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Can AI help in addressing challenge of lack of doctors for cancer care in India?

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As we increasingly see technology playing a dominant role in our life, we are also faced with the question: to what extent can technology actually replace experts or humans? Today, there is no industry more benefited by artificial intelligence (AI) and technology than healthcare. Technology has introduced new surgical interventions, precision robotic surgeries and new therapy areas which have reduced recovery time and significantly improved patient experience. Additionally, artificial intelligence is also being used to drive business operations, standardise quality of service delivery, patient engagement and maintenance of patient and disease records.

Today, with the help of AI and machines, clinicians can unearth the hidden patterns, trends, and correlations. However, once the machines are programmed to function, they can perform far better than humans. While doctors prescribe medical care based on intuition, experience and predictions, AI analyses the data structure, symptoms and patient records to help make an informed decision and minimize the risk.

If we examine the area of cancer treatment and care, till 2018 there were nearly 1.2 million new cancer cases diagnosed per year in the country and this is expected to rise further in the next few years. India has only one oncologist for 1,600 patients, compared to one for 100 patients in the US, and hence faces an acute shortage of expertise. With the rise in non-communicable diseases in the last few years in India, we have seen an increase in the number of cancer patients but with fewer oncologists or specialists to diagnose and treat them. Looking at the broad geographic footprint and the rapid increase in scientific and clinical knowledge about care, physicians in India face a very challenging time in staying up-to-date about best practices in treatment and cancer care management. AI-based systems such as IBM’s Watson can search through millions of pages of data, read countless medical articles, and far exceed the capacity of any human physician in its breadth and scale of knowledge.

In cancer treatment, AI has enabled precision medicine which seeks to tailor medical treatment to the individual characteristics of a patient. This has transformed the delivery of medical care by enabling oncologists to identify which genetic mutations drive certain cancers and sequence our microbiome. It is also assisting in assessing cancer risk. Doctors canpre-empt their patients with the results and work on a long-term plan of patient care.

In terms of predictive analytics and image recognition also in cancer diagnosis, AI may soon become more effective than doctors themselves, in handling millions of images in any reasonable timeframe & interpreting even the most complex clinical images as accurately as today’s most experienced radiologists. AI can also predict or analyse cancer trends among a population or setting through patient records.

However, things are not as rosy as it seems. The harsh reality is AI or any technology cannot engage in high-level conversations or interactions with patients to gain their trust, reassure them, or express empathy. This is basis of human medicine. AI may have exceeded the efficiency of doctors but what it cannot ever replace is the human touch and compassion that doctors provide to the patient. Clinical examination cannot be replaced in the treatment of patients. Physicians are still needed for this traditional physical exams, counselling, patient-physician interaction, critical thinking & interpretation in ambiguous and challenging cases. Cancer support groups provide the kind of attention to issues which patients feel difficult even to express to their doctors.In addition, AI-based systems are based on precedence and they tend to underperform in novel or unusual cases where there is no prior example to build on. In short, AI cannot replace the exemplary work done by doctors.

It can therefore be concluded thatAI-based systems can support the skills of oncologists and general practitioners but are unlikely to replace the traditional physician–patient relationship. It will become a routine part of a clinician’s daily lives, making her/his work more efficient, accurate, and valuable. AI can augment physicians by taking over the routine aspects of their work, enabling the specialist to spend more precious time with their patients, improving the human touch. It is incumbent on medical professionals to learn both the fundamentals of AI technology as well as how AI-based solutions can help them at work in providing better outcomes to their patients.

(Disclaimer: The writer is Dr Suman Karanth, Consultant, Medical Oncology, Fortis Memorial Research Institute (FMRI). Views expressed are a personal opinion.)

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