In an article in Precision Medicine, Catherine Shaffer writes about the role of AI in the future Precision Medicine and the evidence that has to be generated before clinicians fully trust it and feel comfortable using it in their everyday practice. Dr. Razmi was interviewed by Ms. Shaffer and shared his insights on what it will take for AI to gain the trust of the medical community and the evidence required to support the use of AI for Precision Medicine.
From the article:
Ronald Razmi, a cardiologist, cofounder of Zoi Capital, and author of AI Doctor: The Rise of Artificial Intelligence in Healthcare, said that in some use cases, such as subtyping certain types of tumors, AI technology is showing promise and potentially near-term utility, but that utility remains to be demonstrated in large, prospective clinical trials. “Anything we talk about right now in terms of the initial promise of AI in some of these areas is speculative,” Razmi said. “[AI technologies] haven’t changed the practice of medicine yet.”
It’ll take a couple of decades, he suspects, before some of the AI applications being developed today see their way into real-world use. In the meantime, Razmi worries that without a “sober-minded” discussion of AI’s limitations, the hype and large investments surrounding these technologies could lead to the introduction of products to the market that are not ready for prime time.
Bias in an AI algorithm can occur for many reasons, including unconscious bias on the part of developers, disparate representations of groups in datasets, and biases in selected training features. “Unfortunately, the bias we see in training data is only the tip of the iceberg,” Razmi wrote in his book AI Doctor. “All of the data that we use are biased to some degree because they represent specific geographies and demographics, and certain diseases may be over- or underrepresented.”
Although the use of AI in precision medicine and healthcare presents some challenges, AI Doctor author Razmi believes it’s worth the effort to try to refine its use for this purpose. Given the billions of data points generated by interactions between the genome, proteome, microbiome, immune system, and more, Razmi said, “AI is the only technology we have to start going after the secrets of the human body. The trajectory long term is phenomenal.”
When it comes to AI, “[doctors] have concerns about whether they’re going to lose their autonomy. They have concerns about whether it’s going to affect their jobs. They have concerns about whether it’s going to lower their incomes because some of what they’re doing is going to be done by AI,” Razmi said. “But if and when those concerns are addressed, they’re going to be concerned about whether the output can be trusted. And for that, you need to do clinical trials, prospective, large-scale clinical trials, which haven’t been done yet for most technologies in health AI.”
