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      Deep-learning technique predicts clinical treatment outcomes

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      When it comes to treatment strategies for critically ill patients, clinicians want to be able to consider all their options and timing of administration, and make the optimal decision for their patients. While clinician experience and study has helped them to be successful in this effort, not all patients are the same, and treatment decisions at this crucial time could mean the difference between patient improvement and quick deterioration. Therefore, it would be helpful for doctors to be able to take a patient’s previous known health status and received treatments and use that to predict that patient’s health outcome under different treatment scenarios, in order to pick the best path.

      Now, a deep-learning technique, called G-Net, from researchers at MIT and IBM provides a window into causal counterfactual prediction, affording physicians the opportunity to explore how a patient might fare under different treatment plans. The foundation of G-Net is the g-computation algorithm, a causal inference method that estimates the effect of dynamic exposures in the presence of measured confounding variables — ones that may influence both treatments and outcomes. Unlike previous implementations of the g-computation framework, which have used linear modeling approaches, G-Net uses recurrent neural networks (RNN), which have node connections that allow them to better model temporal sequences with complex and nonlinear dynamics, like those found in the physiological and clinical time series data. In this way, physicians can develop alternative plans based on patient history and test them before making a decision.

      “Our ultimate goal is to develop a machine learning technique that would allow doctors to explore various ‘What if’ scenarios and treatment options,” says Li-wei Lehman, MIT research scientist in the MIT Institute for Medical Engineering and Science and an MIT-IBM Watson AI Lab project lead. “A lot of work has been done in terms of deep learning for counterfactual prediction but [it’s] been focusing on a point exposure setting,” or a static, time-varying treatment strategy, which doesn’t allow for adjustment of treatments as patient history changes. However, her team’s new prediction approach provides for treatment plan flexibility and chances for treatment alteration over time as patient covariate history and past treatments change. “G-Net is the first deep-learning approach based on g-computation that can predict both the population-level and individual-level treatment effects under dynamic and time varying treatment strategies.”

      The research, which was recently published in the Proceedings of Machine Learning Research, was co-authored by Rui Li MEng ’20, Stephanie Hu MEng ’21, former MIT postdoc Mingyu Lu MD, graduate student Yuria Utsumi, IBM research staff member Prithwish Chakraborty, IBM Research director of Hybrid Cloud Services Daby Sow, IBM data scientist Piyush Madan, IBM research scientist Mohamed Ghalwash, and IBM research scientist Zach Shahn.

      Tracking disease progression

      To build, validate, and test G-Net’s predictive abilities, the researchers considered the circulatory system in septic patients in the ICU. During critical care, doctors need to make trade-offs and judgement calls, such as ensuring the organs are receiving adequate blood supply without overworking the heart. For this, they could give intravenous fluids to patients to increase blood pressure; however, too much can cause edema. Alternatively, physicians can administer vasopressors, which act to contract blood vessels and raise blood pressure.

      In order to mimic this and demonstrate G-Net’s proof-of-concept, the team used CVSim, a mechanistic model of a human cardiovascular system that’s governed by 28 input variables characterizing the system’s current state, such as arterial pressure, central venous pressure, total blood volume, and total peripheral resistance, and modified it to simulate various disease processes (e.g., sepsis or blood loss) and effects of interventions (e.g., fluids and vasopressors). The researchers used CVSim to generate observational patient data for training and for “ground truth” comparison against counterfactual prediction. In their G-Net architecture, the researchers ran two RNNs to handle and predict variables that are continuous, meaning they can take on a range of values, like blood pressure, and categorical variables, which have discrete values, like the presence or absence of pulmonary edema. The researchers simulated the health trajectories of thousands of “patients” exhibiting symptoms under one treatment regime, let’s say A, for 66 timesteps, and used them to train and validate their model.

      Testing G-Net’s prediction capability, the team generated two counterfactual datasets. Each contained roughly 1,000 known patient health trajectories, which were created from CVSim using the same “patient” condition as the starting point under treatment A. Then at timestep 33, treatment changed to plan B or C, depending on the dataset. The team then performed 100 prediction trajectories for each of these 1,000 patients, whose treatment and medical history was known up until timestep 33 when a new treatment was administered. In these cases, the prediction agreed well with the “ground-truth” observations for individual patients and averaged population-level trajectories.

      A cut above the rest

      Since the g-computation framework is flexible, the researchers wanted to examine G-Net’s prediction using different nonlinear models — in this case, long short-term memory (LSTM) models, which are a type of RNN that can learn from previous data patterns or sequences — against the more classical linear models and a multilayer perception model (MLP), a type of neural network that can make predictions using a nonlinear approach. Following a similar setup as before, the team found that the error between the known and predicted cases was smallest in the LSTM models compared to the others. Since G-Net is able to model the temporal patterns of the patient’s ICU history and past treatment, whereas a linear model and MLP cannot, it was better able to predict the patient’s outcome.

      The team also compared G-Net’s prediction in a static, time-varying treatment setting against two state-of-the-art deep-learning based counterfactual prediction approaches, a recurrent marginal structural network (rMSN) and a counterfactual recurrent neural network (CRN), as well as a linear model and an MLP. For this, they investigated a model for tumor growth under no treatment, radiation, chemotherapy, and both radiation and chemotherapy scenarios. “Imagine a scenario where there’s a patient with cancer, and an example of a static regime would be if you only give a fixed dosage of chemotherapy, radiation, or any kind of drug, and wait until the end of your trajectory,” comments Lu. For these investigations, the researchers generated simulated observational data using tumor volume as the primary influence dictating treatment plans and demonstrated that G-Net outperformed the other models. One potential reason could be because g-computation is known to be more statistically efficient than rMSN and CRN, when models are correctly specified.

      While G-Net has done well with simulated data, more needs to be done before it can be applied to real patients. Since neural networks can be thought of as “black boxes” for prediction results, the researchers are beginning to investigate the uncertainty in the model to help ensure safety. In contrast to these approaches that recommend an “optimal” treatment plan without any clinician involvement, “as a decision support tool, I believe that G-Net would be more interpretable, since the clinicians would input treatment strategies themselves,” says Lehman, and “G-Net will allow them to be able to explore different hypotheses.” Further, the team has moved on to using real data from ICU patients with sepsis, bringing it one step closer to implementation in hospitals.

      “I think it is pretty important and exciting for real-world applications,” says Hu. “It’d be helpful to have some way to predict whether or not a treatment might work or what the effects might be — a quicker iteration process for developing these hypotheses for what to try, before actually trying to implement them in in a years-long, potentially very involved and very invasive type of clinical trial.”

      This research was funded by the MIT-IBM Watson AI Lab. More

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      The downside of machine learning in health care

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      While working toward her dissertation in computer science at MIT, Marzyeh Ghassemi wrote several papers on how machine-learning techniques from artificial intelligence could be applied to clinical data in order to predict patient outcomes. “It wasn’t until the end of my PhD work that one of my committee members asked: ‘Did you ever check to see how well your model worked across different groups of people?’”

      That question was eye-opening for Ghassemi, who had previously assessed the performance of models in aggregate, across all patients. Upon a closer look, she saw that models often worked differently — specifically worse — for populations including Black women, a revelation that took her by surprise. “I hadn’t made the connection beforehand that health disparities would translate directly to model disparities,” she says. “And given that I am a visible minority woman-identifying computer scientist at MIT, I am reasonably certain that many others weren’t aware of this either.”

      In a paper published Jan. 14 in the journal Patterns, Ghassemi — who earned her doctorate in 2017 and is now an assistant professor in the Department of Electrical Engineering and Computer Science and the MIT Institute for Medical Engineering and Science (IMES) — and her coauthor, Elaine Okanyene Nsoesie of Boston University, offer a cautionary note about the prospects for AI in medicine. “If used carefully, this technology could improve performance in health care and potentially reduce inequities,” Ghassemi says. “But if we’re not actually careful, technology could worsen care.”

      It all comes down to data, given that the AI tools in question train themselves by processing and analyzing vast quantities of data. But the data they are given are produced by humans, who are fallible and whose judgments may be clouded by the fact that they interact differently with patients depending on their age, gender, and race, without even knowing it.

      Furthermore, there is still great uncertainty about medical conditions themselves. “Doctors trained at the same medical school for 10 years can, and often do, disagree about a patient’s diagnosis,” Ghassemi says. That’s different from the applications where existing machine-learning algorithms excel — like object-recognition tasks — because practically everyone in the world will agree that a dog is, in fact, a dog.

      Machine-learning algorithms have also fared well in mastering games like chess and Go, where both the rules and the “win conditions” are clearly defined. Physicians, however, don’t always concur on the rules for treating patients, and even the win condition of being “healthy” is not widely agreed upon. “Doctors know what it means to be sick,” Ghassemi explains, “and we have the most data for people when they are sickest. But we don’t get much data from people when they are healthy because they’re less likely to see doctors then.”

      Even mechanical devices can contribute to flawed data and disparities in treatment. Pulse oximeters, for example, which have been calibrated predominately on light-skinned individuals, do not accurately measure blood oxygen levels for people with darker skin. And these deficiencies are most acute when oxygen levels are low — precisely when accurate readings are most urgent. Similarly, women face increased risks during “metal-on-metal” hip replacements, Ghassemi and Nsoesie write, “due in part to anatomic differences that aren’t taken into account in implant design.” Facts like these could be buried within the data fed to computer models whose output will be undermined as a result.

      Coming from computers, the product of machine-learning algorithms offers “the sheen of objectivity,” according to Ghassemi. But that can be deceptive and dangerous, because it’s harder to ferret out the faulty data supplied en masse to a computer than it is to discount the recommendations of a single possibly inept (and maybe even racist) doctor. “The problem is not machine learning itself,” she insists. “It’s people. Human caregivers generate bad data sometimes because they are not perfect.”

      Nevertheless, she still believes that machine learning can offer benefits in health care in terms of more efficient and fairer recommendations and practices. One key to realizing the promise of machine learning in health care is to improve the quality of data, which is no easy task. “Imagine if we could take data from doctors that have the best performance and share that with other doctors that have less training and experience,” Ghassemi says. “We really need to collect this data and audit it.”

      The challenge here is that the collection of data is not incentivized or rewarded, she notes. “It’s not easy to get a grant for that, or ask students to spend time on it. And data providers might say, ‘Why should I give my data out for free when I can sell it to a company for millions?’ But researchers should be able to access data without having to deal with questions like: ‘What paper will I get my name on in exchange for giving you access to data that sits at my institution?’

      “The only way to get better health care is to get better data,” Ghassemi says, “and the only way to get better data is to incentivize its release.”

      It’s not only a question of collecting data. There’s also the matter of who will collect it and vet it. Ghassemi recommends assembling diverse groups of researchers — clinicians, statisticians, medical ethicists, and computer scientists — to first gather diverse patient data and then “focus on developing fair and equitable improvements in health care that can be deployed in not just one advanced medical setting, but in a wide range of medical settings.”

      The objective of the Patterns paper is not to discourage technologists from bringing their expertise in machine learning to the medical world, she says. “They just need to be cognizant of the gaps that appear in treatment and other complexities that ought to be considered before giving their stamp of approval to a particular computer model.” More

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      When should someone trust an AI assistant’s predictions?

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      In a busy hospital, a radiologist is using an artificial intelligence system to help her diagnose medical conditions based on patients’ X-ray images. Using the AI system can help her make faster diagnoses, but how does she know when to trust the AI’s predictions?

      She doesn’t. Instead, she may rely on her expertise, a confidence level provided by the system itself, or an explanation of how the algorithm made its prediction — which may look convincing but still be wrong — to make an estimation.

      To help people better understand when to trust an AI “teammate,” MIT researchers created an onboarding technique that guides humans to develop a more accurate understanding of those situations in which a machine makes correct predictions and those in which it makes incorrect predictions.

      By showing people how the AI complements their abilities, the training technique could help humans make better decisions or come to conclusions faster when working with AI agents.

      “We propose a teaching phase where we gradually introduce the human to this AI model so they can, for themselves, see its weaknesses and strengths,” says Hussein Mozannar, a graduate student in the Social and Engineering Systems doctoral program within the Institute for Data, Systems, and Society (IDSS) who is also a researcher with the Clinical Machine Learning Group of the Computer Science and Artificial Intelligence Laboratory (CSAIL) and the Institute for Medical Engineering and Science. “We do this by mimicking the way the human will interact with the AI in practice, but we intervene to give them feedback to help them understand each interaction they are making with the AI.”

      Mozannar wrote the paper with Arvind Satyanarayan, an assistant professor of computer science who leads the Visualization Group in CSAIL; and senior author David Sontag, an associate professor of electrical engineering and computer science at MIT and leader of the Clinical Machine Learning Group. The research will be presented at the Association for the Advancement of Artificial Intelligence in February.

      Mental models

      This work focuses on the mental models humans build about others. If the radiologist is not sure about a case, she may ask a colleague who is an expert in a certain area. From past experience and her knowledge of this colleague, she has a mental model of his strengths and weaknesses that she uses to assess his advice.

      Humans build the same kinds of mental models when they interact with AI agents, so it is important those models are accurate, Mozannar says. Cognitive science suggests that humans make decisions for complex tasks by remembering past interactions and experiences. So, the researchers designed an onboarding process that provides representative examples of the human and AI working together, which serve as reference points the human can draw on in the future. They began by creating an algorithm that can identify examples that will best teach the human about the AI.

      “We first learn a human expert’s biases and strengths, using observations of their past decisions unguided by AI,” Mozannar says. “We combine our knowledge about the human with what we know about the AI to see where it will be helpful for the human to rely on the AI. Then we obtain cases where we know the human should rely on the AI and similar cases where the human should not rely on the AI.”

      The researchers tested their onboarding technique on a passage-based question answering task: The user receives a written passage and a question whose answer is contained in the passage. The user then has to answer the question and can click a button to “let the AI answer.” The user can’t see the AI answer in advance, however, requiring them to rely on their mental model of the AI. The onboarding process they developed begins by showing these examples to the user, who tries to make a prediction with the help of the AI system. The human may be right or wrong, and the AI may be right or wrong, but in either case, after solving the example, the user sees the correct answer and an explanation for why the AI chose its prediction. To help the user generalize from the example, two contrasting examples are shown that explain why the AI got it right or wrong.

      For instance, perhaps the training question asks which of two plants is native to more continents, based on a convoluted paragraph from a botany textbook. The human can answer on her own or let the AI system answer. Then, she sees two follow-up examples that help her get a better sense of the AI’s abilities. Perhaps the AI is wrong on a follow-up question about fruits but right on a question about geology. In each example, the words the system used to make its prediction are highlighted. Seeing the highlighted words helps the human understand the limits of the AI agent, explains Mozannar.

      To help the user retain what they have learned, the user then writes down the rule she infers from this teaching example, such as “This AI is not good at predicting flowers.” She can then refer to these rules later when working with the agent in practice. These rules also constitute a formalization of the user’s mental model of the AI.

      The impact of teaching

      The researchers tested this teaching technique with three groups of participants. One group went through the entire onboarding technique, another group did not receive the follow-up comparison examples, and the baseline group didn’t receive any teaching but could see the AI’s answer in advance.

      “The participants who received teaching did just as well as the participants who didn’t receive teaching but could see the AI’s answer. So, the conclusion there is they are able to simulate the AI’s answer as well as if they had seen it,” Mozannar says.

      The researchers dug deeper into the data to see the rules individual participants wrote. They found that almost 50 percent of the people who received training wrote accurate lessons of the AI’s abilities. Those who had accurate lessons were right on 63 percent of the examples, whereas those who didn’t have accurate lessons were right on 54 percent. And those who didn’t receive teaching but could see the AI answers were right on 57 percent of the questions.

      “When teaching is successful, it has a significant impact. That is the takeaway here. When we are able to teach participants effectively, they are able to do better than if you actually gave them the answer,” he says.

      But the results also show there is still a gap. Only 50 percent of those who were trained built accurate mental models of the AI, and even those who did were only right 63 percent of the time. Even though they learned accurate lessons, they didn’t always follow their own rules, Mozannar says.

      That is one question that leaves the researchers scratching their heads — even if people know the AI should be right, why won’t they listen to their own mental model? They want to explore this question in the future, as well as refine the onboarding process to reduce the amount of time it takes. They are also interested in running user studies with more complex AI models, particularly in health care settings.

      “When humans collaborate with other humans, we rely heavily on knowing what our collaborators’ strengths and weaknesses are — it helps us know when (and when not) to lean on the other person for assistance. I’m glad to see this research applying that principle to humans and AI,” says Carrie Cai, a staff research scientist in the People + AI Research and Responsible AI groups at Google, who was not involved with this research. “Teaching users about an AI’s strengths and weaknesses is essential to producing positive human-AI joint outcomes.” 

      This research was supported, in part, by the National Science Foundation. More

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      The promise and pitfalls of artificial intelligence explored at TEDxMIT event

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      Scientists, students, and community members came together last month to discuss the promise and pitfalls of artificial intelligence at MIT’s Computer Science and Artificial Intelligence Laboratory (CSAIL) for the fourth TEDxMIT event held at MIT. 

      Attendees were entertained and challenged as they explored “the good and bad of computing,” explained CSAIL Director Professor Daniela Rus, who organized the event with John Werner, an MIT fellow and managing director of Link Ventures; MIT sophomore Lucy Zhao; and grad student Jessica Karaguesian. “As you listen to the talks today,” Rus told the audience, “consider how our world is made better by AI, and also our intrinsic responsibilities for ensuring that the technology is deployed for the greater good.”

      Rus mentioned some new capabilities that could be enabled by AI: an automated personal assistant that could monitor your sleep phases and wake you at the optimal time, as well as on-body sensors that monitor everything from your posture to your digestive system. “Intelligent assistance can help empower and augment our lives. But these intriguing possibilities should only be pursued if we can simultaneously resolve the challenges that these technologies bring,” said Rus. 

      The next speaker, CSAIL principal investigator and professor of electrical engineering and computer science Manolis Kellis, started off by suggesting what sounded like an unattainable goal — using AI to “put an end to evolution as we know it.” Looking at it from a computer science perspective, he said, what we call evolution is basically a brute force search. “You’re just exploring all of the search space, creating billions of copies of every one of your programs, and just letting them fight against each other. This is just brutal. And it’s also completely slow. It took us billions of years to get here.” Might it be possible, he asked, to speed up evolution and make it less messy?

      The answer, Kellis said, is that we can do better, and that we’re already doing better: “We’re not killing people like Sparta used to, throwing the weaklings off the mountain. We are truly saving diversity.”

      Knowledge, moreover, is now being widely shared, passed on “horizontally” through accessible information sources, he noted, rather than “vertically,” from parent to offspring. “I would like to argue that competition in the human species has been replaced by collaboration. Despite having a fixed cognitive hardware, we have software upgrades that are enabled by culture, by the 20 years that our children spend in school to fill their brains with everything that humanity has learned, regardless of which family came up with it. This is the secret of our great acceleration” — the fact that human advancement in recent centuries has vastly out-clipped evolution’s sluggish pace.

      The next step, Kellis said, is to harness insights about evolution in order to combat an individual’s genetic susceptibility to disease. “Our current approach is simply insufficient,” he added. “We’re treating manifestations of disease, not the causes of disease.” A key element in his lab’s ambitious strategy to transform medicine is to identify “the causal pathways through which genetic predisposition manifests. It’s only by understanding these pathways that we can truly manipulate disease causation and reverse the disease circuitry.” 

      Kellis was followed by Aleksander Madry, MIT professor of electrical engineering and computer science and CSAIL principal investigator, who told the crowd, “progress in AI is happening, and it’s happening fast.” Computer programs can routinely beat humans in games like chess, poker, and Go. So should we be worried about AI surpassing humans? 

      Madry, for one, is not afraid — or at least not yet. And some of that reassurance stems from research that has led him to the following conclusion: Despite its considerable success, AI, especially in the form of machine learning, is lazy. “Think about being lazy as this kind of smart student who doesn’t really want to study for an exam. Instead, what he does is just study all the past years’ exams and just look for patterns. Instead of trying to actually learn, he just tries to pass the test. And this is exactly the same way in which current AI is lazy.”

      A machine-learning model might recognize grazing sheep, for instance, simply by picking out pictures that have green grass in them. If a model is trained to identify fish from photos of anglers proudly displaying their catches, Madry explained, “the model figures out that if there’s a human holding something in the picture, I will just classify it as a fish.” The consequences can be more serious for an AI model intended to pick out malignant tumors. If the model is trained on images containing rulers that indicate the size of tumors, the model may end up selecting only those photos that have rulers in them.

      This leads to Madry’s biggest concerns about AI in its present form. “AI is beating us now,” he noted. “But the way it does it [involves] a little bit of cheating.” He fears that we will apply AI “in some way in which this mismatch between what the model actually does versus what we think it does will have some catastrophic consequences.” People relying on AI, especially in potentially life-or-death situations, need to be much more mindful of its current limitations, Madry cautioned.

      There were 10 speakers altogether, and the last to take the stage was MIT associate professor of electrical engineering and computer science and CSAIL principal investigator Marzyeh Ghassemi, who laid out her vision for how AI could best contribute to general health and well-being. But in order for that to happen, its models must be trained on accurate, diverse, and unbiased medical data.

      It’s important to focus on the data, Ghassemi stressed, because these models are learning from us. “Since our data is human-generated … a neural network is learning how to practice from a doctor. But doctors are human, and humans make mistakes. And if a human makes a mistake, and we train an AI from that, the AI will, too. Garbage in, garbage out. But it’s not like the garbage is distributed equally.”

      She pointed out that many subgroups receive worse care from medical practitioners, and members of these subgroups die from certain conditions at disproportionately high rates. This is an area, Ghassemi said, “where AI can actually help. This is something we can fix.” Her group is developing machine-learning models that are robust, private, and fair. What’s holding them back is neither algorithms nor GPUs. It’s data. Once we collect reliable data from diverse sources, Ghassemi added, we might start reaping the benefits that AI can bring to the realm of health care.

      In addition to CSAIL speakers, there were talks from members across MIT’s Institute for Data, Systems, and Society; the MIT Mobility Initiative; the MIT Media Lab; and the SENSEable City Lab.

      The proceedings concluded on that hopeful note. Rus and Werner then thanked everyone for coming. “Please continue to reflect about the good and bad of computing,” Rus urged. “And we look forward to seeing you back here in May for the next TEDxMIT event.”

      The exact theme of the spring 2022 gathering will have something to do with “superpowers.” But — if December’s mind-bending presentations were any indication — the May offering is almost certain to give its attendees plenty to think about. And maybe provide the inspiration for a startup or two. More

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      Meet the 2021-22 Accenture Fellows

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      Launched in October of 2020, the MIT and Accenture Convergence Initiative for Industry and Technology underscores the ways in which industry and technology come together to spur innovation. The five-year initiative aims to achieve its mission through research, education, and fellowships. To that end, Accenture has once again awarded five annual fellowships to MIT graduate students working on research in industry and technology convergence who are underrepresented, including by race, ethnicity, and gender.

      This year’s Accenture Fellows work across disciplines including robotics, manufacturing, artificial intelligence, and biomedicine. Their research covers a wide array of subjects, including: advancing manufacturing through computational design, with the potential to benefit global vaccine production; designing low-energy robotics for both consumer electronics and the aerospace industry; developing robotics and machine learning systems that may aid the elderly in their homes; and creating ingestible biomedical devices that can help gather medical data from inside a patient’s body.

      Student nominations from each unit within the School of Engineering, as well as from the four other MIT schools and the MIT Schwarzman College of Computing, were invited as part of the application process. Five exceptional students were selected as fellows in the initiative’s second year.

      Xinming (Lily) Liu is a PhD student in operations research at MIT Sloan School of Management. Her work is focused on behavioral and data-driven operations for social good, incorporating human behaviors into traditional optimization models, designing incentives, and analyzing real-world data. Her current research looks at the convergence of social media, digital platforms, and agriculture, with particular attention to expanding technological equity and economic opportunity in developing countries. Liu earned her BS from Cornell University, with a double major in operations research and computer science.

      Caris Moses is a PhD student in electrical engineering and computer science specializing inartificial intelligence. Moses’ research focuses on using machine learning, optimization, and electromechanical engineering to build robotics systems that are robust, flexible, intelligent, and can learn on the job. The technology she is developing holds promise for industries including flexible, small-batch manufacturing; robots to assist the elderly in their households; and warehouse management and fulfillment. Moses earned her BS in mechanical engineering from Cornell University and her MS in computer science from Northeastern University.

      Sergio Rodriguez Aponte is a PhD student in biological engineering. He is working on the convergence of computational design and manufacturing practices, which have the potential to impact industries such as biopharmaceuticals, food, and wellness/nutrition. His current research aims to develop strategies for applying computational tools, such as multiscale modeling and machine learning, to the design and production of manufacturable and accessible vaccine candidates that could eventually be available globally. Rodriguez Aponte earned his BS in industrial biotechnology from the University of Puerto Rico at Mayaguez.

      Soumya Sudhakar SM ’20 is a PhD student in aeronautics and astronautics. Her work is focused on theco-design of new algorithms and integrated circuits for autonomous low-energy robotics that could have novel applications in aerospace and consumer electronics. Her contributions bring together the emerging robotics industry, integrated circuits industry, aerospace industry, and consumer electronics industry. Sudhakar earned her BSE in mechanical and aerospace engineering from Princeton University and her MS in aeronautics and astronautics from MIT.

      So-Yoon Yang is a PhD student in electrical engineering and computer science. Her work on the development of low-power, wireless, ingestible biomedical devices for health care is at the intersection of the medical device, integrated circuit, artificial intelligence, and pharmaceutical fields. Currently, the majority of wireless biomedical devices can only provide a limited range of medical data measured from outside the body. Ingestible devices hold promise for the next generation of personal health care because they do not require surgical implantation, can be useful for detecting physiological and pathophysiological signals, and can also function as therapeutic alternatives when treatment cannot be done externally. Yang earned her BS in electrical and computer engineering from Seoul National University in South Korea and her MS in electrical engineering from Caltech. More

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      Enabling AI-driven health advances without sacrificing patient privacy

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      There’s a lot of excitement at the intersection of artificial intelligence and health care. AI has already been used to improve disease treatment and detection, discover promising new drugs, identify links between genes and diseases, and more.

      By analyzing large datasets and finding patterns, virtually any new algorithm has the potential to help patients — AI researchers just need access to the right data to train and test those algorithms. Hospitals, understandably, are hesitant to share sensitive patient information with research teams. When they do share data, it’s difficult to verify that researchers are only using the data they need and deleting it after they’re done.

      Secure AI Labs (SAIL) is addressing those problems with a technology that lets AI algorithms run on encrypted datasets that never leave the data owner’s system. Health care organizations can control how their datasets are used, while researchers can protect the confidentiality of their models and search queries. Neither party needs to see the data or the model to collaborate.

      SAIL’s platform can also combine data from multiple sources, creating rich insights that fuel more effective algorithms.

      “You shouldn’t have to schmooze with hospital executives for five years before you can run your machine learning algorithm,” says SAIL co-founder and MIT Professor Manolis Kellis, who co-founded the company with CEO Anne Kim ’16, SM ’17. “Our goal is to help patients, to help machine learning scientists, and to create new therapeutics. We want new algorithms — the best algorithms — to be applied to the biggest possible data set.”

      SAIL has already partnered with hospitals and life science companies to unlock anonymized data for researchers. In the next year, the company hopes to be working with about half of the top 50 academic medical centers in the country.

      Unleashing AI’s full potential

      As an undergraduate at MIT studying computer science and molecular biology, Kim worked with researchers in the Computer Science and Artificial Intelligence Laboratory (CSAIL) to analyze data from clinical trials, gene association studies, hospital intensive care units, and more.

      “I realized there is something severely broken in data sharing, whether it was hospitals using hard drives, ancient file transfer protocol, or even sending stuff in the mail,” Kim says. “It was all just not well-tracked.”

      Kellis, who is also a member of the Broad Institute of MIT and Harvard, has spent years establishing partnerships with hospitals and consortia across a range of diseases including cancers, heart disease, schizophrenia, and obesity. He knew that smaller research teams would struggle to get access to the same data his lab was working with.

      In 2017, Kellis and Kim decided to commercialize technology they were developing to allow AI algorithms to run on encrypted data.

      In the summer of 2018, Kim participated in the delta v startup accelerator run by the Martin Trust Center for MIT Entrepreneurship. The founders also received support from the Sandbox Innovation Fund and the Venture Mentoring Service, and made various early connections through their MIT network.

      To participate in SAIL’s program, hospitals and other health care organizations make parts of their data available to researchers by setting up a node behind their firewall. SAIL then sends encrypted algorithms to the servers where the datasets reside in a process called federated learning. The algorithms crunch the data locally in each server and transmit the results back to a central model, which updates itself. No one — not the researchers, the data owners, or even SAIL —has access to the models or the datasets.

      The approach allows a much broader set of researchers to apply their models to large datasets. To further engage the research community, Kellis’ lab at MIT has begun holding competitions in which it gives access to datasets in areas like protein function and gene expression, and challenges researchers to predict results.

      “We invite machine learning researchers to come and train on last year’s data and predict this year’s data,” says Kellis. “If we see there’s a new type of algorithm that is performing best in these community-level assessments, people can adopt it locally at many different institutions and level the playing field. So, the only thing that matters is the quality of your algorithm rather than the power of your connections.”

      By enabling a large number of datasets to be anonymized into aggregate insights, SAIL’s technology also allows researchers to study rare diseases, in which small pools of relevant patient data are often spread out among many institutions. That has historically made the data difficult to apply AI models to.

      “We’re hoping that all of these datasets will eventually be open,” Kellis says. “We can cut across all the silos and enable a new era where every patient with every rare disorder across the entire world can come together in a single keystroke to analyze data.”

      Enabling the medicine of the future

      To work with large amounts of data around specific diseases, SAIL has increasingly sought to partner with patient associations and consortia of health care groups, including an international health care consulting company and the Kidney Cancer Association. The partnerships also align SAIL with patients, the group they’re most trying to help.

      Overall, the founders are happy to see SAIL solving problems they faced in their labs for researchers around the world.

      “The right place to solve this is not an academic project. The right place to solve this is in industry, where we can provide a platform not just for my lab but for any researcher,” Kellis says. “It’s about creating an ecosystem of academia, researchers, pharma, biotech, and hospital partners. I think it’s the blending all of these different areas that will make that vision of medicine of the future become a reality.” More