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At a time when artificial intelligence is being incorporated more and more into the mainstream, the University of Florida College of Medicine-Jacksonville has adopted the first federally authorized AI-based computer software to help physicians make faster and more accurate breast and prostate cancer diagnoses.
The software was developed by a New York-based digital pathology company called Paige, which stands for Pathology Artificial Intelligence Guidance Engine. Physicians scan images and send them and related data to the company electronically for analysis.
“AI is a tool, like any other tool,” said Paige CEO Andy Moye, who once was a Navy pilot based at Naval Air Station Jacksonville. “But particularly in health care … it’s a tool that’s going to save lives.”
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Dr. Shahla Masood, the professor who heads the college’s pathology and laboratory medicine department in Jacksonville, said AI is an invaluable supplement to a physician’s and pathologist’s expertise.
AI can provide an objective second opinion and pinpoint a diagnosis when test results indicate multiple possibilities, she said. And the speed of AI’s calculations can lead to treatment getting underway sooner.
“Looking at lab results, they have trained machines to find the earliest changes,” she said. “It’s not about changing traditional diagnosis but using digital pathology as an added process, to give added consistency, much quicker.”
With artificial intelligence trending in the news today and across the world, many people — including some skeptics — want to know more.
What is artificial intelligence and who created it?
The multiple candidates for the father of AI include British logician and computer pioneer Alan Turing in the 1940s and computer scientist and cognitive scientist John McCarthy in the 1950s. The U.S. Department of Defense is even in the mix and began training computers in the 1960s “to mimic basic human reasoning.”
As for a definition of AI, McKinsey Explainers, a series by McKinsey & Co. management consulting firm experts that provides “direct answers to complex questions,” provided the following:
“Artificial intelligence is a machine’s ability to perform the cognitive functions we usually associate with human minds, such as perceiving, reasoning, learning, interacting with an environment, problem-solving and even exercising creativity,” according to McKinsey. “Ultimately, the value of artificial intelligence isn’t in the systems themselves but in how companies use those systems to assist humans — and their ability to explain to shareholders and the public what those systems do — in a way that builds and earns trust.”
Earning trust will be the key to answering a popular Google question: Will AI take over the world?
Business leaders were surveyed on that question at the Yale SEO Summit in June. According to a CNN report, 58% of them said they were “not worried” and that AI could never destroy humanity, while 34% of them said that was a possibility in 10 years and 8% said it could happen sooner in five years.
Experts at LyRise, a platform that helps companies recruit AI talent, wrote that artificial intelligence will not destroy humanity, despite its powerful potential.
“One of the main reasons why AI is not an existential threat is that it is a tool, not a being. AI is created and controlled by humans and it can only do what it is programmed to do,” according to LyRise. “It does not have the ability to make its own decisions or develop its own goals.”
LyRise also noted that AI is designed with safety mechanisms, such as the ability to be overridden by humans, and research is underway “to ensure that AI is developed responsibly and that its potential risks are identified and addressed.”
Masood, of the UF College of Medicine-Jacksonville, equated the impact of AI to that of cellphones or the internet. They might have been intimidating — even frightening — at first, but we have since come to count on them.
“AI is the latest discovery in computer science, how to use computers to focus on learning concepts with almost unlimited applications not only in health care, but industry,” she said. “We can teach machines to learn about anything … To mimic the human mind.”
How can AI benefit health care?
The key benefit is “improved diagnostic speed and accuracy,” according to the magazine Medical Economics.
“AI algorithms can process large amounts of data quickly and accurately, making it easier for health care providers to diagnose and treat diseases,” according to the magazine. “AI algorithms can analyze medical images, such as X-rays and MRI scans, to identify patterns and anomalies that a human provider might miss. This can lead to earlier and more accurate diagnoses, resulting in better patient outcomes.”
Paige’s Moye said AI can navigate “complex pattern recognition, allowing computers … to find patterns in different things.” That, he said, can help doctors determine whether a patient has cancer or not, early on.
“Getting the right diagnosis in a sooner period of time,” he said. “Waiting for results over days and weeks is the most agonizing time.”
In addition, AI can also monitor patients’ vital signs such as heart rate and blood pressure and note sudden changes, among other things, according to Medical Economics.
As a result, AI is one of many tools that can be utilized by physicians, Masood said. Information from the patient and doctor, lab tests and imaging, age and family history are among the other factors considered.
“Medicine is not black and white. Many diseases share similarities,” she said. A diagnosis is made after “we put all these things together like a puzzle. AI is that last piece of the puzzle,” she said.
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What did federal regulators say about Paige AI?
After multiple clinical trials and regulatory reviews, the software received marketing authorization from the U.S. Food and Drug Administration in 2021 for use in prostate cancer diagnosis and later in breast cancer diagnosis.
“Pathologists examine biopsies of tissue suspected for diseases, such as prostate cancer, every day,” said Dr. Tim Stenzel, director of the Office of In Vitro Diagnostics and Radiological Health in the FDA’s Center for Devices and Radiological Health. “Identifying areas of concern on the biopsy image can help pathologists make a diagnosis that informs the appropriate treatment. The authorization of this … software can help increase the number of identified prostate biopsy samples with cancerous tissue, which can ultimately save lives.”
In a Paige study, 18 pathologists evaluated 610 prostate biopsy tissue samples prepared at 218 different institutions. Two evaluations were performed on each sample: one with the assistance of Paige and one without. The study found that physicians using the prostate software had 70% reduction in false negative diagnoses and 24% reduction in false positive diagnoses. Results were published in 2022 in the College of American Pathologists’ Archives of Pathology and Laboratory Medicine.
“That made their eyes open,” Moye said.
How did UF come into play?
Paige, which was founded in 2017, contacted UF about using the software. Moye has a personal tie: He obtained his master’s degree in business from UF in 2007.
In addition to UF, the software is being used at about two dozen other sites, including Memorial Sloan Kettering Cancer Center in New York and by the National Health Service in Oxford, England, Moye said.
“We have the most studied algorithms out there,” he said. “They’ve really got to feel comfortable.”
UF has adopted Paige’s full portfolio of AI offerings, including the Paige Prostate Suite and PaigeBreast Suite.
“The choice to adopt AI was made, first and foremost, with our patients in mind,” Masood said. “WE are committed to providing our patients with the best possible outcomes and to improving the diagnostic experience for our pathologists. Using an AI-powered application saves our pathologists from the tedious and repetitive tasks involved in diagnosis, improves their diagnostic confidence and gives them the ability to focus their attention on the cases that need their expertise the most.”
UF also uses AI in other areas that involve research and validation, she said.
Do other Jacksonville-area hospitals use AI?
To a varying degree, yes.
Rochester, Minn.-based Mayo Clinic “is developing, testing and using in clinical practice” many AI-based tools at all its locations, including its Jacksonville hospital, according to a statement. “Data scientists and clinician-researchers are working together to take expansive sets of data and applying sophisticated AI and machine learning algorithms to achieve medical insights. They are applying AI in a way that quickly solves problems, leading to the creation of new healthcare tools and treatments.”
Also, Mayo in Minnesota has built a new Research Department for AI and Informatics and established a Center for Digital Health and a Department of Quantitative Health Sciences, which are used by all its locations. And it has launched Mayo Clinic Platform, which “enables connections between innovators and users to drive the transformation of heath care,” according to the statement.
HCA Healthcare, which owns and operates HCA Florida Memorial Hospital in Jacksonville and HCA Florida Orange Park Hospital, is “building on a legacy of innovation,” according to a statement. One example: Memorial is one of two HCA hospitals helping to develop a scheduling and staffing program that uses an “AI, machine-learning algorithm to predict staffing needs.”
Ascension St. Vincent’s and Baptist Health hadn’t responded to inquiries yet.
bcravey@jacksonville.com, (904) 359-4109
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