15 Oct, 2018

Le destin de la médecine à l’époque de l’IA

Très bel article du Lancet sur l’intelligence artificielle et la médecine

Qu’est-ce que cela signifie aujourd’hui d’être un médecin ? Est-ce toujours une discipline que nous pratiquons lorsqu’une machine sait mieux que nous le diagnostic, le traitement ou le destin de notre patient ? Serons-nous toujours la main qui rassure par la parole et le soin ? Il reste difficile de prédire quand l’intelligence artificielle (IA) deviendra si puissante qu’elle devancera les êtres humains. Certains voient ce jour arriver bientôt et les prévisions extrêmes voient disparaître des disciplines entières comme la radiologie ou la dermatologie, remplacées par l’IA. La vérité est beaucoup moins claire. La perspective de l’IA est une tache de Rorschach sur laquelle beaucoup transfèrent leurs rêves technologiques ou leurs angoisses
L’article à lire dans le Lancet – October 11, 2018

15 Oct, 2018

The cost of ignoring the warning signs – EEA publishes ‘Late Lessons from Early Warnings, volume II’

New technologies have sometimes had very harmful effects, but in many cases the early warning signs have been suppressed or ignored. The second volume of Late Lessons from Early Warnings investigates specific cases where danger signals have gone unheeded, in some cases leading to deaths, illness and environmental destruction.

The first volume of Late Lessons, published in 2001, was a ground breaking report detailing the history of technologies subsequently found to be harmful. The new 750-page volume includes 20 new case studies, with far-reaching implications for policy, science and society.

Case studies include the stories behind industrial mercury poisoning; fertility problems caused by pesticides; hormone-disrupting chemicals in common plastics; and pharmaceuticals that are changing ecosystems. The report also considers the warning signs emerging from technologies currently in use, including mobile phones, genetically modified organisms and nanotechnology.

The historical case studies show that warnings were ignored or sidelined until damage to health and the environment was inevitable. In some instances, companies put short-term profits ahead of public safety, either hiding or ignoring the evidence of risk. In others, scientists downplayed risks, sometimes under pressure from vested interests. Such lessons could help avoid harm from emerging technologies.  However, five of the stories illustrate  the benefits of quickly responding to early warnings.

The world has changed since the first volume of Late Lessons was published. Technologies are now taken up more quickly than before, and are often rapidly adopted around the world. This means risks may spread faster and further, the report says, outstripping society’s capacity to understand, recognise and respond to these effects in time to avoid harm.

The report recommends the wider use of the ‘precautionary principle’ to reduce hazards in cases of new and largely untested technologies and chemicals. It states that scientific uncertainty is not a justification for inaction, when there is plausible evidence of potentially serious harm.

Such a precautionary approach is nearly always beneficial – after analysing 88 cases of supposed ‘false alarm’, report authors found only four clear cases. The report also shows that precautionary actions can often stimulate rather than stifle innovation.

Key recommendations

  • Science should acknowledge the complexity of biological and environmental systems, particularly where there may be multiple causes of many different effects, the report says. It is increasingly difficult to isolate a single agent and prove beyond doubt that it causes harm. A more holistic view taking many different disciplines into account would also improve the understanding and prevention of potential hazards.
  • Policy makers should respond to early warnings more rapidly, the report says, particularly in cases of large scale emerging technologies. It proposes that those causing any future harm should pay for the damage.
  • Risk assessment can also be improved, the report says, by embracing uncertainty more broadly and acknowledging what is not known. For example, ‘No evidence of harm’ has often been  often misinterpreted to mean ‘evidence of no harm’ when the relevant research was not available.
  • The report calls for new forms of governance involving citizens in choices about innovation pathways and risk analysis. This would help to reduce exposure to hazards and encourage innovations with broader societal benefits. Greater interaction between business, governments and citizens could foster more robust and diverse innovations at less cost to health and the environment.
15 Oct, 2018

Votre obsession pour les technologies embarquées dans vos smartphones pourraient bientôt aider à traiter des maladies mentales

C’est dans le MIT review que j’ai décelé ceci –

Analyzing the way you type and scroll can reveal as much as a psychological test.

There are about 45 million people in the US alone with a mental illness, and those illnesses and their courses of treatment can vary tremendously. But there is something most of those people have in common: a smartphone. A startup founded in Palo Alto, California, by a trio of doctors, including the former director of the US National Institute of Mental Health, is trying to prove that our obsession with the technology in our pockets can help treat some of today’s most intractable medical problems: depression, schizophrenia, bipolar disorder, post-traumatic stress disorder, and substance abuse.

Mindstrong Health is using a smartphone app to collect measures of people’s cognition and emotional health as indicated by how they use their phones. Once a patient installs Mindstrong’s app, it monitors things like the way the person types, taps, and scrolls while using other apps. This data is encrypted and analyzed remotely using machine learning, and the results are shared with the patient and the patient’s medical provider. The assessment included classic neuropsychological tests that have been used for decades, like a so-called timed trail-tracing test.

The seemingly mundane minutiae of how you interact with your phone offers surprisingly important clues to your mental health, according to Mindstrong’s research—revealing, for example, a relapse of depression. With details gleaned from the app, Mindstrong says, a patient’s doctor or other care manager gets an alert when something may be amiss and can then check in with the patient by sending a message through the app (patients, too, can use it to message their care provider).

For years now, countless companies have offered everything from app-based therapy to games that help with mood and anxiety to efforts to track smartphone activities or voice and speech for signs of depression. But Mindstrong is different, because it’s considering how users’ physical interactions with the phones—not what they do, but how they do it—can point to signs of mental illness. That may lead to far more accurate ways to track these problems over time. If Mindstrong’s method works, it could be the first that manages to turn the technology in your pocket into the key to helping patients with a wide range of chronic brain disorders—and may even lead to ways to diagnose them before they start.

Digital fingerprints
Before starting Mindstrong, Paul Dagum, its founder and CEO, paid for two Bay Area–based studies to figure out whether there might be a systemic measure of cognitive ability—or disability—hidden in how we use our phones. One hundred and fifty research subjects came into a clinic and underwent a standardized neurocognitive assessment that tested things like episodic memory (how you remember events) and executive function (mental skills that include the ability to control impulses, manage time, and focus on a task)—the kinds of high-order brain functions that are weakened in people with mental illnesses.

15 Oct, 2018

Le vaccin contre le papillomavirus autorisé pour une classe d’âge plus vaste aux états-unis

 Denise Grady and Jan HoffmanOct. 5, 2018 , dans le New york Times

About 14 million women and men become infected with the human papillomavirus each year in the United States, according to the Centers for Disease Control and Prevention.CreditCreditKeith Bedford/The Boston Globe.  The HPV vaccine, which prevents cervical cancer and other malignancies, is now approved for men and women from 27 to 45-years-old, the Food and Drug Administration said on Friday
The vaccine is Gardasil 9, made by Merck, and had been previously approved for minors and people up to age 26. It works against the human papillomavirus, HPV, which can also cause genital warts and cancers of the vulva, anus, penis and parts of the throat. The virus has many strains. It is sexually transmitted, and most adults encounter at least one strain at some point in their lives. The vaccine protects against nine strains, including those most likely to cause cancers and genital warts.

“Today’s approval represents an important opportunity to help prevent HPV-related diseases and cancers in a broader age range,” Dr. Peter Marks, director of the F.D.A.’s Center for Biologics Evaluation and Research, said in a statement.