Computer Aided Oncology Conference

Every week I go to a few conferences in which cancer cases are discussed.  Oncology, the branch of medicine that treats cancer, is a very active area.  Developments are reported daily.  The rate of clinically important discovery is accelerating.  

I have a good memory, evidenced by my performance in medical school  and  National Boards exams.   But my computer remembers much better than I can.  It never forgets anything. My computer can access the world's medical literature in seconds.  It can translate papers from Chinese.  It can give me the most recently updated recommendations from the NCCN, or the BC Cancer Agency, or the UpToDate  online textbook instantly.  That is why I come to conference armed with my computer linked into the internet.   

 The continuous improvement in computer intellectual power is demonstrated by their relentless ascendancy in high level games.  Chess, Jeopardy and Go are contests in which  complex decision processes are tested and demonstrated.   In 1997, Garry Kasparov lost the world chess champion to a computer,  IBM’s Deep Blue.   It was predictable that the machine would, eventually, win.  IBM's Watson became the greatest of Jeopardy champions. Google’s AlphaGo  is sweeping the Go world.  All of these games, whose masters have extraordinary talents and abilities, are yielding to the machine.  The machine has qualities that no human will ever be able to match... unassisted. 

The machine never forgets. The machine can search its memory, most of the world's knowledge, with lightning rapidity.  It can carry out algorithms at near light speed. The puny, slow moving human memory is no match. 

But humans have qualities that the machine cannot (yet) replicate.  The human has sensitivities, shared in a multifaceted and spectral way, with other humans.  There are ways in which we understand each other that a silicon processor cannot.  It could, possibly, be programmed to mimic the human responses to emotion, but it cannot feel empathy. 

When I bring my computer to conference, I add to the machine.  I tell it what to look up.  I define the search parameters.  Having done this for more than 25 years, I can do it rapidly and well.  It is an art that incorporates a level of speculation about how biological processes might be related.  It also involves a (reasonable) expectation that someone else has had the same question and it has been written about.  

I then decide which articles are truly relevant and estimate the validity of the information.  Even a human brain can do all this in less than two minutes.  I think it works out well.  That is why I continue to do it and encourage others to try it, and improve upon it. 

 The machine is spectacular in the things it can do.  The doctor adds human qualities and direction to that instantly accessible, vast, and reliable knowledge base.  No person can beat the machine in its tasks, but the combination of the human and the machine remains (for the foreseeable future) the best solution, better than the machine alone. 

The presentation of the patient's case at conference and sharing of experiences and opinion  is critically important.  It forces an organized and clear presentation. All the data (pathology, imaging, etc.) is open for inspection and scrutiny. Sometimes, carefully considered human analysis  prevails over all the data.  

  Better data can help create better opinions.

  Let’s improve.