Ada 2020

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.

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

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.

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,”

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

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

estimated that around 45 percent of GP visits could be handled more efficiently via other means; Dr Hirsch and his colleagues are looking to use their tools to give GPs more precise information about specific cases in an even more efficient way. “We’re testing a new approach where we say; ‘ok, let’s try to make a pre-assessment with our software, with a chat-bot’. The chat-bot takes all the time necessary to interview the patient, drawing on the knowledge of cases in the system,” he explains. A GP might not have the time to devote this level of attention to each case, but with a reasoning tool, they can get the key information more efficiently and then decide on the next steps. “The results of the pre-assessment can be handed on to a specialist doctor, and they can look at it in their professional environment,” says Dr Hirsch.

There has been a lot of interest in this tool from GPs, while Dr Hirsch is also keen to widen access to the software, and ultimately put Ada in the pockets of more individual users. With the costs of healthcare rising, in line with demographic pressures, Dr Hirsch believes that empowering patients is key to improving efficiency and adapting healthcare systems to modern demands. “We decided to empower patients and give them tools,” he outlines. This is part of a wider trend; with vast amounts of medical data now available online, the patient-doctor relationship has fundamentally changed. “Patients in future will be empowered by artificial intelligence, by mobile sensors, by lab tests that are delivered directly to them. They will then ask doctors to discuss the case with them, and to make the correct prescriptions,” continues Dr Hirsch.

The app so far has proved popular in App stores across the globe, with over 1 million health assessments generated, and in some cases it has been credited with prompting users to seek immediate medical attention. On the expert side, a pilot study has been established in the department for rare diseases at Hannover University Hospital, which is designed to give medical professionals access to more information. “Sometimes it takes Doctors weeks, even months, to get to the right diagnosis,” explains Dr. Hirsch. Information about comparable previous cases is invaluable in these circumstances. “Doctors want to be able to feed their experience into a system so that their colleagues with similar cases are informed,” says Dr Hirsch. “We’ve now added a ‘share cases’ functionality, so that experts can publish and share information about their cases using this tool.”

Full Project Title

Ada2020 Visual Reasoning Support for Healthcare Professionals

Project Objectives

Ada has developed a unique visual reasoning tool for medical professionals that offers diagnosis decision support at the point of care. It’s award-winning user-interface is designed to structure the patient consultation in a more efficient way, providing physicians with earlier, more comprehensive health information and helping them assess more complex medical conditions. Developed over six years of fundamental research in reasoning, medical diagnosis and artificial intelligence, Ada captures the knowledge of medical experts in a sophisticated reasoning engine that continues to learn from new inputs and multiple closed feedback loops. The Ada2020 project matched its original purpose and went beyond, creating a new model of medical reasoning that will enable doctors and medical researchers to detect and understand individual conditions on a whole new level.

Project Funding

This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 674459. EU contribution: EUR 2 408 315,00.

Contact Details

Dr Martin Hirsch ADA HEALTH GMBH Adalbertstraße 20, 10997 Berlin, Germany W: https://ada.com/ada2020

https://itunes.apple.com/au/app/ada-personalhealth-companion/id1099986434?mt=8

Dr Martin Hirsch

Dr Martin Hirsch grew up in a family of scientists, and is a grandson of the celebrated Nobel Laureate Werner Heisenberg. He studied theoretical medicine before working as an independent researcher. His special interests include cognitive neuroscience, semantic knowledge representation and the use of technology to support human thinking and decision-making.