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    AI has brains—but it’s no MD


    Dr Levine is Practice Director, CCRM New York, and Attending Physician, Lenox Hill Hospital, New York. He has no conflict of interest to report in respect to the content of this article.

    According to Hick’s Law, one of the few laws of experimental psychology, the time it takes for a person to make a choice is directly related to the number of possible alternatives. Simply stated, human decisions and the time required to make those decisions are functions of not only the question at hand, but how the potential answers are ordered and presented. Human decision-making is further complicated by heuristics—the succinct simple rules that we use to make decisions.1

    When we add to this emotions, circumstantial evidence, and societal rules, it seems nearly impossible for anyone, let alone a doctor, to make a reproducible decision, since every situation is unique. This is why many are greatly concerned about medical students being taught by rote memorization, since not every patient fits into a memorized algorithm. Thankfully, technology has developed to help us make not only quicker decisions, but also smarter ones, and in some cases life-saving ones.

    A choice example is IBM’s Watson supercomputer, which is able to interpret patient data (including unstructured text, images, audio, and video) and generate a highly accurate analysis.2 For example, Watson may be able to help select the best treatment for a patient who walks into an emergency room with vague symptoms. Watson may be able to decide when to switch therapies when there’s a lack of response. 

    But, Watson does not know context. For example, Watson for Oncology may determine that the treatment of a patient is futile and recommend palliation without taking into account that the particular patient is a young woman with small children.

    In fact, a recent Wall Street Journal article discussed how after nearly 5 years and more than $60 million, MD Anderson Cancer Center at the University of Texas has “little to show” for their investment in Watson.3 The article notes that Watson’s “clinical trial and drug-protocol data in the system are outdated, and the pilot program doesn’t work with the hospital’s current electronic health records.”

    Brian A. Levine, MD, MS, FACOG
    Dr. Levine is Practice Director at the Colorado Center for Reproductive Medicine, New York, New York.


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