Listen and read 15 Iscanning - Thấm Tâm Vy

Thẩm Tâm Vy, Dec 31, 2019 LISTEN AND READ 15

LISTEN AND READ 15

Medical diagnosis

ISCANNING A system based on ai will search the

retina for early signs of disease THE DIFFERENT parts of a health-care system have different focuses. A hospital’s dementia unit keeps records of patients’ mental abilities. The stroke unit monitors blood flow in the brain. The cardiac unit is interested in that same flow, but through and from the heart. Each agglomeration of equipment and data is effective in its own domain, but for the most part has little relevance to other bits of the body and the conditions that plague them. Thus, like the proverbial blind men feeling an elephant, modern health care offers many fragmented pictures of a patient, but rarely a useful cohesive one. On top of all this, the instruments that doctors use to monitor health are often expensive, as is the training required to wield them. That combined cost is too high for the medical system to scan regularly, for early signs of illness, all patients at risk of dementia, heart disease or a stroke. Rather, doctors work to manage symptoms after a disease has obviously taken hold. An unusual research project called AlzEye, run from Moorfields Eye Hospital in London, in collaboration with University College, London (UCL), may change this. It is attempting to use the eye as a window through which to detect signals about the health of other organs. The doctors in charge of it, Siegfried Wagner and Pearse Keane, are linking Moorfields’ database of eye scans, which offer a detailed picture of the health of the retina, with information about other aspects of its patients’ health garnered from other hospitals around England. This will allow them to look for telltales of disease in the eye scans. The data set includes, whether they know it or not, every one of the 300,000 patients who visited Moorfields between 2008 and 2018 and was over the age of 40—though names and other easily identifiable information are not preserved. The idea is to examine changes to people’s eyes within that ten-year period, and correlate these with, say, the emergence of Alzheimer’s disease in the same patient. Building such a data set while respecting privacy and confidentiality has been a challenge. It took the doctors two and a half years to go through a series of ethics-committee approvals at Moorfields, UCL and NHS Digital, the body which handles agglomerated data from English hospitals. In order to create the database without the consent of the patients involved they invoked a special legal provision known as Section 251 assent, which comes with its own review process and, in essence, empowers senior government health officials to give consent on behalf of patients from whom it would be impractical or impossible to acquire such individually. The data sets were linked together on November 1st [2019], and the process of correlation is now under way.

The Moorfields data set has a lot of linked cases to work with—far more than any similar project. For instance, the UK Biobank, one of the world’s leading collections of medical data about individual people, contains 631 cases of a “major cardiac adverse event”. The Moorfields data contain about 12,000 such. The Biobank has data on about 1,500 stroke patients. Moorfields has 11,900. For the disease on which the Moorfields project will focus to start with, dementia, the data set holds 15,100 cases. The only comparable study had 86. Drs Wagner and Keane are searching for patterns in the eye that betray the emergence of disease elsewhere in the body, and are focusing first, as the name AlzEye suggests, on Alzheimer’s disease. They will seek such patterns with the help of machine-learning algorithms that can crunch through imagery far faster than any human being, and which can spot far tinier variations. (The team has collaborated with DeepMind, a British artificial- intelligence firm co-founded by Mustafa Suleyman, who sits on The Economist’s board.) They …