Artificial Intelligence - INFORMS

Artificial Intelligence: The New Hype in
Healthcare
by Jingmei Yang
SECOND PRIZE in OR/MS Tomorrow Student Writing Competition 2019
Jingmei Yang is a Ph.D. student in Industrial Engineering at the University of Texas at
Arlington.
The future of the healthcare industry has never been as bright as today. The application of
Artificial Intelligence (AI) has made remarkable progress in its impact across a range of
medical applications including drug discovery, remote patient monitoring, medical
diagnostics, risk management, virtual assistants and hospital management. Improvements in
accuracy and efficiency are made possible by innovations in deep neural networks and
high-end computational resources in combination with increasing availability of medical
data. In this report, we summarize some significant AI innovations in healthcare followed
by a discussion on future challenges and opportunities.
AI is achieving the expert-level disease diagnostics. AI is achieving expert-level

prediction and diagnosing of diseases based on image recognition using deep neural
networks. AI can help dermatologists diagnose skin cancer. Roughly 5.4 million incidences
of skin cancer are reported annually in the United States. Early detection of skin cancer
allows medical practitioners and patients to take proactive action in treatment (Rogers et
al., 2012). In 2017, a deep convolution network was built for automated dermatology by
Esteva et al. (2017) at Stanford. Trained on 129,450 images comprised of 2,032 diseases,
the system achieved accuracy levels on par with dermatologists. Powered with this
framework, one possible application is to mobile devices which can potentially extend the
reach of specialists, widening the scope of primary care practice and offering a low-cost
approach to diagnostic care.
Convolution network for skin diseases detection, Source: Esteva et al. (2017), picture
courtesy of the authors.
AI supports the diagnosis of cardiovascular diseases. Cardiovascular risk can be revealed

through analysis of retinal fundus images, a non-invasive way to visualize blood vessels.
Companies such as Google have dedicated resources to developing models which can
extract and quantify risk markers in retinal images. Risk factors such as age, gender,
smoking status, and systolic blood pressure have been used in well established
cardiovascular risk calculators such as SCORE (Framingham and Systemic Coronary Risk
Evaluation), however, were previously not extracted from retinal images. In the Nature
paper by Poplin et al. (2018), they demonstrated how to identify the presence of these risk
factors in the retina. This neural network model is capable of predicting cardiovascular risk
directly through retinal images and quantifies the risk factors to a degree of precision not
achieved before Poplin et al. (2018). With the aid from such an AI system, cardiovascular
risk can be obtained immediately from non-invasive retinal images.
AI can be used for retinal disease diagnosis. A research team in DeepMind developed an
innovative framework that investigates eye scans from routine clinical practice. In a paper
published in Nature, De Fauw et al. (2018) demonstrated that an AI system is capable of
automatically identify- ing retinal diseases in only a minute. Additionally, the system can
classify patients based on their severity and redistribute medical resource to the patients
most in need of urgent care. This prioritization attempts to reduce the long delays between
scan and treatment resulting from the complexity of interpreting the Optical Coherence
Tomography images and the reducing numbers of qualified interpreters. This framework
can make referral recommendations for over 50 sight-threatening retinal diseases at a level
comparable to clinical experts and has great potential for preventing patients with diabetic
retinal disease from sight loss.
Retinal disease diagnosis and referral suggestions framework. Source: De Fauw et al.
(2018), picture courtesy of the authors.
AI can support speech synthesis. Edward Chang, a neurosurgeon, collaborated with a

research team at the University of California - San Francisco successfully map brain signals
into auditable expression using AI (Anumanchipalli et al., 2018). Recurrent neural
networks were trained on brain signals collected from five epilepsy subjects to predict
articulatory movements in the tongue, lips, jaw, and larynx. Next, the networks mapped the
estimated movements onto synthesized phonic speech. This pioneering technology has a
direct application in speech-decoding devices for people with speech impairments resulting
from stroke, traumatic brain injury, or neurological diseases like multiple sclerosis and
Parkinson’s disease.
The neural decoding process with AI, picture taken from Anumanchipalli et al., (2019).
AI in Radiology. Recently there has been a massive amount of publications using deep
learning to process medical imaging such as image denoising, segmentation, and super-
resolution. Of particular interest is a research team from the University of Texas at
Southwestern Medical Center (UTSW) lead by Dr. Steve Jiang. Due to increasing treatment
modalities in radiation therapy, treatment planning is complicated and time-consuming for
dosimetrists. With an effort to cut down on the planning time while maintaining quality, the
team from UTSW built a convolutional neural network to predict the radiation therapy dose
for prostate cancer patients (Nguyen et al., 2019). By mapping the patient’s contours into
local and global features, the model is empowered to predict a dose distribution with
impressive accuracy. If equipped with this dose prediction model in clinical practice,
physicians can use the prediction as a preliminary plan and cooperate with dosimetrists for
further tailoring, making the planning workflow smooth and efficient.
U-net architecture with additional CNN layers used for dose prediction. Source: Nguyen et
al. (2019), picture courtesy of the authors.
Future challenges. Despite the promising applications, it is acknowledged that AI has

unique limitations when applied to healthcare such as clinical interpretability, data
heterogeneity, and patient privacy.
Deep learning is often treated as a black box; its features and parameters are challenging to
understand and interpret in a healthcare setting. Not being able to explain the internal
mechanics of a model is a barrier for the broad adoption of AI since clinical practitioners
place trust heavily on interpretability. As such, researchers have worked on developing
interpretable AI systems. Hopefully, this work will make AI systems easier to understand
and adopt in practice. Data heterogeneity is another challenge. As shown in the study led by
Zech et al. (2018), image data from different hospitals, vendors of imaging modalities and
scanners or reconstruction conditions has significant influence on the model performance.
Acquiring a training dataset from diverse settings, nonidentical populations, or multiple
institutions is beneficial to overcome this problem. Patients’ privacy is also a concern.
Unlike other domains, the healthcare industry handles a lot of sensitive patients’
information. How to balance the usage of all the data and control the infringement of
privacy of patients requires care and effort when developing models.
External validation is necessary for AI to prove its promise. All AI-based models need to be
validated with clinical trials to test its practical value and performance in a real-world
setting. If clinical performance is validated and interpretability of the models are enhanced,
AI has the potential to positively impact clinical practice with better performance and
increased efficiency.
1. Anumanchipalli, G.K., Chartier, J., and E.F. Chang (2018). Speech synthesis from
neural decoding of spoken sentences. Nature, 568(7753):493-498.
2. De Fauw, J., Ledsam, J.R., Romera-Paredes, B., Nikolov, S., Tomasev, N., Blackwell,
S., Askham, H., Glorot, X., O’Donoghue, B., Visentin, D., et al. (2018). Clinically
applicable deep learning for diagnosis and referral in retinal disease. Nature Medicine,
24(9):1342- 1350.
3. Esteva, A., Kuprel, B., Novoa, R.A., Ko, J., Swetter, S.M., Blau, H.M., and S. Thrun
(2017). Dermatologist- level classification of skin cancer with deep neural networks.
Nature, 542(7639):115-118
4. Nguyen, D., Long, T., Jia, X. Lu, W., Gu, W., Iqbal, Z., and Steve Jiang (2019). A
feasibility study for predicting optimal radiation therapy dose distributions of prostate
cancer patients from patient anatomy using deep learning. Scientific reports, 9(1):1076.
5. Poplin, R., Varadarajan, A.V., Blumer, K., Liu, Y., McConnell, M.V., Corrado, G.S.,
Peng, L., and D.R. Webster (2018). Prediction of cardiovascular risk factors from retinal
fundus photographs via deep learning. Nature Biomedical Engineering, 2(3):158-164.
6. Rogers, H.W., Weinstock, M.A., Feldman, S.R., and B.M. Coldiron (2015). Incidence
estimate of non- melanoma skin cancer (keratinocyte carcinomas) in the U.S. population,
2012. Jama Dermatology, 151(10):1081-1086.

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Artificial Intelligence: The New Hype in

AI is achieving the expert-level disease diagnostics. AI is achieving expert-level

AI supports the diagnosis of cardiovascular diseases. Cardiovascular risk can be revealed

AI can support speech synthesis. Edward Chang, a neurosurgeon, collaborated with a

Future challenges. Despite the promising applications, it is acknowledged that AI has

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