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Doctors fear Google skin check app will lead to ‘tsunami of overdiagnosis’ | Health

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Google’s entry into health diagnostics has alarmed health experts who fear a new artificial intelligence tool to identify skin conditions could lead to overdiagnosis, or rare and complex skin conditions being missed.

At a technology conference in the US on Tuesday, Google revealed there are almost 10bn Google searches related to skin, nail and hair issues every year. In response, Google has developed an artificial intelligence “dermatology assist tool” for people with concerns about their skin. Users of the app can use their phone to take three images of their skin, hair or nails from different angles.

The app will then ask users questions about their skin type, how long they have had the issue, and for other symptoms that help narrow down the possibilities.

“The artificial intelligence model analyses this information and draws from its knowledge of 288 conditions to give you a list of possible matching conditions that you can then research further,” Google said in a statement.

“The tool is not intended to provide a diagnosis nor be a substitute for medical advice, as many conditions require clinician review, in-person examination or additional testing like a biopsy. Rather we hope it gives you access to authoritative information so you can make a more informed decision about your next step.”

The immediate past president of the Australasian College of Dermatologists, Dr Andrew Miller, said it was true that there is a global shortage of dermatologists worldwide, making it difficult for people with concerns to see a specialist.

“Around the world there are about 100,000 dermatologists, and considering there are almost eight billion people in the world that’s an amazing shortage,” he said. “We also have maldistribution of more in city and well-off areas and less in rural and disadvantaged areas. So I definitely understand that issues of access are front of mind.”

But Miller said government-subsidised appointments allowing GPs to collaborate with dermatologists were the answer, not artificial intelligence [AI]. He said while telehealth appointments might be subsidised, they were not an ideal way to examine skin or to take photographs, because images taken during video streaming were poor quality.

“What we want is subsidies to be able to work with GPs who will contact us with the patient’s history, and who can take good quality photographs for us and send those through. We can then take our time to analyse those and, with the patient’s consent, work with their GP to come up with a treatment plan. We already do this kind of work where we can, but there is complex back-of-house analytical work that requires more than just a telehealth appointment.

“But there is no Medicare schedule for dermatology to be performed via telehealth in the way we would like to do it, which is involving the GP and having time to analyse properly taken images.”

In this situation Miller said the GP could explain the next steps and treatments, but this level of communication would not be available for people using Google.

“The standard textbook for dermatology is four volumes thick and weighs a couple of kilos,” Miller said. “People do get rare things. One of the things doctors and specialists have is an antennae that there is something wrong even if it may not look obvious, and when talking to a patient you also read body language and get a sense of whether they understand what you are telling them and if they are taking it all in.

“I’d worry that with a computer, people might ignore advice to see a doctor, or the algorithm might miss anything complex. I’d also worry that they might misunderstand questions asked by the app.”

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There is some evidence that AI has diagnostic potential. A 2017 study published in the journal Nature found an artificial intelligence network was capable of classifying skin cancer with a level of competence comparable to dermatologists. “It is projected that 6.3bn smartphone subscriptions will exist by the year 2021, and can therefore potentially provide low-cost universal access to vital diagnostic care,” the paper says.

But assistant professor and NHMRC early career fellow with Bond University’s Institute for Evidence-Based Healthcare Dr Ray Moynihan said; “There is great concern that the entry of Big Tech into healthcare will bring a tsunami of overdiagnosis – because there is a lot of money to be made telling healthy people they are sick.”

While early detection of deadly skin cancers such as melanoma is essential to improving the success of treatment, there is growing concern that harmless lesions are being diagnosed as melanoma, with the consequences being unnecessary treatment, psychological distress and medical costs. A study published in 2020 in the Medical Journal of Australia found 58% of melanomas were overdiagnosed, or 24% of all cancer diagnoses.

“There is already compelling evidence of much overdiagnosis of skin cancer – and over-enthusiastic acceptance of new screening tools could make the problem far worse,” Moynihan said.

“There is of course the chance that careful judicious use of some of this new technology could reduce the problem of overdiagnosis, by better distinguishing between malignant and benign problems – but that would require rigorous evaluation of risks and benefits by independent researchers and regulators.

“What we have at the moment are puffed up press releases and promotional media stories that make no mention of the potential downsides of these experimental AI tools – and one of the biggest downsides is unnecessary diagnosis, and the harm, anxiety and waste that can cause.”

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2021 iPhone photography awards – in pictures | Technology

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The 14th annual iPhone photography awards offer glimpses of beauty, hope and the endurance of the human spirit. Out of thousands of submissions, photojournalist Istvan Kerekes of Hungary was named the grand prize winner for his image Transylvanian Shepherds. In it, two rugged shepherds traverse an equally rugged industrial landscape, bearing a pair of lambs in their arms.

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With Alphabet’s legendary commitment to products, we can’t wait to see what its robotics biz Intrinsic achieves • The Register

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Alphabet today launched its latest tech startup, Intrinsic, which aims to build commercial software that will power industrial robots.

Intrinsic will focus on developing software control tools for industrial robots used in manufacturing, we’re told. Its pitch is that the days of humans having to manually program and adjust a robot’s every move are over, and that mechanical bots should be more autonomous and smart, thanks to advances in artificial intelligence and leaps in training techniques.

This could make robots easier to direct – give them a task, and they’ll figure out the specifics – and more efficient – the AI can work out the best way to achieve its goal.

“Over the last few years, our team has been exploring how to give industrial robots the ability to sense, learn, and automatically make adjustments as they’re completing tasks, so they work in a wider range of settings and applications,” said CEO Wendy Tan White.

“Working in collaboration with teams across Alphabet, and with our partners in real-world manufacturing settings, we’ve been testing software that uses techniques like automated perception, deep learning, reinforcement learning, motion planning, simulation, and force control.”

Tan White – a British entrepreneur and investor who was made an MBE by the Queen in 2016 for her services to the tech industry – will leave her role as vice president of X, Alphabet’s moonshot R&D lab, to concentrate on Intrinsic.

She earlier co-founded and was CEO of website-building biz Moonfruit, and helped multiple early-stage companies get up and running as a general partner at Entrepreneur First, a tech accelerator. She is also a board trustee of the UK’s Alan Turing Institute, and member of Blighty’s Digital Economic Council.

“I loved the role I played in creating platforms that inspired the imagination and entrepreneurship of people all over the world, and I’ve recently stepped into a similar opportunity: I’m delighted to share that I’m now leading Intrinsic, a new Alphabet company,” she said.

The new outfit is another venture to emerge from Google-parent Alphabet’s X labs, along with Waymo, the self-driving car startup; and Verily, a biotech biz. ®

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Charles River to create 90 new jobs at Ballina biologics site

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Charles River is expanding its testing capabilities in Ballina as part of its partnership with Covid-19 vaccine manufacturer AstraZeneca.

Contract research organisation Charles River Laboratories is planning an €8m site expansion in Ballina to facilitate batch release testing for Covid-19 vaccines from AstraZeneca.

The expansion at the Mayo site will create an additional 1,500 sq m of lab space and 90 highly skilled jobs in the area over the next three years.

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The company provides longstanding partners AstraZeneca with outsourced regulated safety and development support on a range of treatments and vaccines, including testing and facilitating the deployment of Vaxzevria for Covid-19 and Fluenz for seasonal infleunza.

The latest investment follows earlier expansions at the Ballina site and Charles River recently announced plans to establish a dedicated laboratory space to handle testing of SARS-CoV-2 and other similar pathogens that cause human disease.

“We are incredibly proud of the transformational changes we have implemented on site and the role that Charles River has played in supporting the safe and timely roll-out of AstraZeneca’s Covid-19 vaccine,” said Liam McHale, site director for Charles River Ballina.

“Throughout the pandemic, our site remained fully operational while keeping our employees safe and having a positive impact on human health. Our expanded facility will provide us with the increased capacity needed to continue the essential services we provide to our clients.”

Charles River acquired the Ballina facility, which focuses on biologics testing, in 2002. The company employs 230 people at its two facilities in Ireland, including the Mayo site and a site in Dublin, established in 2017, which serves as the EMEA and APAC headquarters for the company’s microbial solutions division.

IDA Ireland is supporting the expansion. Mary Buckley, executive director of the agency, said Charles River is an “employer of long standing” in Co Mayo.

“The enhancement of its product lines and the development of additional capability at the Ballina facility is most welcome,” she added. “Today’s announcement is strongly aligned to IDA Ireland’s regional pillar and its continued commitment to winning jobs and investment in regional locations.”

Dan Wygal, country president for AstraZeneca Ireland, added: “Our Covid-19 vaccine, Vaxzevria, undergoes extremely robust safety and quality testing prior to becoming available for patients. We are committed to bringing safe, effective vaccines to Ireland and other markets as quickly as possible, and Charles River will continue to be an important partner in this regard.”

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