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蔡江南:人工智能某些方面已达中级医生水平!

2017-05-08 蔡江南 “江南微微语”微信号

最近一段时间,医疗大数据和人工智能成为非常热门的话题和领域。人类基因组、微生物组、互联网、物联网、IBM的人工智能等新的科技进展,都推动了医疗领域围绕信息化的技术创新热潮。

医疗数据推动医学进步

最近一段时间,医疗大数据和人工智能成为非常热门的话题和领域。人类基因组、微生物组、互联网、物联网、IBM的人工智能等新的科技进展,都推动了医疗领域围绕信息化的技术创新热潮。

信息数据一直是医疗领域的最重要的短板和核心。信息难以获得、信息不确定、信息不对称,都给医疗领域带来了很大的影响。医学从一个主要依靠直觉、经验、症状来治疗的领域,随着数据的积累、扩大,慢慢发现了一些模式,从直觉医学转化为实证医学。当大数据开始出现后,当我们可以精确诊断疾病的原因,从而真正做到对症下药后,我们便达到了精准医学的阶段。因此,信息化和数据的规模和质量,是推动医学进步的重要力量。

大数据首先是指数据的数量巨大,而且甚至是研究某个问题所涉及到的整个数据集群,而不只是其中的一个样本。我们知道,当数据样本足够大时,数据本身的一些误差变得不那么重要。当然,这并不意味着数据本身的质量不再重要。如果数据本身的质量很差,大数据同样无法让我们接近事实的真相。

医疗信息的电子化有助于将不规范、非结构化的数据,转为规范和结构化的数据,从而提高医疗数据的质量。由于医生工作繁忙,医疗数据编码应用的不普及,缺乏医疗数据统一的标准和规范,这些问题对于提高我国医疗数据的质量都是很大的挑战。

推动我国医疗数据在各个部门和机构之间的连通,是提高医疗数据质量的突破点。连通需要数据标准的统一、数据的公开、以及保证数据的安全,这些都需要政府、行业协会、社会第三方机构的参与。

人工智能在辅助诊断上大有用武之地

诊断和治疗是医学的两个重要环节,而诊断又是治疗的基础和前提。诊断的本质就是区分,区别不同的疾病是认识疾病原因的基础。当我们拥有足够有质量的医疗数据后,就具备了做出正确诊断的条件,而人工智能的深度学习就可以发挥作用。所谓深度学习就是从大数据中发现规律,归纳总结出带有规律性的差异,从而进行诊断。

人工智能与人脑相比的优越性在于,可以更高效地处理海量数据,迅速找到一些特征和规律。在图像识别上,人工智能的优越性表现的特别突出。

最典型的例子是,美国斯坦福兼职教授Thrun 从皮肤癌入手,用一个庞大的图像库来训练机器识别恶性肿瘤。2015 年 6 月开始测试这个深度学习系统。使用经皮肤病专家诊断的 14000 张图像,来看这个深度学习系统是否能够准确地将图像分为 3 个诊断类别:良性病变、恶性病变和非癌生长。结果这个系统的正确率为 70%,而两位皮肤病学家的正确率为 66%。人工智能在影像、病理的诊断上将有很大的用武之地。

人工智能还可以利用庞大的医学知识库和数据库,建立医生的临床辅助决策系统,帮助医生进行诊断。

例如,广州市妇女儿童医疗中心,自主开发了一款儿科发热相关的疾病智能诊疗助手。利用大量高质量病历数据的优势,以真实的海量临床电子病历大数据为基础,融合临床指南、专家共识和医学文献,结合分析和深度学习技术建立多维度诊疗模型,对病历进行大量标注工作,通过人工智能提供初步的诊断提示,提高患者和医生的寻医问诊效率。项目自去年8月份上线以来,随着逐渐融入医生的工作流程,其准确率也在逐渐提高。对200份病历的数据分析显示,这个系统目前大约可以达到中级医生的水平。

分级诊疗是一种“搅局式创新”

哈佛商学院著名的创新理论教授克里斯坦,建立了一套医疗创新的理论,我们通常将Disruptive Innovation翻译成“颠覆式创新”。但是这与作者的原意不尽相同,在中文里“颠覆”有两层含义,一是“取代”和“推翻”的意思,二是“突破性”或“天翻地覆”的变化。

其实,英文中的Disruptive并没有这两层含义。不是推翻或取代,而是一种“并存”和“共生”,只是用一种更加“简单”和“便宜”的创新,与原来复杂和昂贵的技术或商业模式来较量。这种创新不一定是一种突破性的改变,只要更简单更便宜即可。这种创新是用简易的技术和商业模式,来挑战原来高大上的技术和商业模式。因此,我觉得使用“搅局”这个词更接近英文的意思。对于原来持有高大上的那一方来说,不那么高大上的创新就是一种搅局。

大家会顾虑“搅局”这个词的贬义。与英文相比,中文的用词往往有褒义和贬义的区分,英文用词比较中性。但是,一个词的意义也会随着时代和环境发生变化,一些原来贬义的词可以变得褒义。例如,“颠覆”这个词在政治语境里往往是贬义的,用于敌对势力的活动。“革命”这个词,也曾经有杀头、推翻政权的贬义。这两个词都变成了褒义用词。所以,搅局这个词,如果我们在一定场合下使用,只要定义清楚,也可以避免误解。

分级诊断就是将大量常见病、多发病、慢性病的病人,从三级医疗机构中、从专家手中,转移到基层医疗机构的全科医生手中。相对于大医院和专家来说,基层全科医疗就是一种更为简单和便宜的“搅局式创新”,分级诊疗就是鼓励搅局式创新。

而大数据和人工智能的推广和普及,本身就是一种搅局式创新,这些技术创新将有助于推动原来需要专家才能做到的诊断,让基层医生借助于智能辅助系统,就能进行初步的诊断工作。因此,大数据和人工智能将会推动分级诊疗的进行。

分级诊断的推进主要还需要依靠基层医生水平的提高,以及医生收入、就业制度的改革。但是,新的医疗技术创新可以在一定程度上促进分级诊疗的进行。因此,在我国医改深化的过程中,创新和政策的变化可以互相促进。

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    2023-09-15 JSDoc 来自浙江省

    人工智能的未来

    0

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    2017-05-12 医鸣惊人

    学习了

    0

  3. 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08:10:12 CST 2017, time=2017-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=196009, encodeId=77a7196009ec, content=希望将来能更好!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200816/e4675a86ea694f12b82202b320dc2654/12f6b900498349e994ce8f516a584d6a.jpg, createdBy=09431951290, createdName=大爰, createdTime=Wed May 10 06:18:21 CST 2017, time=2017-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=195846, encodeId=ef36195846ea, content=想想法虽很好,真实最重要,医生要学习,主观能思辨,诊断准确高,主观不努力,庸医要当道,, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=89da2058068, createdName=1531ed40cbm, createdTime=Tue May 09 13:50:22 CST 2017, 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    2017-05-10 大爰

    希望将来能更好!!

    0

  4. 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time=2017-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=195845, encodeId=f5521958458a, content=做不成高级医师就去做科研吧,至少以后还可以指导下机器人, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib260FNcic8ThYZTmbW36JHpvHcnIog7VbWIQjibo1kwuH9obXRJJtqHn1hYHHLG0DpIMIBVFPhBBpQOJWDk1rbib2Y/0, createdBy=d27274268, createdName=sillywu, createdTime=Tue May 09 13:49:21 CST 2017, time=2017-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=195777, encodeId=e174195e7766, content=抵触科技的想法,终将面临科技的冲击, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/04/24/1c2dbd6706e64df33befd6663f1d6b37.jpg, 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    2017-05-09 1531ed40cbm

    想想法虽很好,真实最重要,医生要学习,主观能思辨,诊断准确高,主观不努力,庸医要当道,

    0

  5. 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    2017-05-09 sillywu

    做不成高级医师就去做科研吧,至少以后还可以指导下机器人

    0

  6. 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createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Tue May 09 08:23:40 CST 2017, time=2017-05-09, status=1, ipAttribution=)]
    2017-05-09 lyh994

    抵触科技的想法,终将面临科技的冲击

    0

  7. 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    2017-05-09 1e1b8538m79(暂无匿称)

    在人工智能方面,误诊率能避免多少

    0

  8. 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    2017-05-09 139****5926

    好文章,学习了,

    0

  9. 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createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Tue May 09 08:23:40 CST 2017, time=2017-05-09, status=1, ipAttribution=)]
    2017-05-09 王国安

    希望能全方位普及。

    0

  10. 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08:10:12 CST 2017, time=2017-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=196009, encodeId=77a7196009ec, content=希望将来能更好!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200816/e4675a86ea694f12b82202b320dc2654/12f6b900498349e994ce8f516a584d6a.jpg, createdBy=09431951290, createdName=大爰, createdTime=Wed May 10 06:18:21 CST 2017, time=2017-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=195846, encodeId=ef36195846ea, content=想想法虽很好,真实最重要,医生要学习,主观能思辨,诊断准确高,主观不努力,庸医要当道,, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=89da2058068, createdName=1531ed40cbm, createdTime=Tue May 09 13:50:22 CST 2017, time=2017-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=195845, encodeId=f5521958458a, content=做不成高级医师就去做科研吧,至少以后还可以指导下机器人, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib260FNcic8ThYZTmbW36JHpvHcnIog7VbWIQjibo1kwuH9obXRJJtqHn1hYHHLG0DpIMIBVFPhBBpQOJWDk1rbib2Y/0, createdBy=d27274268, createdName=sillywu, createdTime=Tue May 09 13:49:21 CST 2017, time=2017-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=195777, encodeId=e174195e7766, content=抵触科技的想法,终将面临科技的冲击, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/04/24/1c2dbd6706e64df33befd6663f1d6b37.jpg, 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createdBy=6ff82057534, createdName=139****5926, createdTime=Tue May 09 08:38:40 CST 2017, time=2017-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=195755, encodeId=31b1195e5590, content=希望能全方位普及。, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/04/27/136abcae2f8e58d33f28258f76f49b4f.jpg, createdBy=7e701980206, createdName=王国安, createdTime=Tue May 09 08:25:01 CST 2017, time=2017-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=195749, encodeId=4d7a195e4966, content=谢谢分享,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, 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    2017-05-09 明月清辉

    谢谢分享,学习了

    0

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