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Voices in AI – Episode 95: A Conversation with Eric Topol

About this Episode

Episode 95 of Voices in AI features Byron speaking with author Eric Topol regarding how Artificial Intelligence could revolutionize medicine and the health care industry.

Listen to this episode or read the full transcript at www.VoicesinAI.com

Transcript Excerpt

Byron Reese: This is Voices in AI, brought to you by GigaOm, and I’m Byron Reese. Today my guest is Eric Topol. He is the author of the book Deep Medicine, and he talks about how the power of artificial intelligence can make medicine better for all humans by freeing physicians from the tasks that interfere with human connection. He holds a degree with highest distinction in the study of biomedicine from the University of Virginia, and he holds an MD, with honor, in the study of medicine from the University of Rochester. Welcome to the show, Eric.

Eric Topol: Thanks very much, Byron.

Tell me a little bit about your background and how did you, obviously with the medicine background, first get into AI and see its potential for transforming the medical industry?

Well, it’s been about a dozen years ago when I started this Research Translational Institute, which was predicated on understanding human beings at a deep level. That was also involving, of course, digital, wearable sensors. Very quickly we saw that there was no shortage of data being generated for each person, whether it’s through different sensors or a genome or electronic health records or images, and it became clear that we needed a rescue for dealing with all this data. Clearly, AI is emerging to fulfill that very objective.

What do you mean, you set out to ‘understand humans’? Is that psychology and sociology and physiology? Is it all of that? That’s a pretty tall order. You have to look at history and anthropology…

Yeah, not quite as diverse as you’re mapping but rather the medical essence of a person. That would be the biological layers like DNA, proteins, the microbiome, the physiologic through sensors layer, the anatomy through scans, and then the environment you can quantify now through sensors, as well as the traditional medical information. We’re not talking about anthropology or psychology as much as we’re talking about what makes a person tick.

If you go to 2000, 2003 when the genome was announced, the first human genome draft, their thought was the DNA is going to have all the operating instructions. I’ve never thought that to be the case and in fact, we need much more information about a person. The whole concept of individualized medicine [means] being able to match up that knowledge of a person with prevention or better management of conditions, or everything we do for screening and medications and making diagnoses, everything we do in medicine, by having a deeper understanding of each person.

Where are we on that journey? If you go back [from] Hippocrates to now—because I’m always struck by how much we don’t know—you can start with the brain and how a thought is encoded and what gives rise to the mind. We used to think the neurons were the story, and then it’s the glial cells and then it’s something else. I read recently we don’t even know how the body maintains its body temperature. How does it always keep us at 98.6? Where are we in terms of our understanding of what you’re trying to[do] – are we still in the era of stone knives and bearskins?

[Laughter] No, we’re not. We’re making tremendous headway. I think it was a remarkable study done on Scott and Mark Kelly, the astronauts, where they compared Scott – these are identical twins – who was out in space at the International Space Station, and every one of these things we just discussed, every layer, was essentially defined: the deepest phenotyping, what we call it, of human beings in history and then the analysis of what was the hit of being in space for a year on Scott, and it was quite a bit of effect on genes, chromosomes, and on his cognition, a significant impairment. We can do this now. We haven’t done it at scale.

We probably now have done genome sequences of a million or so people, but it’s just starting to come together. To answer your question, Byron, we can do each of these. We can do an in-depth probe of a person’s gut microbiome. We can understand things that we never could before. Integrating it all for each human being is another task that is going to require AI because no human being can assimilate all this data.

Yeah I always wonder, will these systems give us more understanding of how things work? Hear me out here because I think about the antidepressant Wellbutrin, which while it was being studied, some people remarked, “You know, I don’t seem to crave smoking as much.” They’re like, really? They do studies and they say “Wow, this is really good for smoking cessation. Let’s call it Zyban and sell it.”

It’s more like we get things out of the data that we don’t necessarily understand, but is it necessarily important that we understand them? We just need to know that it works. We don’t know necessarily how an aspirin stops pain but it’s enough to know that it does, and it doesn’t seem to have terrible side effects. Do you think these sorts of systems are giving us true understanding at a systems level of what a human being is, or are they giving us just a high degree of predictive ability?

Well, there isn’t one simple answer. It depends on the particular focus. In some areas, we’re making significant progress across the board; in others, we’re still at a pretty rudimentary state.

The one thing people are always curious about, of course, is longevity. While the number of people that make it to 100 – the percent of people that make it to 100 goes up every year, the number of people who make it to 125 is stuck at zero forever, seemingly so far. Do you think the kinds of technology you’re studying are going to let us – and I’m not even talking about “curing death” but just break past 125 or 150 for a few people?

It’s possible. I mean, I’m somewhat skeptical about the ability for the science of aging to have a measurable impact on extending lifespan. I don’t know if there are a lot of people who are optimistic that we’ll be able to change that ceiling that you refer to (of 120) and increase the number of people who are centenarians and beyond. That’s really being pursued, but it’s speculative. We are understanding the aging process, that science, far better than ever before and there’s lots of ideas that are being pursued. So far, I don’t see anything that is really making any substantive difference.

Yeah because it always seems like if you ask the people that live a really long time, “Why did you live a long time?” they always have something like, I ate a stick of butter every night, or something that’s completely counter-intuitive.

Yeah we’ve seen that. We’ve had people swear that it was the Twinkies that did it. We have a big elderly program of people who are 85 average, 90 but 85 and above who’ve never been sick, and we’ve had people in that cohort that smoked two packs of cigarettes a day still at age 99. There are some genetic underpinnings that allow people, without any drugs, environmental effects, and things that we don’t understand yet, that give a Teflon coating for some people, not just for lifespan but I think most people would agree it’s actually ‘health span,’ the number of years you can extend where a person is perfectly healthy without any significant chronic conditions. That’s the real goal, not just to be able to say you lived to some ripe old age but you had many different serious conditions including impairment of your cognition.

Listen to this episode or read the full transcript at www.VoicesinAI.com

Byron explores issues around artificial intelligence and conscious computers in his new book The Fourth Age: Smart Robots, Conscious Computers, and the Future of Humanity.

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