% of cancers. Just say everyone has cancer.

    However, knowing someone who was recently misdiagnosed as having cancer getting it wrong has it's costs as well and they are considerable.

    1. Re: False positive rate also matters by Anonymous Coward · · Score: 0

      Poor grammar has its costs as well.

  11. Catching up to Dr Google by Kryptonut · · Score: 1

    *types in "I have a headache*

    Google: You have cancer!

  12. Re:Where does it end? by Anonymous Coward · · Score: 1

    Didn't Voyager use an AI doctor who presented as a hologram?

  13. Re:Where does it end? by WheezyJoe · · Score: 2

    That's one future. Another is the autodoc from Ringworld, Elysium and Passengers. Just climb your sick self in, shut the lid, and the machine fixes you right up.

    --
    Take it easy, Charlie, I've got an Angle...
  14. IBM is still playing catch-up. by Gravis+Zero · · Score: 4, Funny

    IBM needs to up their game because WebMD has been diagnosing me with cancer for years. ;)

    --
    Anons need not reply. Questions end with a question mark.
    1. Re:IBM is still playing catch-up. by Anonymous Coward · · Score: 1

      I'll say, wake me up when it cures MS (not the software giant).

    2. Re:IBM is still playing catch-up. by Anonymous Coward · · Score: 0

      You too? According to WebMD I've already died of cancer, been reborn as a conjoined twin, (the other one is inside me exact same proportions- so we look like one person), and am now experiencing my second mid-life crisis. And both coffee & wine are healthy... or not.

      Watson help!

    3. Re:IBM is still playing catch-up. by PolygamousRanchKid+ · · Score: 1

      Maybe Watson can cure IBM's stagnating business and stock price . . . ?

      Dr. Warren Buffet already threw in the towel on that patient.

      --
      Schroedinger's Brexit: The UK is both in and out of the EU at the same time!
  15. it will black list people (usa only) by Joe_Dragon · · Score: 1

    And soon it will put doctors out of business. they have a union to stop that.

  16. Re:Where does it end? by Anonymous Coward · · Score: 1

    Diagnosis requires knowing what questions to ask. If you rely on patient-reported symptoms and lifestyle questions, you're going to have a lot of misdiagnoses. Even if you run a battery of tests, you'll have so many false positives that it's hard to make out what's going on. A standard blood panel has more than 20 tests, so at least one of them is likely to be outside the 95%-confidence "normal" range even in a healthy patient.

    AI isn't going to help with surgery; as yet robotics is only useful in very controlled environments, and almost no surgery goes exactly the same way twice.

    It isn't going to help with post-op care; people have complex needs that can't be met by machines.

    I can see it helping with imaging; spotting anomalies in scans and even doing scans in an automated fashion. There's a skill to positioning a patient to get a clear scan that I don't believe a machine could easily replace, though.

    It could certainly help keeping track of things during procedures. Checklists WORK, and having a computer keep track of things for you would be useful. The number of stupid mistakes that would be caught by an always-alert computer is frightening. Similarly, an electronic device that could reliably regulate patients taking their meds would be invaluable; especially if it provided that data to their physician.

    In short: there are plenty of areas where automation would free up doctors time, or (as in this case) provide a second opinion. Those things are useful no matter how many doctors you have.

  17. Re:Where does it end? by Anonymous Coward · · Score: 0

    And soon it will put doctors out of business. Too bad for young graduates of 10+ years of training with staggering student loans and no jobs.

    Uh, you seem to forget about all those educational facilities that profit massively from educating humans. It is because of them and their corrupt influence in politics that we will continue to create staggering student loans regardless of job availability.

  18. Re:Where does it end? by Anonymous Coward · · Score: 0

    Within the universe of Star Trek, yes, they had a holographic doctor on the Voyager.

    In the universe where you and I exist, the writers of the show simply wrote a character who used props to pretend to be a holographic doctor. No actual AI existed in that situation. No argument can be made on either side about the effectiveness of AI in medical treatments based on a Star Trek storyline.

  19. If you are in medical jeopardy by Anonymous Coward · · Score: 0

    I'll Take Proper Diagnostic for $500

  20. Article is a bit lite by FeelGood314 · · Score: 1

    Is Watson just making a yes/no answer or is it actually understanding the reports and suggesting courses of action? Can Watson catch an X-Ray or other report that is total BS or one that is suspicious enough to have been created by a human error? Still this is definitely progress.

  21. Family Doctors will be the next automated job by FeelGood314 · · Score: 1

    A doctor makes 20x what a retail worker makes and is likely easier to automate. Retail workers aren't paid much and can stalk shelves, fix broken things and do a multitude of things. They won't all be replaced by online shopping, I still need my immediate gratification. Doctors though are very high paid and my family doctor only orders tests and prescribes things. Evidently in Canada she spends over half her time doing soul crushing paperwork. There is no reason a computer can't 1) listen to symptoms, 2) run tests, 3) examine the results (order more tests?), 4) decide on a coarse of action 5) check if the patient is getting better 6) evaluate its own diagnostic. Hell my family doctor doesn't do 5 and 6.

  22. the problem isn't diagnosis by Hugh+Jorgen · · Score: 0

    It's prevention and treatment... Diagnose until your Big Blue in the face, but without effective treatment what's the point?

  23. No right answer by SeattleLawGuy · · Score: 1

    Watson agrees with humans in 73% to 96% of the cases. But who is right when it disagrees, the human doctor or Watson?

    There are plenty of cancers where there is a philosophical difference in how to approach it surgically and there are questions that make a particular study less applicable in a given circumstance. For example, I know of a stomach cancer case where one doctor advocated strongly for open surgery to excise the tumor and repair the stomach and perform a radical lymphadonectomy followed by chemo and another surgeon who advocated strongly for chemo followed by endoscopic surgery and a more limited lymphadonectomy. There was technically not enough evidence to determine that one course was definitely right or wrong in the given situation compared to the other, so it comes down to a combination of your best guess based on the limited data and which doctor the patient trusts more to do a good surgery.

    But there are also lots of decisions where there's a pretty clear choice.

    And there are lots of decisions where there is a pretty clear choice, but the doctors make a different choice because they are less familiar with another surgery. And some choices are a function of when you are trained. I knew an amazing orthopedic surgeon in NY who was trained in a different era than modern surgeons and was much more conservative about surgery in the last few decades of his practice than everyone trained more recently. Sometimes there is a reason for that (I know old docs who just had much more training than new ones, and there are operations that it is VERY hard to find someone good enough to do reliably these days) and sometimes they're just used to the standards of a different era.

    --
    Real lawyers write in C++
  24. Re:Where does it end? by PolygamousRanchKid+ · · Score: 1

    Just climb your sick self in, shut the lid, and the machine fixes you right up.

    . . . and if it can't fix you up, you are already right there in your coffin, ready to be buried . . . or shipped to the Soylent Green factory.

    This definitely would streamline the whole process.

    --
    Schroedinger's Brexit: The UK is both in and out of the EU at the same time!
  25. Update title? Slashdot editors, are you living in by blibbo · · Score: 1

    Isn't it reasonable to request the Slashdot editors to update the title and add an "EDIT: ...â disclaimer to the summary? The title outright contradicts the summary.

    It's not like Slashdot has printed millions of copies of a newspaper, it's not an epic task to change this.

    I lament that there don't seem to be any online news sources that do the minimum to notice or correct their mistakes, whether directly in-place or as a retraction / correction after the fact.

    Please prove me wrong Slashdot!

  26. Re: Update title? Slashdot editors, are you living by blibbo · · Score: 1

    Are you living the digital age?

  27. Re:Where does it end? by Anonymous Coward · · Score: 0

    Maybe I'm getting my information from questionable sources, but several of your assertions appear to contradict reported current technology.

    First, Watson has (so I understand) at least as good a diagnostic rate as regular MDs, and I believe a better-than-average rate for the less-common problems, presumably because it carries no preconceptions and isn't prone to forget about the off-the-wall cases that they last heard about 20 years ago in medical school. And is also, we hope, being fed up-to-date information that regular doctors might not have have a chance to read for one reason or another.

    Secondly, I'm also led to understand that some surgeries can actually be done better by robots than by regular surgeons. Here again, a robot is less likely to be led astray by what it "thinks" it sees and is capable of adapting much faster. Plus, of course, robotic manipulators can be adapted into shapes and sizes that human fingers were never intended to achieve. Including having more of them than humans could crowd into small spaces.

    It is, of course, the human touch where automation falls short. That said, a lot of doctors have been accused of being deficient in that area themselves and between them and the time constraints most doctors have, the bulk of the human touch in medical care tends to come from the support staff.

  28. Re:Where does it end? by Anonymous Coward · · Score: 0

    That doctor was only supposed to be for emergencies, normally a real entity would have been in charge.

  29. Re:Where does it end? by Anonymous Coward · · Score: 0

    > current technology... First, Watson has (so I understand) at least as good a diagnostic rate as regular MDs

    You are correct, but that is still misleading. Watson is not just as good, it is superior and it was that already 4 years ago.
    2013: "Watson's successful diagnosis rate for lung cancer is 90 percent, compared to 50 percent for human doctors.",
    http://www.wired.co.uk/article/ibm-watson-medical-doctor

    >> as yet robotics is only useful in very controlled environments

    Controlled environments, like when driving cars? Your information seems to be about a decade old. We are no longer programming robots to do stuff, we teach them and they learn by trial and error. And they become better than humans, because unlike people, they actually learn.

    1. Make a robot
    2. Practice with dead animals
    3. Practice with live animals
    4. Keep doing living animals until the robot is better than human vet. At that point, replace all vets with robot surgeons. And profit.
    5. Keep collecting data from all operations on different animals.
    6. Considering that human is just one species of an animal, at this point the robot is probably also better than human surgeons, but if not train it with corpses and people who are going to die anyway.
    7. You should now be able to replace all human surgeons with the robot and profit again.

  30. Re:Where does it end? by Anonymous Coward · · Score: 0

    6. Considering that human is just one species of an animal, at this point the robot is probably also better than human surgeons, but if not train it with corpses and people who are going to die anyway.

    Hmm. I spot a fly in the ointment. What if we're all going to die anyway? After all, nobody lives forever...

  31. Re:Where does it end? by Anonymous Coward · · Score: 0

    But they had a whole story line about the bigotry of StarFleet in keeping holographic AI from having normal jobs and instead get relegated to the jobs nobody wants or only for emergencies. The moral of the story is that AI had advanced to the point that they should have the rights of any other entity.

  32. Re: Where does it end? by Anonymous Coward · · Score: 0

    What a swell idea. And when the 10% of cases where the AI misdiagnoses the cancer turn out not to be the same as the 20% of cases that the human doctor would miss, it won't matter because it's an "edge case" right?