AIMed’s first specialty event – AIMed Cardiology has concluded at Ritz-Carlton, Chicago, Illinois. The one-and-a-half-day event comprised of a series of open seminars, with distinguished guests sharing their insights on various topics concerning the use of artificial intelligence (AI) and related new technologies in the
As much as case studies, research results, and applications were widely shared and discussed among speakers and delegates, both online and off-line audiences were also able to ask questions and expressed their thoughts in the many interactive moments throughout AIMed Cardiology. From AI ethics, democratizatio of data, to the possibility of changing the cardiac disease scoring system, integrating AI into the medical curriculum, and ways to better handle a new generation of tech-savvy patients, we have compiled a list of questions that some of us had raised at the event.
Question: Is there any move in the legal World or the funding World, in making data open-source? Is it possible to give incentives to those who share their data and open up for diverse learning?
Answer from Sara Gerke, Research Fellow, Medicine, AI and Law, The Petrie-Flom Center for Health Law Policy, Biotechnology and Bioethics, Harvard Law School, “I think open-source is a challenging topic when it comes to data privacy. Currently, there is a movement in Europe which encourages the use of synthetic data instead of real data to overcome the challenge. But as what we have seen in oncology, synthetic data can also generate poor results. So, it is challenging to balance when it comes to protecting the individual. Even for de-identified data, there is a chance to re-identify when we have data-triangulation.
Besides, when it comes to the law, there are many data privacy law out there. In the US alone, there are 98 different state laws. Things can get rather complicated at times. Apart from the US compliance, some companies may also have to be aware of the GDPR or General Data Protection Regulation when they venture into Europe. I do hope that the US is moving to a federal law which sits over present state laws and one which mimics GDPR, so that it becomes more harmonized to exchange data Worldwide”.
Question: How do you foresee to include this new generation of tech-savvy patients with ga
Answer: “Indeed, it’s interesting to see some of my younger patients who are coming in to share their insights and what they had found from the internet or via their wearables which capture their performance throughout the day. They are more medically and technologically literate patients who are starting to know and do more than yourself. These patients have an appetite to learn more. So, hospitals need to realize there is a demand, if they are not able to meet these patients’ needs, they will move on elsewhere.
As healthcare professionals, we need to understand that these patients are receiving information and advice out of the doctor’s office and their desire to obtain their own risk score as quickly as possible. We have to adapt and evolve to match their needs and make information accessible, knowledgeable and interpretable and this is when things begin to change. There should no longer be just the hospital visit providing the information, there should also be other avenues”.
Dr. Devyani Chowdhury, Director of Cardiology Care for Children, added, “As a pediatric cardiologist, I will say I have the same experience. I have teenage patients who prefer to have their results being texted to them. So, we cannot deny the change. However, I think the other benefit of technology lies in prevention. I really recommend wearables as patients will come in with a log like step-count and the exercises they have done over the weeks etc. So, I think in prevention, technology is doing well objectively”.
Sara Gerke, Research Fellow, Medicine, AI and Law, The Petrie-Flom Center for Health Law Policy, Biotechnology and Bioethics, Harvard Law School, said, “From a legal perspective, some companies, especially technology tycoons are sitting on some of the data generated by wearables and if they have no intention to share them, silos may be created and these data may not be of any value to move the industry forward. The other problem is, there are at least 100 new applications being introduced every day into the market but the US Food and Drug Administration (FDA) only review about 60 of them every year. So, we miss some transparency here, patients who are using some of these applications may not know how well they work and whether they will be effective on them. I think there is a need for more education”.
John Rumsfeld, Chief Innovation Officer and Professor of Medicine, American College Cardiology & University of Colorado School of Medicine, commented, “I do think the FDA has come a long way, from medical devices to the recent change in leadership and delving into digital health. It’s hard for them to review and curate all the evidence behind digital tools which are growing exponentially, so I feel we should create a kind of community, other organizations could step in and we need to be more forward”.
Question: Looking at how medical fellows are being trained these days and how the industry will progress, should there be an elective in data science in our medical curriculum?
Answer from Dr. Kathy J. Jenkins, Professor of Pediatrics, Senior Associate in Cardiology and Executive Director for the Center for Applied Pediatric Quality Analytics, Boston Children’s Hospital, “We have board exams for individuals to get certify or re-certify. In the realm of pediatric cardiology, there is this enormous document of all the elements that one is supposed to know, in order to pass the board exam and it can be rather demanding. That’s why I called it the traditional study design and biostatistics. It is pretty overwhelming and hard to teach.
So, if we can have some of the AI or machine learning content to be introduced into these board review courses, perhaps we can make these new technologies more mainstream. Once it has been formally brought into the process, it will be a little easier for fellows to embrace it.”
Question: In view of the technological boom and exponential growth of data, do you think our existing scoring system for heart disease needs to be reviewed?
Answer from Dr. Rob Brisk, Department of Cardiology, Craigavon Hospital & School of Computer Science, Ulster University, “I think it goes beyond heart disease. Some of these latest wearables are used by a Worldwide population who can have their electrocardiogram (ECG) being taken once every few minutes. However, some of these deep learning algorithms are not designed and validated with such a wide diversity of patient populations, so there may be biases. I think we should re-visit some of these data and tools at a population level”.
Dr. Rajesh Dash, Assistant Professor of Cardiovascular Medicine & Preventive Cardiology, Stanford University added, “I think it is a combination of approaches because with the wearable device market, putting data stream in the hands of the patients, there is a need to connect with the care team at least for decision making. I am not sure how to regulate that but in my own clinic, which is a prevention clinic, we combined telemedicine and connected devices in patients’ homes to measure their weight, body fat, heart rate and what is happening objectively about them.
We have the information on the Cloud so that we can have the access and patients can ask us questions without having to drive into the clinic. I believe such inclusion of device space in remote monitoring, is clinically actionable because we are not isolating any form of information and we are able to see patients in their daily context, I think there is a better space”.
AIMed Radiology, the second AIMed specialty event will embark tomorrow (19 June) at the same venue: Ritz-Carlton, Chicago, Illinois. Once again, the open seminars will be live-streamed for the audience around the World. You may wish to register your interest here. Do follow us on Twitter, Instagram, Facebook and Youtube for more event updates.
A science writer with data background and an interest in the current affair, culture,