ARTIFICIAL INTELLIGENCE DIAGNOSES ABUSE
A new computer program developed by doctors could not only detect
victims of abuse, but also may eventually be used to diagnose a
variety of diseases and conditions.

By Eric Bland
Mon Oct 26, 2009 07:00 AM ET
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A new program can isolate victims of abuse by looking for specific
patterns within a patient's medical history.
iStockPhoto
A broken bone one day, a particular infection a few months later and
depression the following year may appear to be separate, medical
issues.

However, to a new artificial intelligence program developed by Boston
doctors, these are all symptoms of domestic abuse.

The new software can identify abuse victims up to six years before
these cases would otherwise be found and could eventually be used to
diagnose just about any disease or injury.

"It's very difficult to detect domestic abuse because it often happens
in the privacy of the home," said Ben Reis, a doctor at Children's
Hospital Boston (CHB) who helped develop the program.

"Doctors are often on the front lines of detecting abuse, but so often
the doctor is focused on treating the injury, they don't see the
context behind it."

Dozens of studies over the last 40 years have correlated various
illnesses, injuries and other conditions with abuse. Bruising to the
middle of the forearm or the core of the body instead of the elbow or
knee can signal abuse. Depression or {*filter*}ism may also be symptoms
of this condition.

The new program takes all of these studies and puts them in one place.
Before a doctor even consults with a patient, the software will alert
the doctor about the likelihood of abuse in a particular case using a
color-coded system.

It would then be up to the doctor whether to treat the patient as a
victim of abuse.

To create the artificial intelligence program, the CHB doctors used
six years of data from more than 560,000 patients ages 18 years and
older.

While many studies have correlated certain injuries with abuse, Reis,
along with his colleagues Isaac Kohane and Kenneth Mandi, tasked the
program with finding its own connections between an abuse diagnosis
and records of injuries leading up to that diagnosis.

The program picked up domestic abuse an average of two years before it
was diagnosed. In one case, the program detected abuse more than six
years before it was diagnosed by a physician.

Robert Sege, a doctor at the Boston Medical Center not involved with
the study, is very impressed with the research.

"By the time someone is identified as abused, the abuse has generally
gone on for a long time," said Sege. "This is really powerful. If I
had this with particular patients, I would be aware of the possibility
and ask them more detailed questions or tell them about the kinds of
services we provide."

Electronic health records are the {*filter*}pin of the artificial
intelligence system, according to both Reis and Sege.

Abuse victims often seek medical treatment at different locations for
each injury to avoid detection. Each hospital or doctor keeps separate
patient records but often fail to share those records.

Keeping one, consolidated electronic record of a patient activity
would enable the software to detect abuse.

The record doesn't even have to be particularly detailed, says Reis.
The CHB doctors used only the most basic patient data, "the lowest
common denominator," as Reis calls it, to diagnose abuse in patients.
Using better data should only increase the program's success at abuse
detection.

Better data could also allow the program to diagnose a variety of
diseases more accurately as well. Ultimately, Reis and his colleagues
want to expand their software to consider every human disease, a
project he likens to the Human Genome Project, a multinational, $3
billion effort to sequence the entire human genome.

To support their research Reis was recently granted a four-year, $1.3
million grant to expand their research.

"We want to do a fundamental analysis of the entire human 'disease-
some' -- if there is such a word -- to check the predictability of all
diseases," said Reis.

It will take years to finish a complete analysis of all diseases. Even
when a project is done, and an artificial intelligence system capable
of diagnosing a host of diseases is created, doctors don't need to
worry about losing their jobs.

"We are here to empower doctors," said Reis, "not replace them."

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