Watson, Go Away! I Don't Need You!

Eliot Siegel, M.D., schooling IBM's Watson at the University of Maryland; Image courtesy RSNA.org

Surely you've heard by now of Watson, the IBM conglomeration of 90 servers and 360 microprocessor chips that whupped the pants off the former Jeopardy champion. Watch out, boys and girls, Watson is headed to a hospital near you, and he (it?) may challenge you as much as he did Ken Jennings.

Eliot Siegel, M.D., professor of Diagnostic Radiology and Nuclear Medicine at the University of Maryland is taking the lead in teaching Watson about Medicine. 

From the RSNA News:

Well before Watson's gameshow victory, experts at the University of Maryland (UM) School of Medicine in Baltimore and Columbia University Medical Center began working with IBM to apply Watson's analytics capabilities to healthcare. Specifically, Watson is being developed as an assistant capable of reading electronic health records (EHR) and providing instant feedback to physicians in ways not always available from doctors and nurses.

"This breakthrough in computer science will allow us to explore this technique for medical diagnosis,"

It seems we have achieved a computer that learns heuristically, although 10 years later than Arthur C. Clarke predicted in "2001:  A Space Odyssey."

Earlier attempts at artificial intelligence required every possible question and answer to be hard-coded into the system, a time-consuming process with little value in healthcare, said Martin Kohn, M.D., Chief Medical Scientist, Care Delivery Systems, IBM Research.

"Watson uses a probabilistic, evidence-based approach," Dr. Kohn said. "It generates and scores many hypotheses using an extensible collection of natural language processing, machine learning and reasoning algorithms. Many previous such efforts relied on programmed decision rules. Watson is a self-learning system that does not rely on such rules. It gathers and weighs evidence to refine its hypotheses."

Watch this clip (sorry, I couldn't embed it) of an interview with Dr.Siegel, and you'll get a taste of the future, and perhaps a bit of a chill up your spine as well. Early on in the interview, Dr. Siegel quite matter-of-factly describes how the U of M team will guide Watson through medical school, then internship, and then residency. Say what?

Watson is currently in the testing phase in that learning process, said Dr. Siegel, who pointed out the similarity to real-life students progressing from medical school to residencies.

The first step—acquiring book knowledge—is already under way. Watson's database already includes information from medical journals and textbooks such as the Merck Manual of Diagnosis and Therapy, Harrison's Principles of Internal Medicine, the American College of Physicians Medicine and Stein's Internal Medicine.

Next, experts will work to develop Watson's understanding of the physiology of the human body, followed by the third step: gathering experience.

"Watson not only needs the general knowledge that made him so successful on 'Jeopardy,' but also information from the databases specific to medicine," Dr. Siegel said.

This isn't fair!  If I could just take a text book, stick it up my, ummmm, brain, and have it instantly memorized, I would be whiz, too!

The ultimate goal is for Watson to be a helper to physicians and to serve man:

Radiology stands to benefit tremendously from Watson's capabilities, experts say.
"The technology has the potential to provide decision support on a scale not dreamt of prior to this," said Nancy Knight, Ph.D., the director of Academic and Research Development and a founder of the Maryland Imaging Research Technologies Laboratory at UM.

"Watson can supply the radiologist at the point of care with complete patient information from the electronic health record, including imaging history, allowing the radiologist to mine an often exhaustive number of records to identify the most important points," Dr. Knight said. "It also provides the latest and most extensive scientific knowledge and clinical experience that can be used to inform decisions about diagnosis, additional tests, management and likely prognoses."

Phew.  The damn thing isn't going to read scans.  Yet.

My congratulations to IBM and Dr. Siegel on a huge step into the future.  But I am very, very worried about one facet of this program:

IBM is also working with speech-recognition software developer Nuance Communications to give Watson the analytics capabilities necessary for physician-patient consultations.

I think we humans just got a break.