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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

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      Finding common ground in Malden

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      When disparate groups convene around a common goal, exciting things can happen.

      That is the inspiring story unfolding in Malden, Massachusetts, a city of about 60,000 — nearly half people of color — where a new type of community coalition continues to gain momentum on its plan to build a climate-resilient waterfront park along its river. The Malden River Works (MRW) project, recipient of the inaugural Leventhal City Prize, is seeking to connect to a contiguous greenway network where neighboring cities already have visitors coming to their parks and enjoying recreational boating. More important, the MRW is changing the model for how cities address civic growth, community engagement, equitable climate resilience, and environmental justice.                                                                                        

      The MRW’s steering committee consists of eight resident leaders of color, a resident environmental advocate, and three city representatives. One of the committee’s primary responsibilities is providing direction to the MRW’s project team, which includes urban designers, watershed and climate resilience planners, and a community outreach specialist. MIT’s Kathleen Vandiver, director of the Community Outreach Education and Engagement Core at MIT’s Center for Environmental Health Sciences (CEHS), and Marie Law Adams MArch ’06, a lecturer in the School of Architecture and Planning’s Department of Urban Studies and Planning (DUSP), serve on the project team.

      “This governance structure is somewhat unusual,” says Adams. “More typical is having city government as the primary decision-maker. It is important that one of the first things our team did was build a steering committee that is the decision maker on this project.”

      Evan Spetrini ’18 is the senior planner and policy manager for the Malden Redevelopment Authority and sits on both the steering committee and project team. He says placing the decision-making power with the steering committee and building it to be representative of marginalized communities was intentional. 

      “Changing that paradigm of power and decision-making in planning processes was the way we approached social resilience,” says Spetrini. “We have always intended this project to be a model for future planning projects in Malden.”

      This model ushers in a new history chapter for a city founded in 1640.

      Located about six miles north of Boston, Malden was home to mills and factories that used the Malden River for power, and a site for industrial waste over the last two centuries. Decades after the city’s industrial decline, there is little to no public access to the river. Many residents were not even aware there was a river in their city. Before the project was under way, Vandiver initiated a collaborative effort to evaluate the quality of the river’s water. Working with the Mystic River Watershed Association, Gradient Corporation, and CEHS, water samples were tested and a risk analysis conducted.

      “Having the study done made it clear the public could safely enjoy boating on the water,” says Vandiver. “It was a breakthrough that allowed people to see the river as an amenity.”

      A team effort

      Marcia Manong had never seen the river, but the Malden resident was persuaded to join the steering committee with the promise the project would be inclusive and of value to the community. Manong has been involved with civic engagement most of her life in the United States and for 20 years in South Africa.

      “It wasn’t going to be a marginalized, token-ized engagement,” says Manong. “It was clear to me that they were looking for people that would actually be sitting at the table.”

      Manong agreed to recruit additional people of color to join the team. From the beginning, she says, language was a huge barrier, given that nearly half of Malden’s residents do not speak English at home. Finding the translation efforts at their public events to be inadequate, the steering committee directed more funds to be made available for translation in several languages when public meetings began being held over Zoom this past year.

      “It’s unusual for most cities to spend this money, but our population is so diverse that we require it,” says Manong. “We have to do it. If the steering committee wasn’t raising this issue with the rest of the team, perhaps this would be overlooked.”

      Another alteration the steering committee has made is how the project engages with the community. While public attendance at meetings had been successful before the pandemic, Manong says they are “constantly working” to reach new people. One method has been to request invitations to attend the virtual meetings of other organizations to keep them apprised of the project.

      “We’ve said that people feel most comfortable when they’re in their own surroundings, so why not go where the people are instead of trying to get them to where we are,” says Manong.

      Buoyed by the $100,000 grant from MIT’s Norman B. Leventhal Center for Advanced Urbanism (LCAU) in 2019, the project team worked with Malden’s Department of Public Works, which is located along the river, to redesign its site and buildings and to study how to create a flood-resistant public open space as well as an elevated greenway path, connecting with other neighboring cities’ paths. The park’s plans also call for 75 new trees to reduce urban heat island effect, open lawn for gathering, and a dock for boating on the river.

      “The storm water infrastructure in these cities is old and isn’t going to be able to keep up with increased precipitation,” says Adams. “We’re looking for ways to store as much water as possible on the DPW site so we can hold it and release it more gradually into the river to avoid flooding.”

      The project along the 2.3-mile-long river continues to receive attention. Recently, the city of Malden was awarded a 2021 Accelerating Climate Resilience Grant of more than $50,000 from the state’s Metropolitan Area Planning Council and the Barr Foundation to support the project. Last fall, the project was awarded a $150,015 Municipal Vulnerability Preparedness Action Grant. Both awards are being directed to fund engineering work to refine the project’s design.

      “We — and in general, the planning profession — are striving to create more community empowerment in decision-making as to what happens to their community,” says Spetrini. “Putting the power in the community ensures that it’s actually responding to the needs of the community.”

      Contagious enthusiasm

      Manong says she’s happy she got involved with the project and believes the new governance structure is making a difference.

      “This project is definitely engaging with communities of color in a manner that is transformative and that is looking to build a long-lasting power dynamic built on trust,” she says. “It’s a new energized civic engagement and we’re making that happen. It’s very exciting.”

      Spetrini finds the challenge of creating an open space that’s publicly accessible and alongside an active work site professionally compelling.

      “There is a way to preserve the industrial employment base while also giving the public greater access to this natural resource,” he says. “It has real implications for other communities to follow this type of model.”

      Despite the pandemic this past year, enthusiasm for the project is palpable. For Spetrini, a Malden resident, it’s building “the first significant piece of what has been envisioned as the Malden River Greenway.” Adams sees the total project as a way to build social resilience as well as garnering community interest in climate resilience. For Vandiver, it’s the implications for improved community access.

      “From a health standpoint, everybody has learned from Covid-19 that the health aspects of walking in nature are really restorative,” says Vandiver. “Creating greater green space gives more attention to health issues. These are seemingly small side benefits, but they’re huge for mental health benefits.”

      Leventhal City Prize’s next cycle

      The Leventhal City Prize was established by the LCAU to catalyze innovative, interdisciplinary urban design, and planning approaches worldwide to improve both the environment and the quality of life for residents. Support for the LCAU was provided by the Muriel and Norman B. Leventhal Family Foundation and the Sherry and Alan Leventhal Family Foundation.

      “We’re thrilled with inaugural recipients of the award and the extensive work they’ve undertaken that is being held up as an exemplary model for others to learn from,” says Sarah Williams, LCAU director and a professor in DUSP. “Their work reflects the prize’s intent. We look forward to catalyzing these types of collaborative partnership in the next prize cycle.”

      Submissions for the next cycle of the Leventhal City Prize will open in early 2022.    More

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      Study finds lockdowns effective at reducing travel in Sierra Leone

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      Throughout the Covid-19 pandemic, governments have used data on people’s movements to inform strategies for containing the spread of the virus. In Europe and the United States, for example, contact-tracing apps have used Bluetooth signals in smartphones to alert people when they’ve spent time near app users who have tested positive for Covid-19. 

      But how can governments make evidence-based decisions in countries where such fine-grained data isn’t available? In recent findings, MIT researchers, in collaboration with Sierra Leone’s government, use cell tower records in Sierra Leone to show that people were traveling less during lockdowns. “When the government implemented novel three-day lockdowns, there was a dual aim to reduce virus spread and also limit social impacts, like increased hunger or food insecurity,” says Professor Lily L. Tsai, MIT Governance Lab’s (MIT GOV/LAB) director and founder. “We wanted to know if shorter lockdowns would be successful.”   

      The research was conducted by MIT GOV/LAB and MIT’s Civic Data Design Lab (CDDL), in partnership with Sierra Leone’s Directorate for Science, Innovation and Technology (DSTI) and Africell, a wireless service provider. The findings will be published as a chapter in the book “Urban Informatics and Future Cities,” a selection of research submitted to the 2021 Computational Urban Planning and Urban Management conference. 

      A proxy for mobility: cell tower records

      Any time someone’s cellphone sends or receives a text, or makes or receives a call, the nearest cell tower is pinged. The tower collects some data (call-detail records, or CDRs), including the date and time of the event and the phone number. By tracking which towers a certain (anonymized) phone number pings, the researchers could approximately measure how much someone was moving around.  

      These measurements showed that, on average, people were traveling less during lockdowns than before lockdowns. Professor Sarah Williams, CDDL’s director, says the analysis also revealed frequently traveled routes, which “allow the government to develop region-specific lockdowns.” 

      While more fine-grained GPS data from smartphones paint a more accurate picture of movement, “there just isn’t a systematic effort in many developing countries to build the infrastructure to collect this data,” says Innocent Ndubuisi-Obi Jr., an MIT GOV/LAB research associate. “In many cases, the closest thing we can use as a proxy for mobility is CDR data.”

      Measuring the effectiveness of lockdowns

      Sierra Leone’s government imposed the three-day lockdown, which required people stay in their homes, in April 2020. A few days after the lockdown ended, a two-week inter-district travel ban began. “Analysis of aggregated CDRs was the quickest means to understanding mobility prior to and during lockdowns,” says Michala Mackay, DSTI’s director and chief operating officer. 

      The data MIT and DSTI received was anonymized — an essential part of ensuring the privacy of the individuals whose data was used. 

      Extracting meaning from the data, though, presented some challenges. Only about 75 percent of adults in Sierra Leone own cellphones, and people sometimes share phones. So the towers pinged by a specific phone might actually represent the movement of several people, and not everyone’s movement will be captured by cell towers. 

      Furthermore, some districts in Sierra Leone have significantly fewer towers than others. When the data were collected, Falaba, a rural district in the northeast, had only five towers, while over 100 towers were clustered in and around Freetown, the capital. In areas with very few towers, it’s harder to detect changes in how much people are traveling. 

      Since each district had a unique tower distribution, the researchers looked at each district separately, establishing a baseline for average distance traveled in each district before the lockdowns, then measuring how movement compared to this average during lockdowns. They found that travel to other districts declined in every district, by as much as 72 percent and by as little as 16 percent. Travel within districts also dropped in all but one district. 

      This map shows change in average distance traveled per trip to other districts in Sierra Leone in 2020.

      Image courtesy of the MIT GOV/LAB and CDDL.

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      Lockdowns have greater costs in poorer areas

      While movement did decline in all districts, the effect was less dramatic in poorer, more sparsely populated areas. This finding was to be expected; other studies have shown that poorer people often can’t afford to comply with lockdowns, since they can’t take time off work or need to travel to get food. Evidence showing how lockdowns are less effective in poorer areas highlights the importance of distributing resources to poorer areas during crises, which could both provide support during a particularly challenging time and make it less costly for people to comply with social distancing measures. 

      “In low-income communities that demonstrated moderate or low compliance, one of the most common reasons why people left their homes was to search for water,” says Mackay. “A policy takeaway was that lockdowns should only be implemented in extreme cases and for no longer than three days at a time.”

      Throughout the project, the researchers collaborated intimately with DSTI. “This meant government officials learned along with the MIT researchers and added crucial local knowledge,” says Williams. “We hope this model can be replicated elsewhere — especially during crises.” 

      The researchers will be developing an MITx course teaching government officials and MIT students how to collaboratively use CDR data during crises, with a focus on how to do the analysis in a way that protects people’s privacy.

      Ndubuisi-Obi Jr. also has led a training on CDR analysis for Sierra Leonean government officials and has written a guide on how policymakers can use CDRs safely and effectively. “Some of these data sets will help us answer really important policy questions, and we have to balance that with the privacy risks,” he says. More

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      Lockdowns reveal inequities in opportunities for walking activities

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      Lockdowns saved lives during the global SARS-CoV-2 pandemic. But as much as they have slowed the spread of Covid-19, there have been some unintended consequences.

      New MIT research shows that lockdowns in 10 metropolitan areas throughout the United States led to a marked reduction in walking. These decreases were mostly seen among residents living in lower-income areas of the city, effectively reducing access to physical activity for minorities and people suffering from illnesses such as obesity and diabetes.

      “Walking is the cheapest, most accessible physical exercise that you can do,” says Esteban Moro, visiting research scientist in the MIT Connection Science Group and senior author on the Nature Communications paper published on June 16. “Places in which people have lower incomes, less park access, and more obesity prevalence were more affected by this walking reduction — which you can think of as another pandemic, the lack of access to affordable exercise.”

      The research focused on recreational versus utilitarian walking done by residents in the U.S. cities of New York, Los Angeles, Chicago, Boston, Miami, Dallas, San Francisco, Seattle, Philadelphia, and Washington D.C. (Utilitarian walking is defined as having a goal; for example, walking to the store or to public transportation. Recreational walking is a walk meant for leisure or exercise.)

      Comparing cellphone data from February 2020 to different time points throughout 2020 lockdowns, the researchers saw an average 70 percent decrease in the number of walks — which remained down by about 18 percent after loosened restrictions — a 50 percent decrease in distance walked, and a 72 percent decrease in utilitarian walking — which remained down by 39 percent even after restrictions were lifted.

      On their face, these findings may not be surprising. When people couldn’t leave their homes, they walked less. But digging deeper into the data yields troubling insights. For example, people in lower-income regions are more likely to rely on public transportation. Lockdowns cut back on those services, meaning fewer people walking to trains and buses.

      Another statistic showed that people in higher-income areas reduced their number of utilitarian walks but were able to replace some of the lost movement with recreational walks around their neighborhoods or in nearby parks.

      “People in higher-income areas generally not only have a park nearby, but also have jobs that give them a degree of flexibility. Jobs that permit them to take a break and walk,” says Moro. “People in the low-income regions often don’t have the ability, the opportunity or even the facilities to actually do this.”

      How it was done

      The researchers used de-identified mobile data obtained through a partnership within the company Cuebiq’s Data for Good COVID-19 Collaborative program. The completely anonymized dataset consisted of GPS locations gathered from smartphone accelerometers from users who opted into the program. Moro and his collaborators took these data and, using specifically designed algorithms, determined when people walked, for how long, and for what purpose. They compared this information from before the pandemic, at different points throughout lockdown, and at a point when most restrictions had been eased. They matched the GPS-identified locations of the smartphones with census data to understand income level and other demographics.

      To make sure their dataset was robust, they only used information from areas that could reasonably be considered pedestrian. The researchers also acknowledge that the dataset may be incomplete, considering people may have occasionally walked without their phones on them.

      Leisure versus utilitarian walks were separated according to distance and/or destination. Utilitarian walks are usually shorter and involve stops at destinations other than the starting point. Leisure walks are longer and usually happen closer to home or in dedicated outdoor spaces.

      For example, many of the walks recorded pre-Covid-19 were short and occurred at around 7 a.m. and between 3 and 5 p.m., which would indicate a walking commute. These bouts of walking were replaced on weekends by short walks around noon.

      The key takeaway is that most walking in cities occurs with the goal of getting to a place. If people don’t have the opportunity to walk to places they need to go, they will reduce their walking activity overall. But when provided opportunity and access, people can supplement utilitarian activity with leisure walking.

      What can be done about it

      Taking into account the public health implications of physical inactivity, the authors argue a reduction in access to walking should be considered a second pandemic and be addressed with the same rigor as the Covid-19 pandemic.

      They suggest several tactical urbanization strategies (defined as non-permanent but easily accessible measures) to increase safety and appeal for both utilitarian and recreational walkers. Many of these have already been implemented in various cities around the world to ease economic and other hardships of the pandemic. Sections of city streets have been closed off to cars on weekends or other non-busy times to allow for pedestrian walking areas. Restaurants have been given curb space to allow for outdoor dining.

      “But most of these pop-up pedestrian areas happen in downtown, where people are high-income and have easier access to more walking opportunities,” notes Moro.

      The same attention needs to be paid to lower-income areas, the researchers argue. This study’s data showed that people explored their own neighborhoods in a recreational way more during lockdown than pre-pandemic. Such wanderings, the researcher say, should be encouraged by making any large, multi-lane intersections safer to cross for the elderly, sick, or those with young children. And local parks, usually seen as places for running laps, should be made more attractive destinations by adding amenities like water fountains, shaded pavilions, and hygiene and sanitation spaces.

      This study was unique in that its data came straight from mobile devices, rather than being self-reported in surveys. This more reliable method of tracking made this study more data-driven than other, similar efforts. And the geotagged data allowed the researchers to dig into socioeconomic trends associated with the findings.

      This is the team’s first analysis of physical activity during and just after lockdown. They hope to use lessons learned from this and planned follow-ups to encourage more permanent adoption of pedestrian-friendly pandemic-era changes.

      The Connection Science Group, co-led by faculty member Alex “Sandy” Pentland — who, along with Moro was a co-author on the paper along with six others from the UK, Brazil, and Australia — is part of the MIT Sociotechnical Systems Research Center within the MIT Institute for Data, Systems, and Society. The collaborative research exemplified in this study is core to the mission of the SSRC; in pairing computer science with public health, the group not only observes trends but also contextualizes data and use them to make improvements for everyone.

      “SSRC merges both the social and technological components of the research,” says Moro. “We’re not only building an analysis, but going beyond that to propose new policies and interventions to change what we are seeing for the better.” More