Applications of Artificial intelligence

in Medicine

Student Name: Mostafa Kareem Nessem

Student ID: 21045

Course Name: Artificial intelligence

Prepared for: Dr/ Ahmed Youssef

Date: 7/1/2023
Table of contents
Table of contents............................................................................................1
Table of figures..............................................................................................1
Introduction...................................................................................................2
What is an intelligent algorithm........................................................................3
Top 4 applications of AI in medicine today...........................................................4
1. Diagnose diseases...............................................................................4
How computers learn to make diagnoses...................................................4
2. Develop drugs faster............................................................................5
Stage 1: Targets identification for intervention...........................................6
Stage 2: Drug candidates discovering........................................................6
Stage 3: Speeding up clinical trials...........................................................7
Stage 4: Biomarkers finding for disease diagnosis.........................................7
3. Personalize treatment..........................................................................8
4. Improve gene editing...........................................................................8
Some AI algorithms in medical field....................................................................9
1. DLAD (Deep Learning based Automatic Detection)....................................10
2. LYNA (Lymph Node Assistant).............................................................10
Risk taken in healthcare due to AI....................................................................11
 Harming patients due to Artificial intelligence errors................................11
 Wronge use of Medical Artificial intelligence tools...................................12

Table of figures

Figure 1........................................................................................................3
Figure 2........................................................................................................5
Figure 3........................................................................................................6
Figure 4........................................................................................................9
Figure 5......................................................................................................10
Figure 6......................................................................................................12
Figure 7......................................................................................................13

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Introduction

Perhaps sooner than expected, a patient might first consult a computer before
consulting a doctor, ushering in the "standard" medical practice of the future. It
seems feasible that the days of misdiagnosis and treating disease symptoms rather
than their underlying cause could soon be a thing of the past thanks to developments
in artificial intelligence (AI). Consider how many years' worth of blood pressure
readings you have, or how much space you would need to free up on your laptop to fit
a complete 3D representation of an organ. More uses of artificial intelligence and
high-performance data-driven medicine are made possible by the growing body of
data created in clinics and saved in electronic medical records through routine testing
and medical imaging. The methods used by physicians and researchers to solve clinical
problems have evolved and will continue to change due to these applications.

Although some algorithms can perform on equal or even better than physicians in
many activities, they have not yet been fully incorporated into routine medical
practice. Why? Because there are many regulatory issues that need to be resolved
first, even if these algorithms have the potential to significantly influence medicine
and increase the effectiveness of medical interventions.

The potential for artificial intelligence (AI) to completely transform the healthcare
sector – to help with better diagnosis and provide a more personalized, precision
approach to therapy – may seem endless. Among the most important uses of AI in
medicine are disease prediction, automated genetic data analysis, medical robotics,
telemedicine, and virtual doctors. The coronavirus pandemic has driven the
development and implementation of AI applications in the medical and clinical areas
since AI-related technologies are at the center of the response to this global health
disaster.

Like other technical advances, AI in the healthcare sector has benefits and
drawbacks that are particular to it, and it necessitates a particular set of regulatory
frameworks to address the socio-ethical effects of its use.

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What is an intelligent algorithm

Intelligent algorithms must learn how to execute their tasks in a similar way to how
doctors are taught through years of medical school, completing assignments and
practical examinations, obtaining grades, and learning from mistakes. In general,
tasks that require human intellect to complete, such pattern and speech recognition,
picture analysis, and decision making, can be performed by AI algorithms. However,
when providing an image to an algorithm, for example, humans must directly instruct
the computer what to look for in the image. In summary, AI algorithms are excellent
at automating laborious jobs and occasionally exceed humans at the tasks they have
been programmed to execute.

Computer systems must first be given structured data that each data point has a label
or annotation that the algorithm can recognize in order to create an effective AI
algorithm (Figure 1). Like when students take examinations, the algorithm's
performance is examined to guarantee correctness after it has been exposed to
sufficient sets of data points and their labels. These algorithm "exams" typically entail
programmers entering test data for which they already know the answers in order to
judge the algorithm's propensity to identify the right response. The algorithm can be
updated, given more data, or implemented based on the testing results to assist the
program's creator in making judgements.

Figure 1

Figure 1: An example of an algorithm that can rebuild the location of a missing finger
after learning the fundamental anatomy of a hand is shown in the figure above.
Various hand x-rays are used as the input, and the output is a tracing of the locations
of the missing hand parts. The hand outline that may be created and applied to other

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photographs serves as the model in this instance. This might make it possible for
doctors to determine where a prosthetic or limb reconstruction should be done

Top 4 applications of AI in medicine today

1. Diagnose diseases

Years of medical training are required for accurate disease diagnosis. Even then,
diagnosis is frequently a laborious, lengthy process. The demand for expertise far
outweighs the supply in many fields. Doctors are under pressure as a result, and
critical patient diagnostics are frequently delayed.

Recent developments in machine learning, particularly in the area of deep learning

algorithms, have greatly improved the accuracy and accessibility of disease diagnosis.

How computers learn to make diagnoses

Algorithms that use machine learning can train themselves to recognize patterns in
the same way that doctors do. One significant distinction is that algorithms require
hundreds of concrete examples in order to learn. Additionally, since robots can't read
between the lines in textbooks, these examples must be neatly digitalized.

Therefore, machine learning is especially useful in fields where the diagnostic data a
doctor considers has already been digitized.

For example:

 Using CT images to identify strokes or lung cancer

 Using cardiac MRI images and electrocardiograms in evaluating various heart
diseases such as risk of sudden cardiac death
 Using skin images in classifying skin lesions
 Using eye images in finding indicators of diabetic retinopathy

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 Figure 2

Since there is a ton of reliable data available in these situations, algorithms are
improving their diagnostic abilities on par with those of specialists. The algorithm's
ability to generate conclusions in a fraction of a second and its ability to be
economically replicated globally make up the gap. All people, wherever, will soon
have access to affordable, top-quality radiological diagnostic services.

AI won't soon replace doctors

It's doubtful that AI will completely replace doctors. Instead, AI technologies will be
employed to draw the expert's attention to possibly cancerous tumors or risky cardiac
patterns, freeing the doctor to concentrate on the interpretation of those signals.

2. Develop drugs faster

Drug development is a notoriously pricey procedure. Machine learning can increase

the productivity of several analytical procedures used in drug development. This
might save years of labor and hundreds of millions of dollars in investments.

Recently AI has successfully been used in the 4 main stages of developing drugs, these
4 stages are as following:

 Stage 1: Targets identification for intervention

 Stage 2: Drug candidates discovering
 Stage 3: Speeding up clinical trials
 Stage 4: Biomarkers finding for disease diagnosis

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 Figure 3

Stage 1: Targets identification for intervention

Understanding the basic causes of a disease (pathways) and its resistance mechanisms
is the first stage in therapeutic development. The next step is to choose effective
targets for the disease (usually proteins). Deep sequencing and short hairpin RNA
(shRNA) screening are two examples of high-throughput methods that are widely used
and have significantly expanded the amount of data accessible for identifying
potential target pathways. It remains difficult to combine the large number and
variety of data sources and then identify the pertinent patterns using conventional
methods.

Machine learning algorithms can more quickly analyze all the data that is available
and can even be trained to recognize excellent target proteins on their own.

Stage 2: Drug candidates discovering

Finding a substance that can interact with the specified target molecule in the
appropriate manner is the next step. This entails screening a large number of
candidate compounds for their impact on the target (affinity), as well as their off-
target adverse effects, frequently thousands or even millions (toxicity). These
substances might be bioengineered, synthetic, or natural.

But current software is frequently wrong and generates a lot of undesirable

suggestions (false positives), making it exceedingly difficult to quickly identify the
top therapeutic possibilities (known as leads).

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Additionally, machine learning techniques can be useful in this situation since they
can be trained to anticipate a molecule's appropriateness using structural fingerprints
and molecular descriptors. Then scientists quickly sort through millions of possible
molecules to find the best candidates—those with the fewest negative consequences.
In the end, this helps to speed up the drug design process.

Stage 3: Speeding up clinical trials

Finding qualified participants for clinical studies is challenging. If you pick the wrong
candidates, the trial will go on longer and cost more time and money.

By automatically selecting qualified applicants and guaranteeing the proper

distribution for participant groups, machine learning helps hasten the design of
clinical studies. Patterns that distinguish good candidates from bad can be found
using algorithms. Additionally, they can act as an early warning system for a clinical
study that is not yielding solid findings, enabling the researchers to take action sooner
and potentially saving the drug's development.

Stage 4: Biomarkers finding for disease diagnosis

Only until you are certain of your diagnosis may you begin treating individuals for a
disease. Some techniques, like whole genome sequencing, are exceedingly expensive
and need sophisticated lab equipment in addition to specialist knowledge.

Biomarkers are molecules that can definitively determine whether a patient has a
disease by being detectable in bodily fluids (usually human blood). They safeguard
and reduce the cost of disease diagnosis.

They can also be used to track the development of the condition, which helps doctors
decide on the best course of action and keep track of how well the medication is
working.

However, it can be challenging to find the right biomarkers for a certain condition.
Tens of thousands of possible molecular candidates are screened in this costly, time-
consuming process.

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AI can speed up the process by automating a significant amount of the manual effort.
The algorithms divide molecules into excellent and bad candidates, allowing
clinicians to concentrate on examining the most promising candidates.

We can use Biomarkers to identify the following:

 Earlier determination of the disease percentage – diagnostic biomarker
 The risk that some patient developing the disease – risk biomarker
 The expected progress of disease – prognostic biomarker
 The degree of response of a patient to a drug – predictive biomarker

3. Personalize treatment

Varying medications and treatment plans have different effects on certain patients.
Therefore, individualized care has a huge potential to lengthen patients' lives. But it
might be quite challenging to pinpoint the variables that should influence the therapy
decision.

This difficult statistical labor can be automated with the aid of machine learning,
which can also assist in identifying the traits that predict a patient's response to a
certain treatment. As a result, the algorithm can forecast how likely a patient
will respond to a specific medication.

By comparing the treatments and results of similar patients, the system gains this
knowledge. The predicted outcomes make it much simpler for medical professionals
to create the ideal treatment strategy.

4. Improve gene editing

CRISPR, and more specifically the CRISPR-Cas9 system for gene editing, represents a
significant advancement in our ability to accurately and economically modify DNA,
much like a surgeon.

Short guide RNAs (sgRNA) are used in this method to target and edit a particular
region of DNA. However, the guide RNA can fit in various DNA sites, which may have
unforeseen consequences (off-target effects). One of the main obstacles to the

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widespread use of the CRISPR system is the careful selection of guide RNA with the
fewest harmful side effects.

The best predictions for a given sgRNA's level of guide-target interactions and off-
target effects come from machine learning algorithms, it has been demonstrated. This
has the potential to drastically accelerate the production of guide RNA for every
section of human DNA.

Figure 4

Some AI algorithms in medical field

Numerous clinical issues are amenable to AI applications due to improvements in
computer capacity and the vast amounts of data generated by healthcare systems.
Here are two examples of current applications of precise and therapeutically useful
algorithms that can help patients and doctors by simplifying diagnosis.

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1. DLAD (Deep Learning based Automatic Detection)
One of the many examples of an algorithm that performs better than physicians
in image classification tasks is the first of these algorithms. An AI programme
called DLAD (Deep Learning based Automatic Detection) was created by
researchers at Seoul National University Hospital and College of Medicine in the
fall of 2018 to analyse chest radiographs and detect aberrant cell development,
such as possible malignancies (Figure 5). On the same photos, the system
outperformed 17 out of 18 physicians in a comparison of their detecting skills.

Figure 5

Figure 5: The image entered into the algorithm is displayed on the left panel. The
right panel displays a zone of possibly harmful cells that a doctor should carefully
examine, as determined by an algorithm.

2. LYNA (Lymph Node Assistant)

The second of these algorithms was developed by Google AI Healthcare
researchers in the fall of 2018, who developed LYNA (Lymph Node Assistant), a
learning system that examined histology slides stained tissue samples to
recognise metastatic breast cancer tumours from lymph node biopsies. Although
this is not the first application of AI to undertake histological analysis, it is
important to note that this system was able to identify problematic spots in the
provided biopsy samples that were indistinguishable to the human eye. On two
datasets, LYNA was put to the test, and it successfully identified samples as
malignant or noncancerous 99% of the time. Additionally, LYNA cut the customary
slide viewing time in half when used in conjunction with doctors' regular analysis
of stained tissue samples.

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Risk taken in healthcare due to AI
William B. Schwartz predicted that "computing science will certainly have its
greatest influence by supplementing and, in some circumstances, largely
replacing the intellectual tasks of the physician" in an article that was
published more than 50 years ago (Schwartz, 1970). Although there are some
promising healthcare AI technologies, Schwartz's prediction has not yet come
to fruition in full. It is challenging to determine the true impact of AI health
applications' initial outcomes since they are not as reliable as anticipated
(Roski et al., 2019; Fihn et al., 2019).

In this part, we'll go over the primary dangers that the literature has
determined are most likely to result from AI's eventual integration into
healthcare. We will concentrate on two groups of hazards and difficulties:

1. Harming patients due to Artificial intelligence errors

2. Wronge use of Medical Artificial intelligence tools

 Harming patients due to Artificial intelligence errors

There are still at least three significant sources of mistake for AI in clinical
practise, even if AI developers have access to massive datasets of high enough
quality for training their AI technology.

First off, when using an AI tool, noise in the input data can have a major
negative impact on AI predictions. For instance, scanning errors are widespread
with ultrasonic scanning, which is the most used imaging modality in clinical
practise due to its portability and inexpensive cost (Farina et al., 2012). This is
mostly dependent on the operator's background, the patient's participation,
and the clinical setting (such as an emergency ultrasound) (Pinto et al., 2013).
Such errors are anticipated to occur in some scans, even in high-income
countries with high levels of medical training, which would impair subsequent
AI forecasts.

Second, dataset shift, a frequent issue in machine learning that arises when
the statistical distribution of the data used in clinical practise differs, even
marginally, from the distribution of the dataset used to train the AI algorithm,
may result in AI misclassifications (Subbaswamy et al., 2020). This change may
result from variations in the patient populations, hospital acquisition
procedures, or the use of equipment made by various manufacturers. According
to a recent study (Campello et al., 2020), AI models trained on cardiac

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 magnetic resonance image (MRI) scans from two scanners (such as Siemens and
Philips) become less accurate when used with MRI data obtained from various
devices (e.g. General Electric and Canon).

Figure 6

Finally, as AI systems struggle to adjust to sudden changes in the environment and

context in which they are used, predictions may be inaccurate. Harvard Medical
School researchers gave an excellent example in the field of AI for medical
imaging to help illustrate the issue (Yu & Kohane, 2019). They envisioned an
artificial intelligence (AI) system that was trained to recognise dark or dense
areas on chest X-ray pictures that are connected to lesions in serious illnesses like
lung cancer. They then outlined many straightforward instances where the AI
could result in inaccurate predictions, including: the patient wears a wedding ring
and places their hand on their chest during the scan, or if the X-ray technician
forgets to remove the adhesive ECG connectors from the patient's chest. In these
cases, there's a chance that the AI model can mistake these circular artefacts for
one of the recognised chest tumours, leading to a false positive.

 Wronge use of Medical Artificial intelligence tools

Existing medical AI systems are vulnerable to misuse or human mistake due to a
number of variables (Figure 7).
First off, end users and clinical experts have typically had little to no input into
the design and development of these tools. Because of this, the user—whether
a doctor, nurse, data management, or patient—must learn to use and adapt to
the new AI technology, which might result in complex and unnatural
interactions and experiences.

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The clinical user may then have trouble comprehending and using the AI
algorithm in daily practise, which will reduce the appearance of
educated decision-making and raise the likelihood of human error.
The expansion of easily accessible medical AI applications is another factor
contributing to possible medical AI misuse that could bring harm to patients
and citizens. For instance, numerous businesses have created commercial
smartphone apps for skin cancer screening that allow users to take and upload
pictures of their skin through the app, which are then immediately analysed
and evaluated by the app's AI algorithm. These apps include Skinvision, MelApp,
skinScan, and SpotMole, to name a few.
Although the general public has easy access to these tools, there is sometimes
little information available on the development and validation of the relevant
AI algorithms, and their dependability and therapeutic efficacy is not always
shown. For instance, a recent study that examined six mobile apps for the
identification of skin cancer revealed their poor effectiveness and substantial
bias risk (Freeman et al., 2020). "Current algorithm-based smartphone apps
cannot be relied upon to detect all cases of melanoma or other skin
malignancies," the scientists wrote in their conclusion. The public is not
adequately protected by the current regulatory procedure for issuing the CE
marking for algorithm-based apps (Freeman et al., 2020)

Figure 7

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Summary
We are already using AI to develop pharmaceuticals, customise therapies, and even
modify genes more effectively.
But this is only the start. We can utilise AI to assist us identify important patterns that
we can use to make precise, economical decisions in complex analytical procedures
the more we digitise and combine our medical data.

A promising area of research and development is the application of artificial

intelligence in clinical practise, which is developing quickly alongside other cutting-
edge disciplines like precision medicine, genomics, and teleconsultation. Health
policy should now be concentrated on addressing the ethical and financial challenges
related with this pillar of the evolution of medicine, while scientific research should
continue to be rigorous and transparent in creating new solutions to improve
contemporary healthcare.

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