Ada 2020 brings personalised healthcare a step closer With medical information accessible at the touch of a button, researchers are looking to harness the power of technology to help diagnose disease accurately and efficiently. Dr Martin Hirsch tells us about the work of the Ada2020 project in developing a decision support tool, research which could help reduce the costs of healthcare A GP may be presented with a wide variety of cases during the course of the working day, encompassing everything from the common cold through to more exotic diseases. As GPs tend to act as the first point of contact in healthcare systems, they are often responsible for the initial diagnosis, yet this can be difficult, particularly when a patient presents with quite unusual symptoms. “A doctor cannot reasonably be expected to keep 8,000 rare diseases in mind,” points out Dr Martin Hirsch. Based at Ada Health in Berlin, Dr Hirsch is the Principal Investigator of the Ada2020 project, an EU-funded initiative developing a visual reasoning tool called Ada for both medical professionals and the general public. “We integrated data about rare diseases into the tool and we enabled doctors to take rare diseases into consideration in diagnosis,” he says. The majority of GPs only have a few minutes with each patient however, so in many cases they focus more on alleviating the symptoms than precisely diagnosing the condition, while specialists are also under significant time pressures. It’s often the patients themselves and university hospitals who take the time to accurately diagnose a disease, so Dr Hirsch and his colleagues in the project differentiated the software accordingly. “We developed a patient version on the one hand, and an expert version on the other,” he explains. The expert version can cooperate with the patient version, an approach which is designed to help support diagnostic decision-making and train the system to grow more intelligent. “We aim to produce a decision support system that helps patients better understand their health. Then they can send over the assessment to a doctor, who has more options in their part of the tool, and they can closely work together,” says Dr Hirsch. 36
Probabilistic Reasoning At the core of the software is a probabilistic reasoning engine that works in concert with a medical knowledge base that includes detailed information about the relationship between specific symptoms and disease. The data required for the visual reasoning tool are the symptoms, the diseases and the probabilistic relationship between these two. “If you have this symptom, how probable is this disease? And if you have
Researchers at Ada in Berlin have addressed this by adding another layer in the tool to augment this approach, looking at the pathological state in the body which lies behind the symptoms of a disease. This allows researchers to identify which symptoms are not independent of each other, while Dr Hirsch says it also brings other benefits. “We will show that this improved approach has a much higher level of diagnostic accuracy than previous methods,”
We aim to produce a decision support system that gives patients access to earlier, more relevant health information. Then they can send over the assessment to a doctor, who has more options in their part of the tool, and they can closely work together to focus on outcomes and prevention this disease, how probable is this symptom?” outlines Dr Hirsch. While Ada’s approach is based on the best available methodologies for modelling this relationship, Dr Hirsch says these still do have some shortcomings. “The basic assumption with most current approaches is that the observables are independent of each other. However, in diseases, the observables – the symptoms – are not always in fact independent of each other,” he explains.
he explains. With more information about the underlying causes of symptoms, the tool can also take the time course of a disease and masking-effects of chronic medication into consideration and can be used to identify the most effective course of treatment. “We will be able to make assessments and give advice regarding treatment in a very personalised way,” continues Dr Hirsch. This approach could help improve efficiency in the healthcare system. It is
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