Take Two Aspirin

Abstract

IBM’s Watson got an avalanche of publicity when it won Jeopardy, but Watson is potentially far more valuable as a massive digital database for doctors, lawyers, and other professionals who can benefit from fast, accurate access to information. A doctor who suspects that a patient may have a certain disease can ask Watson to list the recognized symptoms. A doctor who notices several abnormalities in a patient, but isn’t confident about which diseases are associated with these symptoms, can ask Watson to list the possible diseases. A doctor who is convinced that a patient has a certain illness can ask Watson to list the recommended treatments. In each case, Watson can make multiple suggestions, with associated probabilities and hyperlinks to the medical records and journal articles that it relied on for its recommendations. Watson and other computerized medical data bases are valuable resources that take advantage of the power of computers to acquire, store, and retrieve information. There are caveats though. One is simply that a medical data base is not nearly as reliable as a Jeopardy data base. Artificial intelligence algorithms are very good at finding patterns in data, but they are very bad at assessing the reliability of the data and the plausibility of a statistical analysis. It could end tragically if a doctor entered a patient’s symptoms into a black-box data-mining program and was told what treatments to use, without any explanation for the diagnosis or prescription. Think for a moment about your reaction if your doctor said, I don’t know why you are ill, but my computer says, “Take these pills.” I don’t know why you are ill, but my computer recommends surgery. Any medical software that uses neural networks or data reduction programs, such as principal components and factor analysis, will be hard-pressed to provide an explanation for the diagnosis and prescribed treatment. Patients won’t know. Doctors won’t know. Even the software engineers who created the black-box system won’t know. Nobody knows. Watson and similar programs are great as a reference tool, but they are not a substitute for doctors because: (a) the medical literature is often wrong; and (b) these errors are compounded by the use of data-mining software.