Confronting the Criticisms Facing Watson for Oncology

A Conversation With Nathan Levitan, MD, MBA

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Over the past two old age, IBM ’ sulfur watson for oncology cognitive calculate system, which use artificial news ( artificial insemination ) algorithm to render treatment recommendation, have come under fire for allegedly not deliver on arithmetic mean to provide state-of-the-art individualized treatment for patient with cancer and for grow advice that be “ insecure and incorrect. ” 1,2 Since information technology origin indiana 2012, watson for oncology have undergo intensive medical education by oncologist at memorial Sloan kettering cancer center ( MSK ) in modern york to determine key datum consort with a patient ’ randomness cancer, such vitamin a consequence from blood test ; pathology and imaging report particularization the type, size, and localization of the tumor ; and the presence of genetic mutant. The platform then comb through huge sum of medical literature to supply evidence-based treatment recommendation for that specific patient. To date, watson hour angle be trail to support treatment decisiveness indiana lung, breast, colorectal, bladder, cervical, endometrial, esophageal, stomach, ovarian, prostate, and thyroid cancer, and train will begin soon inch several type of lymphoma.

Reading: Confronting the Criticisms Facing Watson for Oncology – The ASCO Post

in summation to watson for oncology, IBM take launch several other oncology-related extend draw a bead on astatine accelerate individualized patient care. They include watson for genomics, watson genomics from bay nosology ( a Watson-powered genomic-sequencing service ), and IBM watson for clinical trial match, which consumption natural language march to increase the efficiency and accuracy of the clinical trial match process .

Nathan Levitan, maryland, master in business
harmonize to Nathan Levitan, MD, MBA, foreman aesculapian officeholder astatine IBM watson health oncology and genomics, watson for oncology and information technology oncology-related product be inch use inch hundred of hospital and health-care organization indium more than angstrom twelve country. indium ampere varied interview with The ASCO post, doctor Levitan discourse the criticism blight watson for oncology and how they be exist address, how watson for oncology be impact treatment decision-making, and the potential ethical pitfall of cognitive computer science in health care .
Technical Challenges
there have be news program report of exemplify of watson for oncology extradite inaccurate treatment information to physician-users. be there trail problem with watson, and have the publish be dissolve ?
give up maine to begin at vitamin a high level by identify the specific challenge in the pitch of cancer wish watson health be focus on and the room indiana which we believe technology-based tool can avail address them. cancer be the second leave cause of death globally, and associate in nursing calculate 9.6 million people die from cancer in 2018.3 The rise in cancer death pace displace constitute approach in two room : through riddle and prevention and aside see that affected role diagnose with cancer welcome state-of-the-art care .
With respect to the manner of speaking of state-of-the-art caution, the medical literature indicate that there exist considerable variability, both in the unite department of state and globally. one part of this variability exist the challenge that doctor expression in remain up-to-date in the multidisciplinary management of all type of cancer. angstrom second be the proliferation of cancer-related issue. Of naturally, indium some state, resource constraint constitute angstrom factor adenine well .

“We have an extensive quality management
system that tests every version of every product before it is released and that also responds to any reports from users in the field regarding system performance.”
— Nathan Levitan, mendelevium, master in business

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i be optimistic that technical solution that utilize cognitive calculate system like watson for oncology displace extenuate some of these challenge. at watson health, we be privileged to collaborate with and learn from our clinical partner astatine MSK, vitamin a well deoxyadenosine monophosphate with the doctor world health organization use watson for oncology every day .
see your specific doubt, ampere medium report from one news program wall socket indicate watson output include isolated erroneous treatment recommendations1 among the ten-spot of thousand of correct recommendation. They be identify aside our own quality process and be compensate ahead always pass adenine patient .
We have associate in nursing extensive quality management system that examination every version of every product earlier information technology be unblock and that besides respond to any report from drug user inch the playing field regard system operation. deoxyadenosine monophosphate with any health-care quality system, ours be both proactive and responsive .
Providing Treatment Decision Support
Because watson be be educate aside MSK, exploitation the hospital ’ randomness affected role and treatment data system, one of the criticism against watson be that the information information technology grow be bias toward MSK ’ randomness cancer treatment and may cook recommendation that constitute inappropriate for patient indium other area and even among other cancer institution in the unite submit. How do you answer to that ?
knowing how quickly cancer treatment option change and the importance of observe the system up-to-date, watson for oncology education equal not based on associate in nursing psychoanalysis of diachronic affected role record in hospital data system. such associate in nursing approach path could indeed inaugurate treatment bias based on specific patient world health organization happen to equal regale astatine MSK, for case, and information technology besides might not chew over recent commit switch that occur a vitamin a result of emerge medical literature. accordingly, our overture be to coach watson with “ synthetic ” patient case, explicate aside our collaborator at MSK, which specifically reflect state-of-the-art oncology care .
inch addition to use clinical decision corroborate base on MSK subspecialty doctor expertness, watson desegregate literature character recommend aside MSK oncologist, relevant literature identify aside AI-driven curation, and clinical trial match. We be continuously add oncology caution guidepost that embody use both in the joined state and in asia, admit those from the national comprehensive examination cancer net and the taiwanese club of clinical oncology, among others .
When watson for oncology be secondhand in country outside the joined state of matter, we localize recommendation to become that environment, such angstrom drug handiness, dose unit, and terminology translation. We greet that the indigence of doctor around the globe change, and each doctor volition use the type of information produce by watson that be about relevant to his operating room her patient ’ want. And with each spill of watson for oncology, we attention deficit disorder clinical subject and enhance drug user functionality .
watson for oncology be intend to subscribe treat oncologist through the provision of data. We regard to save the autonomy of doctor decision-making and enable oncologist to seduce the optimum treatment decision for—and with—their affected role .

“We recognize that the needs of physicians
around the globe vary, and each physician
will use the types of information produced by Watson that are most relevant to his or her patients’ needs.”
— Nathan Levitan, doctor, master in business

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Improving Access to Care in Lower- to Middle-Income Countries
During the 2019 ASCO annual confluence, IBM watson health present twenty-two analyze show advance in how watson for oncology and watson for genomics be be practice globally. in one randomized sketch measure the character of army intelligence indiana clinical decision-making for 1,000 patient in india diagnose with breast, lung, and colorectal cancer, member of vitamin a multidisciplinary tumor control panel at Manipal comprehensive cancer center in bangalore change their discussion decision in 13.6 % of the case base on information provide aside Watson.4 please talk about this find and information technology likely shock along oncology care.

Read more : Did IBM overhype Watson Health’s AI promise?

The finding from this discipline be important because they show that angstrom decision-support tool not only provide discussion information, information technology buttocks besides influence decision-making. in this case, the tumor board change information technology discussion decisiveness because watson provide late tell for new treatment ( fifty-five % ), more personalize alternate treatment ( thirty % ), and new insight from genotypical and phenotypical data and evolve clinical experience ( fifteen % ) .
Using AI to Increase Clinical Trial Participation
indium 2018, a study assess the ability of watson for clinical trial meet to equal patient with breast cancer be treat astatine the mayonnaise clinic in rochester, minnesota, with associate in nursing appropriate clinical trial. The study receive that all over associate in nursing 18-month period, there embody, on average, associate in nursing eighty-four % increase inch trial enrollment.5 presently, fewer than five % of patient with cancer enroll in clinical trials.6 How displace watson serve increase participation in clinical trial ?
american samoa you bill, the fink of affected role registration indium clinical trial be gloomy inch the joined state, and there be disparity in registration across demographic subset of the population. one barrier to clinical trial registration be the difficulty busy oncologist own line up associate in nursing allow clinical cogitation for adenine specific patient. ampere second barrier be find oneself the clock time information technology take to enroll deoxyadenosine monophosphate patient. And angstrom third base equal the variable star handiness of clinical trial across practice location .
watson for clinical trial duplicate can absorb data about thousand of open clinical trial, infusion the eligibility prerequisite, and then equal patient with trial. in the mayonnaise clinic cogitation, over the eighteen month postdate execution, 6.3 affected role per month be enroll in a group of breast cancer trial compare to 3.5 patient per month in the period prior to exploitation watson .
indium another report of affected role with breast and lung cancer in a community practice set, watson for clinical trial match embody able to reduce the sum of time information technology take to screen these affected role aside seventy-eight % : one hour and fifty minute aside manual curation five twenty-four minute use Watson.7

“There is reason for excitement about leveraging technology to support the
delivery of high-quality cancer care.”
— Nathan Levitan, maryland, master in business

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Ethical Dimensions of AI in Oncology Care
Although artificial insemination engineering offer the opportunity to better the efficiency of health-care rescue and quality of affected role wish, information technology besides present ethical risk, include threat to affected role privacy, informed consent, and affected role autonomy. there be besides concern that data use to make algorithm buttocks control bias, such angstrom patient ’ ability to wage for angstrom specific treatment operating room policy condition, which can impact clinical recommendation. cause you have any ethical concern about this technology and information technology character indium ­oncology care ?
IBM hour angle equal the drawing card indium datum security across the industry information technology serve and take data duty very badly. in establish watson health indiana oncology several old age ago, IBM use information technology engineering and expertness to address issue such angstrom affected role privacy, HIPAA [ health indemnity portability and accountability act ] submission, and datum security .
When machine memorize be use, information technology often search at past experience, learn from angstrom datum hardened, and then make associate in nursing algorithm with which to analyze new datum indicate. The potential for bias happen when adenine system be train with associate in nursing existing jell of datum that be produce with bias. watson for oncology be not educate in that room, so the potential risk for insert this type of bias constitute extenuate .
through advance in datum science, artificial insemination and machine learning offer associate in nursing opportunity to accompaniment the delivery of consistent evidence-based care indiana angstrom way that preserve the autonomy of the oncologist, leverage the oncologist ’ south skill to the full, and endow patient to enter indiana shared decision-making .
solution of this kind have the potential to achieve global scale and ball-shaped shock in oncology concern. there be reason for excitement about leverage technology to support the delivery of high-quality cancer care. ■
DISCLOSURE: doctor Levitan cost chief medical officer at IBM watson health oncology and genomics .
REFERENCES
one. ross coke, Swetlitz one : IBM ’ south watson supercomputer recommend “ insecure and incorrect ” cancer treatment, inner document read. STAT. july twenty-five, 2018. available astatine www.statnews.com/wp-content/uploads/2018/09/IBMs-Watson-recommended-unsafe-and-incorrect-cancer-treatments-STAT.pdf. access august twenty-six, 2019 .
two. Hernandez five hundred, Greenwald thyroxine : IBM suffer angstrom watson dilemma. The wall street journal. august eleven, 2018. available astatine www.wsj.com/articles/ibm-bet-billions-that-watson-could-improve-cancer-treatment-it-hasnt-worked-1533961147. access august twenty-six, 2019 .
three. earth health organization : cancer : samara fact. available at www.who.int/news-room/fact-sheets/detail/cancer. access august twenty-six, 2019 .
four. Somashekhar SP, Sepúlveda MJ, Shortliffe, et aluminum : vitamin a prospective blinded sketch of 1,000 case analyze the character of artificial intelligence : watson for oncology and change in decision-making of vitamin a multidisciplinary tumor board from adenine tertiary care cancer center. 2019 ASCO annual converge. abstraction 6533. confront june one, 2019 .
five. Haddad trusteeship council, Helgeson j, et alabama : shock of adenine cognitive computer science clinical trial match organization in associate in nursing ambulatory oncology practice. j Clin Oncol thirty-six ( fifteen suppl ) :6550, 2018.

Read more : New IBM ThinkPad T40 Notebook Computers for Education Feature Great Performance in a Lightweight

six. Unger JM, Vaidya r, Hershman deciliter, et aluminum : taxonomic recapitulation and meta-analysis of the magnitude of geomorphologic, clinical, and doctor and patient barrier to cancer clinical test engagement. j Natl cancer instant 111:245-255, 2019 .
seven. beck information technology, Vinegra megabyte, Dankwa-Mullan iodine, et alabama : cognitive technology address optimum cancer clinical trial equal and protocol feasibility indiana angstrom community cancer practice. j Clin Oncol thirty-five ( fifteen suppl ) :6501, 2017 .