Should the Healthcare Sector Adopt Black-Box AI?

AI is arguably the most talked about topic of recent times and I am sure that everybody who has read about, or thought about AI, has their own intuition on how it could change the world. This article seeks to stimulate thought and discussion on two opposing perspectives on the adoption of AI. To frame this discussion, I will first introduce a neural network (a computer which can learn and make decisions like the human brain) that is able to detect breast cancer before doctors; it is called Mirai.

Regina Barzilay, Professor of Computer Science at MIT, was driven to develop a computer like Mirai, after developing breast cancer despite undergoing regular mammograms (breast X-Rays) from her doctor and repeatedly getting the all-clear.

Barzilay and her team trained the computer by feeding it millions of mammograms from women who had been deemed cancer free by a doctor and subsequently been diagnosed with breast cancer. Mirai established patterns in the mammograms, identifying features which the human eye cannot see or are over-looked by doctors. Mirai’s predictions were compared with those of doctors, considering all the relevant risk factors, and it was found that Mirai’s predictions were nearly twice more accurate than doctors. Essentially, Mirai can see where cancer will develop or see cancer at its earliest stages.

Mirai is a black-box AI. This means that humans can be certain on what Mirai produces, but not certain on how Mirai produces this output. Black-box AI is built up of several layers with varying functions, the layers identify different features of an image, however the links between these layers are non-linear, meaning it is not clear how the layers interact. Ultimately, the complexity of these systems means that their methods of producing results are unknown, even to the developers. 

Although, Mirai could be used to diagnose millions of women across the world with breast cancer at an earlier stage, the AI has not been adopted by the healthcare sector in the way you might expect. One Oncologist said, “The first rule of medicine is to do no harm.” Healthcare professionals feel uneasy about using a practice which they are completely unable to understand. Whereas Barzilay asserts that because Mirai has been proven to be more effective than the current process, the black-box argument should not be part of the discussion.

Where the results are proven, is it reasonable to require an explanation as to a black-box AI’s method?

Imagine a world where humans and goldfish could communicate with one another. The goldfish asks his owner: “Please explain to me why you pour those pellets into my tank every day?” To answer this question, the owner must explain why they keep the goldfish and sustain it’s life, what the pellets are, what role the pellets play in keeping the goldfish alive and why the pellets must be poured into the tank. To explain the first proposition alone, the owner would have to explain the great extent of human development that makes it feasible for humans to keep goldfish in their homes, and what satisfaction they receive from doing so. One would argue that there is no possible way of explaining these matters to an animal whose brain is less than 1.5cm long. In considering that the goldfish is dependent on its owner’s benefaction to stay alive, does the pesky goldfish deserve this laborious explanation, which is surely incomprehensible to the goldfish, or should the fish keep swimming and eat its pellets?

Image Credit: Pexels – Mart Production

This analogy provides a whimsical illustration of the argument in favour of adopting Mirai in hospitals. It serves to demonstrate that regardless of whether humans can understand how Mirai works, the results are proven. These results would have a significantly positive impact to ensure that women with breast cancer receive earlier, less invasive treatment and potentially have their lives saved. These results could benefit millions of women and their families across the world, regardless of Mirai’s hidden methodology.  

Consider an alternative scenario, of future Britain. A new political party emerges who promises that they can bring ultimate prosperity and happiness to the country. However, because of the hypothetical politicians’ superior intelligence, they announce that their government will completely lack transparency and accountability to the citizens. This is because the citizens could not comprehend the highly complex governmental inner workings. There are many people who would say, “Yes, I would vote for this party, because of their proven results.” Yet, how could you be sure that these results will always be achieved, will their governmental methods produce the same results when the country suffers a drought, or invasion? Possibly, but there is nothing to support any conclusion. Even if you could trust this government based on their past results, their lack of transparency and accountability means you could never be certain on whether this government will get things right.   

The preceding analogy highlights some of the potential risks with adopting and relying on black-box AI. There is a huge danger that one false output from Mirai could cause a person to not receive cancer treatment where they need it, or alternatively are caused to suffer through invasive treatment that they do not need. An exhaustive list of the potential dangers is impossible because of one’s lack of understanding on how Mirai works. The benefits which AI like Mirai could have, are potentially immeasurable, yet so are the drawbacks. The possibility that humans will one day understand the methods of black-box AI is not precluded. So surely, the day humans can fully comprehend black-box AI is the day that we can be more comfortable with its adoption.

What do you think?

Herbal Helpers: New Approaches to Tackling Spring Sneezes

March is here and spring is fast approaching. With longer days, buds on bushes, and crocuses poking their heads up in Hyde Park, it doesn’t seem long before we leave winter behind. In Eastern tradition, the changes our bodies undergo with the shift in seasons are equally celebrated. 

In winter our energy or ‘qi’ retreats deep into our bodies, leaving us feeling stagnant and sleepy. As spring arrives our qi expands, flower-like, moving towards the outer regions of our body. We feel more social, want to move more, and sleep less. 

Like all changes, this shift is not easy. The sudden release of energy in your body can often lead to feelings of overwhelm and anxiety. Coupled with the impending exam season, this time can be brutally overwhelming for many. 

Luckily, nature provides numerous solutions to these maladies. In Traditional Chinese Medicine, the liver is responsible for guiding the energy as it moves outwards. There are many things we can do to support this organ as it undergoes its vital tasks, making the transition to spring easier for ourselves and our bodies. 

My three favorite ways to help my body out are: 

1. Rescue remedy: This herbal tincture is an amazing natural solution to stress and strain. The flower essences have calming properties to help ease you through exam preparations and general feelings of overwhelm. 

2. Beetroot. Beetroot . Beetroot! This red root is full of antioxidants, acting as a natural blood cleanser it helps your liver carry out its functions quickly and easily. 

3. Milk thistle tea: The silymarin substance in this plant can help ease inflammation in the liver and promote cell repair, counteracting the effects of one too many nights out. 

Unfortunately for us, the change in seasons also brings new bouts of cold and flu. The winter pathogens replicate easier in the warmer weather, meaning you might just have to fight off one more cold before the warmer weather properly arrives. 

Traditional Chinese Medicine recommends that we treat ourselves holistically, preparing the entire body to ward off the pathogens, rather than curatively, once the symptoms arise, as we typically do in the West. 

So, how can we protect ourselves against the last of the winter bugs? 

1. Echinaforce: Another herbal tincture you can easily get in roots, this remedy distills the echinacea flower, which is extremely effective at supporting your immune system against colds and flus. 

2. Ginger, lemon, and turmeric tea: This golden trio of ingredients is guaranteed to give your immune system the extra boost it needs. The anti-inflammatory properties in the ginger, antibacterial in the turmeric, and vitamin C in the lemon will snuff out any lingering viruses. Adding a teaspoon of honey also makes this tea more satisfying and sweet. 

3. Vitamin C: An oldie but a goldie. Upping your vitamin C by eating a few more oranges is a super easy way to do your immune system a world of good. 

Often overlooked, these plant based antidotes are just as, if not more effective than your everyday drugstore remedies. Strengthening your body before the sickness has time to strike is always preferable to numbing the symptoms with paracetamol and Lemsip.

Insights into Little Known Medical Secrets 

Ever wondered about the behind the scenes of medicine throughout the 19th and 20th century? Want to know more about the work Florence Nightingale did? Or how prisons were used to perform population wide experiments to determine if the inmates had a genetic disposition to criminal acts? 

The Thackray Museum of Medicine is excited to announce the return of their popular annual “Insights Lectures” this autumn. The talks aim to further the mission for the public to engage with academic debate over the development and history of medicine. These talks go beyond what we can see in the museum collections and provide in-depth knowledge on how we look after ourselves and push us to assess our own needs by understanding the roots, peaks, and troughs of healthcare evolution. Leading researchers from a variety of fields will work in tandem to provide topical insights varying from medical history and the environment to ethics, politics and Victorian architecture. 

I spoke to Laura Sellers; the curator of the lectures, about the importance of the talks, and the clarity they provide in a contemporary world of swirling digital infodemics and medical misinformation, particularly since COIVD-19. Laura emphasises that as healthcare consumers, we must understand where things come from; the sources, the human cost and history of innovation, developing research and enlightening skeletal remains allowing reinterpretation of misunderstood communities. These elements allow us to re-frame the way we look at ourselves and others. For example, if we followed the advice of Donald Trump to inject disinfectant into our bodies (classed as an “expert” by his presidential title) during the COVID-19 pandemic, we can assume the death rates of the virus would have been significantly larger in the US. Consider the unfathomable concept that doctors used to promote cigarettes! By immersing ourselves in historical narratives, the lectures give the everyday public liberty and opportunity to understand how, why, and when information changes, allowing freedom to make informed decisions on our own health and wellbeing. 

The first of the monthly lectures commence on the 4th of November, where Laura Sellers and Dr Stella Butler (Librarian Emeritus at UOL and Honorary Research Fellow at UCL) will discuss Florence Nightingale’s revolutionary transformation of hospitals and a key psychological question as to whether criminality is a human characteristic that we can change or if it is innate to people. Laura was able to give us a preview of what is to come; during the 19th century, the concept of a “prison” was still unestablished. Early ideas focussed on time in prison representing a reformatory period whereby convicts would emerge cognitively changed. You may be surprised to hear that this did not work! Eventually, they concluded that healthcare was the only way to truly change prison life. From this idea, they could keep re-building and improving prisons, whether that be ventilation, or access to work, constant tweaks were made. 

It was actually a prison doctor who discovered you can get Vitamin C from a potato!” 

He could do this because prisons essentially consisted of a controlled experimental body. Residents lived the same way, ate the same food, wore the same clothes, and performed the same labour; “everything about their lives was managed, which means you can effectively experiment on that population.” The results of observing and adjusting elements of prison life meant they could try and work out if criminality is, indeed, a changeable human characteristic or if it is innate to people. These observations fundamentally “changed how punishment happened in the UK”. 

Everyone learns in different ways and lectures are not for everyone. Laura is trying to use as many wide-ranging events and topics as possible, relevant to the Harehills and St. James’s Hospital community as well as the wider population of Leeds, particularly university students. Laura’s main objective is to reach and inform as many people as she can. The museum are increasing their use of digital platforms and local community engagement; “What we try and do is give people access in different ways”. Again, when reliable, impartial, and accurate medical information is readily accessible, we are free to make more informed choices for our health. 

The museum is located in Harehills, just a 30-minute walk from Leeds Train Station, with easy access to regular buses. The museum offers much more than just the Insights Lectures, including its Culture Club, targeted at a slightly younger audience (16-21). Tickets for the lectures are priced at £10 (or £60 for the full series) and can be found on The Thackray Museum of Medicine website under “What’s On“. 

Insights into Little Known Medical Secrets – Upcoming Thackray Museum of Medicine Insights Lectures

Ever wondered about the behind the scenes of medicine throughout the 19th and 20th century? Want to know more about the work Florence Nightingale did? Or how prisons were used to perform population wide experiments to determine if the inmates had a genetic disposition to criminal acts?

Our local Thackray Museum of Medicine is about to bring back their annual “Insights Lectures” commencing on November 4th. Their expert speakers aim to spark medical debate within the audience and reveal wonderous truths found nowhere else. To encourage us to re-assess our healthcare needs, the talks will explore the intricate details of medical evolution to expand our understanding about why things are the way they are.

I spoke to Laura Sellers, the curator of the lectures. She highlights the importance of their content in a world full of abundant information. She encourages that we should push ourselves to understand where things come from. Let’s consider sources; should we blindly follow the advice of “experts”, just because they hold a position of power? Where did this information stem from? Is it opinion or fact?

The first of the lectures, led by Laura, examine Florence Nightingale’s revolutionary approach in changing hospitals for the better and whether criminality is an innate human characteristic or if it can be changed? In early prison history, you may be surprised to hear that prison populations were used as experimental samples to test this!

The museum is just a short bus ride from the city into Harehills; if you wish to know more, look no further than our November print issue for a further article, and make sure you take this opportunity to engage with accurate and insightful information, if you truly want to understand what is going on around us. Whats even better is that students go free to all Insights Lectures – to redeem this, just contact groups@thackraymuseum.org to book your place now.