Calling Dr Watson To Radiology - RSNA Presentation
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Transcript of Calling Dr Watson To Radiology - RSNA Presentation
Calling Dr Watson to RadiologyWatson in Healthcare from NuanceNick van Terheyden, M.D.Chief Medical Information Officer – Clinical Language UnderstandingNuance
Medicine used to be simple, ineffective and relatively safe.
Now it is complex, effective and potentially dangerous
Sir Cyril Chantler, Kings Fund Chantler C. The role and education of doctors in the delivery of health care.
Lancet 1999;353:1178-81u
Information Overload – Big Data
Medical information is doubling approximately every 5 years
- Brent James, MD, MStat, Chief Quality Officer, Intermountain Health Care
1.8 zetabytes of information created this year – majority of it unstructured – 57 Billion 32Gb iPods (Source: IDC)- That’s enough information to fill 57 billion 32GB Apple iPads
(which could build a mountain of iPads 25 times higher than Mt Fuji
Watson can sift through 200 million pages in 3 secs
Watson DeepQAHOW DOES IT WORK
. . .
Answer Scoring
Models
Answer & Confidence
Question
Evidence Sources
Models
Models
Models
Models
ModelsPrimarySearch
CandidateAnswer
Generation
Hypothesis
Generation
Hypothesis and Evidence Scoring
Final Confidence Merging & Ranking
Synthesis
Answer Sources
Question & Topic Analysis
EvidenceRetrieval
Deep Evidence Scoring
Learned Modelshelp combine and
weigh the Evidence
HypothesisGeneration
Hypothesis and Evidence Scoring
QuestionDecompositio
n
1000’s of Pieces of Evidence
Multiple Interpretations
100,000’s Scores from many Deep Analysis
Algorithms
100’s sources
100’s Possible Answers
Balance& Combine
DeepQA: The Technology Behind Watson
Architecture
Cloud to Cloud
…..community of CASE Content Partners
…..community of consumers – large and small
CLU……
User ExperienceBy Nuance and Partners…..
….community ofContent Publishers
DeepQA Solutions
for Healthcare
Large Institutio
nal Providers
EMRs
How Does Watson Perform in Healthcare
Question and Answer SetsSuccess
Question: This hormone deficiency is associated with Kallmann's syndrome.- Passage: Isolated deficiency of GnRH or its receptor causes
failure of normal pubertal development and amenorrhea in women. This disorder is termed Kallmann syndrome when it is accompanied by anosmia and has also been termed idiopathic hypogonadotropic hypogonadism (IHH).”
Answer: GnRH
Notes: We know that “GnRH” is a hormone (from the ontology) so that lets us choose it as the most likely answer.
Question and Answer SetsMiss
Question: Eponym from Victorian literature for obesity hypoventilation syndrome.- Correct passage: Obesity-hypoventilation syndrome is
also known as pickwickian syndrome, in reference to Charles Dickens’…
- Correct answer: Pickiwickian Syndrome- Wrong passage: Other clinical features associated with
obesity-hypoventilation syndrome are daytime hypersomnolence and cor pulmonale.
- Wrong answer: cor pulmonale
Radiology Use Case
Radiologists identifies radiological findings in a report- Hepatic Lesion in Woman with History of Breast CA- Too Small to Classify (TSTC)- Offer follow up and alternative assessment criteria helping classify
more accurately for interval follow up or imaging work up
Ask Watson- discrimination points, appropriate follow up, critical results etc
Watson Consumes the report and patient context information- Offers next steps, differential list, new/recent information & links
What possible next steps/studies would be appropriate to rule in/out diagnosis and/or determine best course of treatment
Generic Use Cases
Medical Diagnosis- Consumption of medical records, results etc offering
differential diagnosis and probability analysis with links to underlying literature sources
- True personalization of medicine based on large cohort historical data analysis
Interactive Model- Requires real time access to patient data from multiple
sources including provider/patient interaction- Ongoing refinement based on dynamic interaction and
learning
Challenges
Ambiguous human language
Integration with existing systems – extract of complete data set for history, results etc- Often in disparate systems- Non standard interfaces- Non standard format- Unstructured narrative
Medical Data Sources and Ongoing Access and Updating
Patient interaction with technology vs humans- Telemedicine and consumer trend towards home based care
Replacing the Doctor?
Study done by the Mayo Clinic in 2006 identified the most important characteristics patients feel a good doctor must possess
The Ideal clinician is- confident,- empathetic,- humane,- personal,- forthright,- respectful, and- thorough
These facets are entirely human and will be hard for technology to replace
Mayo Clin Proc. 2006;81(3):338-344
Calling Dr Watson to RadiologyWatson in Healthcare from NuanceNick van Terheyden, M.D.Chief Medical Information Officer – Clinical Language UnderstandingNuance