AI加持，精准医疗触手可及

对人工智能而言，医疗领域是一个很有应用前景的领域。人工智能在医疗健康领域中的应用主要包括医学影像、虚拟护士助理、健康管理、医疗风险分析、药物挖掘、辅助诊断、医学研究和营养学等。

AI加持，精准医疗触手可及

译者：何翔宇

校对：刘 璠

策划：刘 璠

From A&E to AI

让医疗智能起来

本文选自 The Economist | 取经号原创翻译

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Artificial intelligence will improve the speed and precision of medical treatments

人工智能可以提升医疗服务的速度和准确性

FOUR years ago a woman in her early 30s was hit by a car in London. She needed emergency surgery to reduce the pressure on her brain. Her surgeon, Chris Mansi, remembers the operation going well. But she died, and Mr Mansi wanted to know why. He discovered that the problem had been a four-hour delay in getting her from the accident and emergency unit of the hospital where she was first brought, to the operating theatre in his own hospital. That, in turn, was the result of a delay in identifying, from medical scans of her head, that she had a large blood clot in her brain and was in need of immediate treatment.

四年前，一个三十多岁的妇女在伦敦遭遇了车祸，她需要立即手术来缓解颅内压力。她的主治医生克里斯·曼西（Chris Mansi）记得手术进行得很顺利，可伤者还是离开了人世。这其中的原因困扰着曼西。曼西发现，问题出在伤者手术前被耽搁的四小时时间里。在这段时间中，伤者从事发地点首先被送至了另一家医院，然后才转移到了曼西所在的医院，时间耽误在了确认伤者病情上。头部扫描结果显示伤者脑部有一个大血块，需要立即医治。

It is to try to avoid repetitions of this sort of delay that Mr Mansi has helped set up a firm called Viz.ai. The firm’s purpose is to use machine learning, a form of artificial intelligence (AI), to tell those patients who need urgent attention from those who may safely wait, by analysing scans of their brains made on admission.

为了避免这种情况再次发生，曼西创建了Viz.ai公司，目的是通过机器学习（一种人工智能形式）来分析病人入院时的脑部扫描结果，从而辨别出那些需要紧急处理的病人。

That idea is one amongmyriadprojects now under way with the aim of using machine learning to transform how doctors deal with patients. Though diverse in detail, these projects have a common aim. This is to get the right patient to the right doctor at the right time.

当前，有很多项目致力于研究如何利用机器学习来改变医生诊治病人的方式，Viz.ai是其中之一。尽管这些项目的内部差异较大，但他们具有目标上的一致性，就是让病人能够得到医生及时准确的救治。

myriad/'mɪrɪəd/ adj. a large indefinite number 无数的；种种的

In Viz.ai’s case that is now happening. In February the firm received approval from regulators in the United States to sell its software for the detection, from brain scans, of strokes caused by ablockagein a large blood vessel. The technology is being introduced into hospitals in America’s “stroke belt”—the south-eastern part, in which strokes are unusually common. Erlanger Health System, in Tennessee, will turn on its Viz.ai system next week.

Viz.ai公司的成果正影响着医疗领域。二月份，美国监管部门批准Viz.ai公司出售其软件。该软件可以通过脑部扫描探测由大血管堵塞引起的中风。这项科技成果被美国东南部的医院引入。该地区被称作“中风地带”，中风发生率极高。田纳西的厄兰格健康系统下周会启用Viz.ai系统。

The potential benefits are great. As Tom Devlin, a stroke neurologist at Erlanger, observes, “We know we lose 2m brain cells every minute the clot is there.” Yet the two therapies that can transform outcomes—clot-busting drugs and an operation called a thrombectomy—are rarely used because, by the time a stroke is diagnosed and a surgical team assembled, too much of a patient’s brain has died. Viz.ai’s technology should improve outcomes by identifying urgent cases, alerting on-call specialists and sending them the scans directly.

该软件的潜在优势是巨大的。Tom Devlin是厄兰格的一名中风神经科医生。他谈到:“脑部血块会导致每分钟有两百万个脑细胞死亡。”尽管溶栓药物和血栓切除术可以有效治疗这一病情，但现实情况中却很少能够派上用场。因为当医院诊断出中风病情并启动手术时，患者的大脑往往已经大面积受损。Viz.ai技术可以辨别出需要施以急救的患者，随时提醒医生，并直接发送扫描结果，从而改善治疗结果。

The AIs have it

AI应用广泛

Another area ripe for AI’s assistance is oncology. In February 2017 Andre Esteva of Stanford University and his colleagues used a set of almost 130,000 images to train some artificial-intelligence software to classify skin lesions. So trained, and tested against the opinions of 21 qualified dermatologists, the software could identify both the most common type of skin cancer (keratinocyte carcinoma), and the deadliest type (malignantmelanoma), as successfully as the professionals. That was impressive. But now, as described last month in a paper in the Annals of Oncology, there is an AI skin-cancer-detection system that can do better than most dermatologists. Holger Haenssle of the University of Heidelberg, in Germany, pitted an AI system against 58 dermatologists. The humans were able to identify 86.6% of skin cancers. The computer found 95%. It also misdiagnosed fewerbenignmoles as malignancies.

人工智能另一个成熟应用的领域是肿瘤学。2017年2月，斯坦福大学的Andre Esteva和他的同事使用了将近13万张图像训练人工智能软件对皮肤病变进行分类。在21名皮肤病专家的指导下，软件进行了针对性的训练和测试。经过训练，软件的鉴别水平和行业专家不相上下，不仅可以检测出如角化细胞癌这种常见的皮肤癌症，也可以辨别最致命的恶性黑色素瘤。这个结果令人惊叹。上个月，《肿瘤学年鉴》上发表的一篇论文称，某种智能皮肤癌检测系统的准确率高于大多数皮肤科医生。德国海德堡大学的Holger Haenssle将人工智能系统与58名皮肤科医生进行了对比。医生们检测皮肤癌的准确率为86.6%，电脑则达到了95%。同时，电脑将某些良性痣误认为恶性肿瘤的比例也相对较低。

malignant/məˈlɪgnənt/ adj. (of a tumour or disease 肿瘤或疾病) that cannot be controlled and is likely to cause death 恶性的

benign/bɪˈnaɪn/ adj. (medical 医) (of tumours growing in the body 体内生长的肿瘤) not dangerous or likely to cause death 良性的 OPP malignant

There has been progress in the detection of breast cancer, too. Last month Kheiron Medical Technologies, a firm in London, received news that a study it hadcommissionedhad concluded that its software exceeded the officially required performance standard for radiologists screening for the disease. The firm says it will submit this study for publication when it has received European approval to use the AI—which it expects to happen soon.

乳腺癌的检测水平也在进步。上个月，伦敦Kheiron Medical Technologies公司委托的一项研究表明，该公司的软件在筛查乳腺癌方面的表现超过了放射科医生的行业标准。该公司称，不久之后，在该软件的使用通过欧盟批准后，公司会将研究结果公之于众。

commission/kəˈmɪʃn/ verb PIECE OF ART/ MUSIC, ETC. 艺术、音乐等作品 to officially ask sb to write, make or create sth or to do a task for you 正式委托（谱写或制作、创作、完成）

This development looks important. Breastscreeninghas saved many lives, but it leaves much to be desired.Overdiagnosisandovertreatmentare common. Conversely, tumours are sometimes missed. In many countries such problems have led to scans being checked routinely by a second radiologist, which improves accuracy but adds to workloads. At a minimum Kheiron’s system looks useful for a second opinion. As it improves, it may be able to grade women according to their risks of breast cancer and decide the best time for their next mammogram.

该研究取得的进展很重要。乳房筛查挽救了许多生命，但也还有很多不足之处。过度诊断和过度治疗很常见。相反，肿瘤有时却被忽视。很多国家通过安排另外的医生定期复核扫描结果来提升准确率，但这种方法增加了工作量。Kheiron’s的系统至少是另一种可行的方案。随着系统不断完善，未来可以根据女性患乳腺癌的风险对她们进行健康评级，以决定下次乳房造影检测的最佳时间。

screen/skri:n/ verb [often passive] ~ (sb) (for sth) to examine people in order to find out if they have a particular disease or illness 筛查；检查

Efforts to use AI to improve diagnosis are under way in other parts of medicine, too. In eye disease, DeepMind, a London-based of Alphabet, Google’s parent company, has an AI that screens retinal scans for conditions such as glaucoma, diabetic retinopathy and age-related macular degeneration. The firm is also working on mammography.

人们也利用人工智能提高其它医学领域的诊断水平。在眼疾方面，总部设在伦敦的谷歌母公司Alphabet下属的DeepMind部门通过扫描视网膜来检测青光眼、糖尿病性视网膜病变和老年性黄斑变性等眼部疾病。同时，该公司也在研究乳房造影检测。

Heart disease is yet another field of interest. Researchers at Oxford University have been developing AIs intended to interpret echocardiograms, which are ultrasonic scans of the heart. Cardiologists looking at these scans are searching for signs of heart disease, but can miss them 20% of the time. That means patients will be sent home and may then go on to have a heart attack. The AI, however, can detect changes invisible to the eye and improve the accuracy of diagnosis. Ultromics, a firm in Oxford, is trying to commercialise the technology and it could be rolled out later this year in Britain.

心脏疾病是另一个热门领域。牛津大学的研究人员通过开发智能系统软件来解释超声波心动图。心脏科医生通过观察扫描结果来寻找心脏病患者，但是这种方式会遗漏20%的病人。那些未被检测出来的患者则有可能会在患病却不自知的情况下离开医院。人工智能可以探测到人眼不易察觉的变化，提高诊断准确率。位于英国牛津的Ultromics公司一直希望将该科技商业化，可能今年晚些时候在英国推出。

There are also efforts to detect cardiac arrhythmias, particularly atrial fibrillation, which increase the risk of heart failure and strokes. Researchers at Stanford University, led by Andrew Ng, have shown that AI software can identify arrhythmias from an electrocardiogram (ECG) better than an expert. The group has joined forces with a firm that makes portable ECG devices and is helping Apple with a study looking at whether arrhythmias can be detected in the heart-rate data picked up by its smart watches. Meanwhile, in Paris, a firm called Cardiologs is also trying to design an AI intended to read ECGs.

也有人致力于检测心律失常，特别是会增加心力衰竭和中风的风险的心房颤动。Andrew Ng率领的斯坦福大学的研究团队证明利用心电图，人工智能软件可以比专家更准确地检测心律失常。该研究团队已经开始和一家制造便携式心电图设备的公司合作，并且正在帮助苹果公司研究心律失常是否可以通过其智能手表获得的健康数据检测出来。同时，巴黎的Cardiologs公司也在设计人工智能系统以分析心电图。

Seeing ahead

AI的前景

Eric Topol, a cardiologist and digital-medicine researcher at the Scripps Research Institute, in San Diego, says that doctors and algorithms are comparable in accuracy in some areas, but computers have the advantage of speed. This combination of traits, he reckons, will lead to higher accuracy and productivity in health care.

位于圣地亚哥的美国斯克利普斯研究所的心脏病专家和数字医学研究员Eric Topol认为，医生和算法在某些领域的准确率方面不相上下，但是电脑具有速度优势。将准确率和速度相结合，可以提高医疗卫生行业的诊断准确率和诊断效率。

Artificial intelligence might also make medicine more specific, by being able to draw distinctions thateludehuman observers. It may be able to grade cancers or instances of cardiac disease according to their risks—thus, for example, distinguishing those prostate cancers that will kill quickly, and therefore need treatment, from those that will not, and can probably be left untreated.

人工智能可以将人类无法察觉的事物区分开来，从而将医学进一步细化。它也许可以根据病症的危险系数给癌症和心脏病分级。比如，将前列腺癌这种极度危险、需要立即治疗的疾病，与那些危险系数较低、可以不加治疗的疾病区别开来。

elude/iˈlu:d/ verb if sth eludes you, you are not able to achieve it, or not able to remember or understand it 使达不到；使不记得；使不理解

What medical AI will not do—at least not for a long time—is make human experts redundant in the fields it invades. Machine-learning systems work on a narrow range of tasks and will need close supervision for years to come. They are “black boxes”, in that doctors do not know exactly how they reach their decisions. And they are inclined to become biased if insufficient care is paid to what they are learning from. They will, though, take much of thedrudgeryand error out of diagnosis. And they will also help make sure that patients, whether being screened for cancer or taken from the scene of a car accident, are treated in time to be saved.

然而，在较长的一段时间内，医疗领域人工智能软件的介入并不会让该领域内的医生下岗。机器学习系统工作范围有限，且未来数年需要严密监管。它们就像“黑盒”一般。医生不知道它们是如何得出结论的。如果不仔细把控学习内容，系统作出的判断很可能会有失偏颇。但是，这些系统确实可以避免很多诊断过程中的重复性工作和错误判断，帮助接受癌症检测的病人和车祸中的伤者得到及时的治疗，从而挽救生命。

black boxesIn science, computing, and engineering, a black box is a device, system or object which can be viewed in terms of its inputs and outputs (or transfer characteristics), without any knowledge of its internal workings. Its implementation is "opaque" (black). Almost anything might be referred to as a black box: a transistor, an algorithm, or the human brain.

drudgery/'drʌdʒərɪ/ n. hard monotonous routine work 苦工;贱役;单调沉闷的工作

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