ARTIFICIAL INTELLIGENCE IN

MEDICINE: CHALLENGES AND

OPPORTUNITIES
Optional Assignment
Introduction to AI Convergence

Done by: Karshiev Sanjar (ID: 2021320544)

Received by: Hyoung-kyun Roh M.D., Ph.D.

JUNE 23, 2022

KYUNGPOOK NATIONAL UNIVERSITY
Department of Artificial Intelligence
 Introduction

Modern medicine uses artificial intelligence (AI) to help doctors in their daily work,
with AI systems assisting during surgery, alerting when patients become unstable, or even
analyzing x-rays. This technology has undergone significant changes over the past few years,
allowing you to analyze an ever-growing amount of data. However, these AI-assisted tools are
still largely unintegrated into current practice. What are the limitations that prevent their
application, and what are the potential benefits of these AI technologies?

To address those questions, we must first recall what artificial intelligence is and what
its goals are. Simply expressed, the purpose of AI is to replicate human thinking in the capacity
of technology to make judgments. More precisely, because to the use of computational and
algorithmic advances, a sub-branch of AI known as Machine Learning (ML) has grown in
popularity. ML technology is unusual in that it develops a model from observable data rather
than attacking a problem using hard-coded rules given by experts (i.e., the machine learns
from the observed data). In medicine, the goal of ML technology is to replicate doctors'
choices using data from observed patients. For instance, a radiologist makes a diagnosis by
analyzing an x-ray. By collecting data from thousands of x-rays and patient diagnoses, the
machine learning model aims to draw conclusions similar to those of the medical practitioners
it learns from. This type of technology can help physicians make faster decisions by providing
them with a "first" diagnostic opinion, freeing up physicians' time to focus valuable attention
on more complex cases and help more patients.

Google AI recently built such a model, which produced 'more accurate' prediction
findings than physicians themselves. The researchers obtained over 46.8 billion data points
from de-identified electronic health records (EHR) from two US academic medical centers with
216,221 patients hospitalized for at least 24 hours, which they used in deep learning methods
predicting in-hospital mortality rates, prolonged length of stay, and all of a patient's final
discharge diagnoses. This study's findings, as well as those of other comparable research, have
been widely debated.
 The Challenge of Medical AI Data

This case study is one example of how to comprehend a critical issue in medical AI:
repeatability. Because of reproducibility issues, the reported experiments are difficult for other
teams to replicate (with reproducibility being a central element for how scientific knowledge
is tested and develops). This phenomena is explained by a number of causes. First, data have
significant commercial value because of their potential, but also because of the costs
associated with gathering, cleaning, stocking, and labeling them. This prohibits data from
being shared with the medical community, which may profit from it in a competitive medical
market. Furthermore, medical data, in particular, are extremely sensitive. Ensuring privacy is
critical since the data is not only useful but might also be harmful to the patient if exploited.
(For example, would your insurance company want to know your whole medical history?)
Maintaining patients' privacy rights in these research remains a technological problem, since
de-identified data no longer ensures anonymity due to the vast quantity of data collected on
each individual.
Next, data is typically tainted by biases that reflect past ideas and choices. For example,
a common medical practice in the 1980s that is now being questioned may be over-
represented in historical statistics derived from earlier records. This might result in the creation
of a model that is no longer relevant. Furthermore, due to historical and current practices,
some groups who would benefit from a newly constructed ML model may be
underrepresented by the data utilized in it. Pregnant women, who are seldom included in
clinical trials, are well-known instances, as is ethnic diversity, which may not be reflected in
the data sample. Other medical-specific data biases include how disease-specific drugs are
created on people who are more likely to be sick from it, neglecting rare cases that are viewed
as odd by the ML model. These biases result in models that do not work for certain people
or, worse, harm them.
Another limitation of using healthcare data is its incompleteness: clinicians make
diagnoses not only based on a sequence of statistics, but also after engaging with the patient
and appraising their general status based on cues that cannot be adequately represented
merely by numbers. To paraphrase an old adage, algorithms cannot simulate what is not
measured.
 Will Artificial Intelligence Replace Doctors?

All of these concerns highlight to a major shortcoming of AI: the models do not
interact with the patient, instead drawing inferences based on certain data points. This is
critical to consider, particularly in the medical context, where increased patient-doctor
communication has been related to better health outcomes. Furthermore, the sense of a
human connection is essential. Patients have better health results when their doctors have
comparable qualities to them (e.g., cultural background, gender, socioeconomic background,
etc.), according to research, since it makes talks simpler and allows the doctor to better analyze
their patient's overall status.
To accurately diagnose a patient, it is necessary to view them as a person immersed
in numerous social and environmental systems, any combination of which may be contributing
to medical concerns, and to interpret their situation holistically. A patient's health and well-
being cannot be determined just by their symptoms; background information regarding the
social and economic elements of their existence is also important. So far, machines have been
unable to replicate these relationships, which I would argue are essential to our humanity and
a crucial component of what makes well-practiced medicine so effective.
The consequent trust in machines is exacerbated by the complexity of the generated
models themselves, as their researchers seek to overcome the numerous obstacles associated
with medical data. Because of their intricacy, these models are sensitive to their training data,
but they also limit our comprehension of a single choice. One reason medical AI has not been
generally adopted in the medical community is the lack of medical interpretation. Simpler (but
more understandable) models are utilized instead.
AI models are tuned to provide the best results on a specific measure. This important
component of ML is both its strength and its weakness. If not correctly understood or used,
this structure might lead to models favoring the majority and disregarding exceptional
occurrences, indicating unsuitable judgments. In other words, in a fully automated system, a
little modeling error might result in AI-recommended medical therapies that exacerbate
patients' diseases. This last element brings up the legal issue of accountability. Who is liable
for wrongdoing when an algorithm exhibits "abnormal" behavior or delivers medical advice
that has disastrous consequences?
 What can we expect in the future?

Addressing these several obstacles is required if we are to use medical AI in our

hospitals, which is why they are such an active research axis. Interpretability is being thoroughly
researched, and better understood models are currently being utilized to develop more robust
and interpretable technologies. To assure their efficacy, extensive testing and validation
approaches are being investigated. Initiatives to share code and data are emerging, allowing
researchers to build on one other's earlier work. These measures are critical if we are to make
more widespread use of these promising medical AI solutions.

In a lighter vein of technology involvement, and without going into an exhaustive list
of machine learning applications in healthcare, a plethora of models have been constructed
in many medical specializations to substitute human cognition in repetitive activities. Because
of their ability to swiftly handle massive volumes of multivariate data, these applications offer
significant benefits. This has enabled them to automatically detect previously unknown signals
in data, leading to new medical discoveries. These technologies can thus be used to improve
medical understanding in addition to mimicking human behavior. This has been found in
simulations that take use of computer speed, with human medical experience guided by
machine learning. So far, for example, this has aided researchers in focusing on interesting
molecular topologies that may lead to more effective medications and vaccines.

Conclusion

The future of AI in medicine is undoubtedly complicated. However, ML provides a

glimpse of a future in which long-term health evolutions can be better understood via the
evolution of observed data, potentially allowing a transition from effect-based to cause-based
care. This trend would contribute to a more preventative approach to medicine, concentrating
on preventing disease rather than treating its symptoms. Artificial intelligence holds
tremendous potential, but, like any instrument, it has limitations and hazards. To capitalize on
medical AI's capabilities, we will need to develop the necessary tools and frameworks to
address its deficiencies, notably the technological, ethical, and legal issues discussed here.
 References:

1. Introduction to AI convergence, Lecture 1: Introduction AI in Diabetic Retinopathy Dx

2. Introduction to AI convergence, Lecture 3: AI as a Data Science

3. Karshiev Sanjar, Machine Learning for health care, where are we now?, Student presentation
during Introduction to AI convergence class

4. Medium.com article: Challenges and opportunities of AI in healthcare,

https://medium.com/good-data-initiative/artificial-intelligence-in-medicine-challenges-
opportunities-ahead-ed0977c6c1da

5. Artificial Intelligence in Healthcare, https://medium.com/analytics-vidhya/artificial-intelligence-

in-healthcare-40ff4e0a346b