X-Prize Foundation Wants To Make Tricorders a Reality

By Kyle Munkittrick | August 3, 2010 11:30 am

tricorder

Doctors are not doing so well. In addition to being extremely expensive to train, maintain, and, of course, to visit, they have a lot of other problems. If your doctor is a drunk, an addict, or just plain-old incompetent, his or her colleagues may not tell you or anyone else.[1] Even when doctors are sober and sharp, their diagnoses are often, ahem, less than correct. Mark Walker’s “Uninsured, Heal Thyself” paints a pretty terrifying picture:

Physicians can and do misdiagnose frequently: they prescribe for nonexistent diseases or injuries and fail to notice symptoms or make the correct inferences. An article in the Journal of the American Medical Association noted: “Two 1998 studies validate the continued truth that there is an approximately 40% discordance between what clinical physicians diagnose as causes of death antemortem and what the postmortem diagnoses are” (Lunberg, 1998). This is a pretty shocking statistic: in 4 out of 10 deaths there is a disagreement between what physicians think is the cause of death prior to autopsy, and autopsy findings.[2]

Egads. Is there any solution to the doctor debacle? Walker proposes computer-aided diagnosis:

For example, in a well-known 1971 study, a computer diagnostic system was pitted against experienced physicians in the diagnosis of acute abdominal pain: computer diagnosis was 91.1% accurate compared to 79.7% for experienced physicians (de Dombal et. al., 1972). In another study, computer diagnosis matched that of neurosurgeons, orthopedic surgeons and general practitioners in overall average in diagnosing lower back pain. While humans surpassed computers in non-critical cases, computers surpassed humans in diagnosing more critical spinal symptoms in which quick intervention is correlated with better outcomes (Bounds et. al., 1998).

The X-Prize Foundation (famous for spurring the privatization of space flight) agrees with Walker. The foundation is developing a new prize: the “AI Physician X Prize, which will be won by the first team to build an artificial intelligence system that can offer a medical diagnosis as good as or better than a diagnosis from a group of 10 board-certified doctors.”[3] Ten doctors – forget a second opinion, every diagnosis would come with a tenth opinion!

And where would one keep such an artificial intelligence? Why in a smartphone, of course. A hand-held computer used to diagnose medical issues: that sounds suspiciously like something Dr. Bev Crusher might be using on the USS Enterprise; namely a tricorder. Or, as Dilbert creator Scott Adams calls it, an exobrain.[4] My iPhone already has access to Wikipedia, WebMD, the Mayo Clinic and a free app for the University of Maryland Medical System’s medical encyclopedia. In a pinch I could probably use it to help in an emergency until professionals arrived. My knowledge and intelligence is expanded instantly by virtue of owning a hand-held computer with a wireless data signal.

Now imagine an app as smart and accurate as a panel of ten doctors in the hands of a trained MD or EMT, emphasis on the “trained.” Walker’s essay focuses on allowing patients to self-diagnose, but the huge benefit would be for professional diagnoses. Instead of being required to memorize thousands of potential diseases and syndromes, each with their own fickle and bizarre permutations, a doctor’s two primary goals would become 1) ensuring accurate, exhaustive entry of symptoms into the tricorder and 2) giving comprehensive, patient oriented care. Diagnoses, particularly esoteric ones, would become the prerogative of the device, instead of certain hobbled, cantankerous MDs named “House.” In addition to the symptoms entered by the doctor, the tricorder would have access to the patient’s entire medical history — including reoccurring issues, worsening conditions, potential genetic dispositions, and a plethora of other minutia — that could be the difference between sending someone home with “drink fluids and come back if it gets worse” and hospitalization. Furthermore, long, infection-prone hospital stays for “observation” would be reduced or even eliminated thanks to better initial diagnoses.

With so much potential to help, the tricorder may become an ever-present part of the doctor’s uniform, just as the stethoscope did in a previous era.

1. “Doctors don’t rat out their incompetent colleagues,” Salon
2. “Uninsured, Heal ThyselfJET Press
3. “The Next Five Years of the X-Prize” CNET
4. “Exobrain” Dilbert Blog

CATEGORIZED UNDER: Artificial Intelligence, Medicine

Comments (7)

  1. I’m sure doctors are excited about this, another great way for patients to come in having already misdiagnosed themselves.

  2. @Rhacodactylus My sister is only alive today because she correctly diagnosed herself where the doctor just told her it was *something nervous’.

  3. Chris Winter

    Walter Bodmer, in The Book of Man, devotes some space to the diagnosis of obscure diseases. One such is Huntington’s chorea (now known as Huntington’s disease.) Folksinger Woody Guthrie was perhaps the best-known victim of Huntington’s. On page 73, Bodmer quotes from the testimony given to Congress in 1976 hearings on establishing a commission on the disease:

    “We heard of people who had spent their life savings trying to get proper diagnosis of the disease; of a seventy-six-year-old woman, with no social security, who had to look after middle-aged sons who were so badly affected they had to wear nappies all the time; of people visiting relatives in psychiatric hospitals, hearing them screaming and seeing them tied up; of one woman who spent $26,000 on medical bills for thirty-one different doctors before anyone recognized her condition; of families that had been decimated by Huntington’s; and of men and women who lost jobs because they were thought to be drunk. It certainly put Huntington’s in context.”

    Yes. And part of that context, it must be said, is the abysmal quality of diagnosis provided. No one should have to visit thirty-one doctors to get their disease properly identified, no matter how rare that disease is (provided that it is not totally unknown). And Huntington’s chorea is not that rare; it affects five out of every 100,000 births. It was described in 1872, and Woody Guthrie began to show its effects in 1951. Such defective diagnosis is not a problem specific to Huntington’s chorea; it is a systemic and persistent shortcoming of the American medical establishment.

  4. RJ

    Given the complex system that the human body is and all the social, political, economic etc. pressures that could influence a diagnosis I’m surprised that doctors could ever get it right, and certainly not on the first attempt. I think that even more important than a computerized diagnosis would be the ability for these gadgets to collect data for real doctors, like a black box system for the body. Unfortunately, I would guess we are probably about a decade away from getting our current medical data off of dead trees and there are plenty of social, political, and economic roadblocks to those efforts.

  5. GrayGaffer

    A friend of mine recently suffered a ruptured appendix. His doctors took a week to arrive at that diagnosis. By which time his abdomen was so riddled with sepsis they could not operate. He had to endure 3 months of extreme antibiotics before they went in the do the surgical part. He is very lucky to have survived what should have been a two day hospitalization and short recuperation.

    This is not a rare organ failure. And Seattle is not exactly the back of beyond, medically speaking. I was aghast that they took so long. He described his initial symptoms to me during a phone call after his surgery, and it took me only 5 minutes on teh Google to find a diagnostic aid that recommended immediate hospitalization for a ruptured appendix based on just what he told me.

    Back in the 1980’s I studied Expert Systems in my CS MSc classes. Medical diagnostics was one of the fields described as most eminently suitable for rule-based systems based on domain expert input during construction. I don’t mean simplistic decision tree diagnostics, I’m talking about fully associative rule-based reasoning systems. It was possible to do that even then on the early 8088 based IBM PC. I have to believe then that it is only this litigious society that has delayed the adoption of such technology.

  6. Robert

    I have Sarcoidosus (sp?).

    My diagnosis took over 6 months, several specialists, and much pain and anxiety.

    A device such as this would comoe up with it quicker, until it looked at my history.

    You see, Sarcoid is typically diagnosed in young African American women. I’m a middle aged caucasian man.

    So until it took an intuitive leap, it’s mundane.

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