YORKTOWN, New York: Some fellow in his pajamas, home sick with bronchitis and complaining online about it, could soon be contributing to a digital collection of medical information designed to help speed diagnoses and treatments.
A doctor who is helping to prepare IBM’s Watson computer system for work as a medical tool says such blog entries may be included in Watson’s database.
Watson is best known for handily defeating the world’s best ‘‘Jeopardy!’’ players on the TV quiz show earlier this year. IBM says Watson, with its ability to understand plain language, can digest questions about a person’s symptoms and medical history and quickly suggest diagnoses and treatments.
The company is still perhaps two years from marketing a medical Watson, and it says no prices have been established. But it envisions several uses, including a doctor simply speaking into a handheld device to get answers at a patient’s bedside.
Watson won’t be the first such product on the medical market, however, and one rival company says it isn’t impressed.
At a recent demonstration for The Associated Press, Watson was gradually given information about a fictional patient with an eye problem. As more clues were unveiled – blurred vision, family history of arthritis, Connecticut residence – Watson’s suggested diagnoses evolved from uveitis to Behcet’s disease to Lyme disease. It gave the final diagnosis a 73 per cent confidence rating.
‘‘You do get eye problems in Lyme disease but it’s not common,’’ Dr. Herbert Chase said. ‘‘You can’t fool Watson.’’
For ‘‘Jeopardy!’’ Watson was fed encyclopedias, dictionaries, books, news, and movie scripts. For health care, it’s on a diet of medical textbooks and journals. It could also link to the electronic health records that the federal government wants hospitals to maintain. Medical students are peppering it with sample questions to help train it.
Chase, a Columbia University medical school professor, says anecdotal information –such as personal blogs from medical websites – may also be included.
‘‘What people say about their treatment … it’s not to be ignored just because it’s anecdotal,’’ Chase said. ‘‘We certainly listen when our patients talk to us, and that’s anecdotal.’’
Chase and other experts say cramming Watson with the latest medical information will help with a major problem in modern health care: information overload.
‘‘For at least 30 years it’s been clear that it’s not possible for us to know everything,’’ he said. ‘‘Every day, doctors have questions they can’t find the answers to. Even if you sit down at a search engine, it’s so labor intensive and it takes so long to find answers.’’
Carl Kesselman, director of the Health Informatics Center at the University of Southern California, says the ‘‘deluge of information’’ is a significant problem.
‘‘Advances in medicine are increasing rapidly: genomics, specialized drugs, off-label uses, increasingly finer-grained classifications of disease,’’ said Kesselman, who is not involved with the Watson project. ‘‘The ability to ask ‘Jeopardy!’-style questions and get that kind of information retrieval, to sort through all the stuff out there and point you to the latest literature, would be of potentially huge value.’’
Michael Yuan, chief scientist at Ringful Health, a medical consulting company in Austin, Texas, that has worked with IBM, cited a 1999 study of 103 doctors that found they fielded more than 1,100 questions a day, of which 64 per cent were never answered.
‘‘That’s a huge potential for people to make mistakes,’’ he said. ‘‘Watson is the type of solution that can really reduce that.’’
In ‘‘Jeopardy!’’ Watson was asked for one correct answer, whether it was answering questions about Sir Christopher Wren, the Lion of Nimrud or the Church Lady from ‘‘Saturday Night Live.’’
But in its medical guise, when presented a set of symptoms, Watson offers several possible diagnoses, ranked in order of its confidence.
‘‘In medicine, we don’t want one answer, we want a list of options,’’ Chase said.
Kesselman said having options might help doctors accept a computer’s findings.
‘‘Will a physician ever blindly accept a diagnosis coming out of a computer? I don’t think that will happen anytime soon,’’ he said.
Chase said seeing more than one choice might also help doctors move away from what he called ‘‘anchoring,’’ or getting too attached to a diagnosis.
‘‘If a person has a 95 per cent chance of having disease X, there’s still a one-in-20 chance that they have something else,’’ he said. ‘‘We often forget what’s in that 5 per cent. But Watson won’t.’’
The treatment application works much like the diagnosis application. In the demonstration, Watson first suggested the antibiotic doxycycline for treating Lyme disease, then switched to cefuroxime when told the patient was pregnant and allergic to penicillin.
Chase said Watson will know the latest treatment guidelines – which are complex and often updated _ ‘‘and can see if they’re not being met.’’
