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      這些問題不解決 在醫療領域AI只能“打下手”

      時間: 2019-08-12      來源: 科技日報      于紫月



      智能“閱片”、臨床決策、護理機器人……近年來,隨著人工智能的蓬勃發展,人工智能與醫學結合的相關技術開發也進行得如火如荼。

      近日,人工智能在藥物研發領域邁出重要一步,澳大利亞研究團隊將全球首個AI設計藥物——“渦輪增壓”流感疫苗推入人體試驗階段,這款藥物開發用時兩年時間。

      就像“互聯網+”一樣,“人工智能+”的模式必然會給我們的生活帶來翻天覆地的變化,但在涉及生理和生命的醫學領域,人工智能落地還將面臨哪些挑戰?

      質與量并重 基礎數據仍需“精煉”

      不論在何種領域,數據都是讓機器聰明起來的根本。

      “人工智能若想在醫學領域長足發展,數據質量、數據量和標準化方面還有待改進和完善。” 8月6日,天津市腫瘤醫院副院長徐波在接受科技日報記者采訪時表示。

      “醫療大數據如何‘降噪’是個關鍵問題。”徐波指出,醫療大數據涉及的類型近年來呈多模態發展。而病例數據覆蓋面廣,服務用戶多樣,如何構建以病人、醫生、醫院和政府等多中心的數據治理體系,進而面向不同的用戶提供不同的數據視圖和分析結果,是醫療大數據采集及研究中亟待解決的問題。

      自改革開放以來,我國醫學領域發展迅速,信息化程度也在逐漸提高。但是隨著醫療設備更新迭代,數據的格式和錄入的內容也在不斷變化。以慢性病為例,即便是同一位病人在同一家醫院治療,幾年前后的數據內容和形式也可能會大有不同。更何況我國醫學領域在病種分類、名稱方面也有部分尚未統一,還有一些醫生會采用口語、簡稱,如“乳腺癌”和“乳癌”就是不同醫師對同一種病癥的不同叫法,這也會給人工智能在臨床決策或影像分析時平添困擾。

      “盡管我國醫院的數據龐大, 但由于疾病的復雜性,數據維度、特性各不相同, 質量參差不齊,導致很多細分的病種實際可用數據量少,尤其是較為罕見的疾病類型。如果是多學科交叉的病癥可使用的數據量就更加有限了。”徐波表示。

      此外,數據共享也存在壁壘。我國當前醫院與醫院、同一家醫院內科系互不相連, 沒有統一標準的臨床結構化病歷報告,不同地域甚至不同醫院之間的數據庫無法通用。

      我國人口數量龐大,醫學數據體量也很大,但在某種程度上,人工智能發展卻陷入了“無數據可用”的尷尬境地,怎樣才能將這座“富礦”充分挖掘出來呢?

      “數據標準化和規范化是解決該問題的必經之路。”在徐波看來,應加快醫療數據電子化、標準化的進程, 打破醫療機構的數據壁壘, 建立數據共享機制,進一步“精煉”醫學領域數據。

      醫工結合 學科交叉人才緊缺

      “既懂醫療又懂AI技術的復合型、戰略型人才極其短缺, 其中10年以上資深人才尤為缺乏。同時, 醫務人員對AI的接納度不足, 部分醫務人員甚至對AI抱有抵觸心理。”上海市衛生和健康發展研究中心(上海市醫學科學技術情報研究所)健康科技創新發展部執行主任何達曾在相關期刊發表文章時提到,AI技術的使用需要對醫務人員進行專業化規范培訓, 在此背景下, 建立完善的人才培養和人才引進機制是重中之重。

      徐波告訴科技日報記者,智能醫學領域是人工智能和醫療健康這兩個專業性極強領域的結合,如今二者都能深入研究的人才是“香餑餑”。而正是因為二者專業性極強,人才培養的模式才更加復雜、更值得深入探討。

      去年,南開大學和天津大學首次在本科開設智能醫學工程專業,開啟了培養人工智能+醫學領域專業人才的新征程。今年,包括重慶大學、東北大學在內的7所院校也成功申報獲批開設相關專業。南開大學醫學院相關負責人曾表示,該專業是掛靠在學校醫學院下的一個工科專業,為了滿足學生學科交叉的學習需求,會邀請外院的教師上課教學。

      在徐波看來,智能醫學領域發展時間短,能大范圍推廣的培養模式尚需一定的時間摸索。但歸根結底,如果讓部分有興趣的醫學生在校期間就能接觸到一些人工智能相關的工科基礎知識,將會對其后續向著智能醫學方向發展起到一定的引導和輔助作用。

      雖然現階段交叉人才缺口很大,但值得慶幸的是,家長和學生對智能醫學工程專業高度認可。2018年,天大、南開智能醫學工程專業首批招生投放涵蓋全國十幾個省市,招生期間,民眾的相關咨詢持續火爆,未投放省市同樣反響熱烈。

      市場良性發展 監管體系亟須加強

      除了數據和人才兩大基礎方向,新興的智能醫學在商業模式和法律監管等方面也需要人們投注目光。

      以目前人工智能與醫學最常見的結合點——醫學影像為例,現階段該領域的AI產品在國內主要采用免費試用的合作方式,雖然短期來看,醫院是獲益的,但長遠計算,優質AI企業會因長期無法盈利而難以為繼,無法持續為醫院提供更好的產品。

      合理的商業化模式尚在“摸著石頭過河”的階段,而相配套的監管機制也亟須完善。清華大學法學院院長申衛星此前在接受科技日報記者采訪時表示,目前只有《民法總則》第127條提出,“法律對數據、網絡虛擬財產的保護有規定的,依照其規定”。但具體如何保護數據,并沒有詳細說明。

      以往,機器被歸為工具一類,工具造成的損害責任通常是產品設計者、制造者來承擔,但如果工具經過人工智能深度學習,成為自主型產品后造成損害,這到底是誰的責任?依舊是產品的責任還是智能系統開發單位的責任?這些疑問都需要明確的法條來解答。

      記者了解到,我國不僅對智能醫學數據的隱私保護、責任規范、安全性等沒有明確的法律指示,人工智能在醫療健康領域應用的質量標準、準入體系、評估體系也未設置詳細的準則, 無法對AI數據和算法進行有效驗證和評價。

      “目前國際上也沒有成功的案例經驗可供借鑒,發展出一套符合我國國情、相對完善的智能醫學監管體系還需要一定的時間和多學科、多行業的研究者和實踐者共同努力。”徐波表示,較為科學的監管體系之下,人工智能企業在符合各項標準和法規的范圍內探索良性的商業化營收模式,各院所、高校、醫院等單位合理利用各自資源,進行有效合作,有助于整個智能醫學領域的健康、穩步發展。

      責任編輯: 史娜

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