Tag Archives: Health

How AI could predict sight-threatening eye conditions

Age-related macular degeneration (AMD) is the biggest cause of sight loss in the UK and USA and is the third largest cause of blindness across the globe. The latest research collaboration between Google Health, DeepMind and Moorfields Eye Hospital is published in Nature Medicine today. It shows that artificial intelligence (AI) has the potential to not only spot the presence of AMD in scans, but also predict the disease’s progression.

Vision loss and wet AMD

Around 75 percent of patients with AMD have an early form called “dry” AMD that usually has relatively mild impact on vision. A minority of patients, however, develop the more sight-threatening form of AMD called exudative, or “wet” AMD. This condition affects around 15 percent of patients, and occurs when abnormal blood vessels develop underneath the retina. These vessels can leak fluid, which can cause permanent loss of central vision if not treated early enough.

Macular degeneration mainly affects central vision, causing "blind spots" directly ahead (Macular Society).

Wet AMD often affects one eye first, so patients become heavily reliant upon their unaffected eye to maintain their normal day-to-day living. Unfortunately, 20 percent of these patientswill go on to develop wet AMD in their other eye within two years. The condition often develops suddenly but further vision loss can be slowed with treatments if wet AMD is recognized early enough. Ophthalmologists regularly monitor their patients for signs of wet AMD using 3D optical coherence tomography (OCT) images of the retina.

The period before wet AMD develops is a critical window for preventive treatment, which is why we set out to build a system that could predict whether a patient with wet AMD in one eye will go on to develop the condition in their second eye. This is a novel clinical challenge, since it’s not a task that is routinely performed.

How AI could predict the development of wet AMD

In collaboration with colleagues at DeepMind and Moorfields Eye Hospital NHS Foundation Trust, we’ve developed an artificial intelligence (AI) model that has the potential to predict whether a patient will develop wet AMD within six months. In the future, this system could potentially help doctors plan studies of earlier intervention, as well as contribute more broadly to clinical understanding of the disease and disease progression.

We trained and tested our model using a retrospective, anonymized dataset of 2,795 patients. These patients had been diagnosed with wet AMD in one of their eyes, and were attending one of seven clinical sites for regular OCT imaging and treatment. For each patient, our researchers worked with retinal experts to review all prior scans for each eye and determine the scan when wet AMD was first evident. In collaboration with our colleagues at DeepMind we developed an AI system composed of two deep convolutional neural networks, one taking the raw 3D scan as input and the other, built on our previous work, taking a segmentation map outlining the types of tissue present in the retina. Our prediction system used the raw scan and tissue segmentations to estimate a patient’s risk of progressing to wet AMD within the next six months.

To test the system, we presented the model with a single, de-identified scan and asked it to predict whether there were any signs that indicated the patient would develop wet AMD in the following six months. We also asked six clinical experts—three retinal specialists and three optometrists, each with at least ten years’ experience—to do the same. Predicting the possibility of a patient developing wet AMD is not a task that is usually performed in clinical practice so this is the first time, to our knowledge, that experts have been assessed on this ability.

While clinical experts performed better than chance alone, there was substantial variability between their assessments. Our system performed as well as, and in certain cases better than, these clinicians in predicting wet AMD progression. This highlights its potential use for informing studies in the future to assess or help develop treatments to prevent wet AMD progression.

Future work could address several limitations of our research. The sample was representative of practice at multiple sites of the world’s largest eye hospital, but more work is needed to understand the model performance in different demographics and clinical settings. Such work should also understand the impact of unstudied factors—such as additional imaging tests—that might be important for prediction, but were beyond the scope of this work.

What’s next

These findings demonstrate the potential for AI to help improve understanding of disease progression and predict the future risk of patients developing sight-threatening conditions. This, in turn, could help doctors study preventive treatments.

This is the latest stage in our partnership with Moorfields Eye Hospital NHS Foundation Trust, a long-standing relationship that transitioned from DeepMind to Google Health in September 2019. Our previous collaborations include using AI to quickly detect eye conditions, and showing how Google Cloud AutoML might eventually help clinicians without prior technical experience to accurately detect common diseases from medical images.

This is early research, rather than a product that could be implemented in routine clinical practice. Any future product would need to go through rigorous prospective clinical trials and regulatory approvals before it could be used as a tool for doctors. This work joins a growing body of research in the area of developing predictive models that could inform clinical research and trials. In line with this, Moorfields will be making the dataset available through the Ryan Initiative for Macular Research. We hope that models like ours will be able to support this area of work to improve patient outcomes.

Source: Google in Europe

How AI could predict sight-threatening eye conditions

Vision loss and wet AMD

How AI could predict the development of wet AMD

What’s next

Source: The Official Google Blog

Dr. Karen DeSalvo on “putting information first” during COVID-19

Dr. Karen DeSalvo knows how to deal with a crisis. She was New Orleans Health Commissioner following Hurricane Katrina and a senior official at the Department of Health and Human Services when Ebola broke out. And now, as Google’s Chief Health Officer, she’s become the company’s go-to medical expert, advising our leaders on how to react to the coronavirus. Dr. DeSalvo has been a voice of reassurance for Googlers, but her expertise is helpful outside of Google, too. I recently spoke to Dr. DeSalvo about how we’ll get through the crisis, what Google is doing to help and what makes her optimistic despite the challenges we face.

How is the coronavirus different from other public health crises you’ve dealt with?
In my work in New Orleans, whether it was a hurricane, a fire or a power outage, we drew resources from other parts of the country if we needed help. In this case, the entire world has been impacted. Everyone is living with uncertainty, disrupted supply chains, impacts on travel and social infrastructure. While this creates a sense of community that I hope will continue beyond the pandemic, the downside is that we have less opportunity to send assistance to other places. Where there is opportunity, we’ve seen people paying it forward, like when California deployed ventilators to the East Coast. The sense of community that grows out of any disaster is the bright spot, for me.

How are industries sharing ideas and research in this global crisis?
Physicians are using technology to talk to each other constantly about what they’re seeing and doing, and in prior outbreaks this real-time communication wasn’t possible. It makes a huge difference in clinical care. In the medical community, you sometimes have to pay for a journal article. But now if you want to read about COVID-19, it’s free for any researcher, scientist, clinician or layperson. That’s putting information first, putting knowledge and science above proprietary interest.

It’s happening in science, too. For instance, there’s a collaboration between competitors in the private sector on designing trials and assessing the outcome of drugs and vaccines. At Google, our Deepmind colleagues were able to use quantum computing to show protein folding, helping advance the thinking about therapeutics and vaccines. I don’t think we’ve seen this spirit of collaboration in the history of science, and it’s one of the reasons I’m so optimistic.

What is Google doing to help curb misinformation?
In this historic moment, access to the right information at the right time will save lives. Period. This is why our Search teams design our ranking systems to promote the most relevant and reliable information available. We build these protections in advance so they’re ready when a crisis hits, and this approach serves as a strong defense against misinformation.

When COVID-19 began to escalate, we built features on top of those fundamental protections to help people find information from local health authorities. We initially launched an SOS alert with the World Health Organization to make resources about COVID-19 easily discoverable. This has evolved into an expanded Search experience, providing easy access to more authoritative information, alongside new data and visualizations.

We’re surfacing content that’s accessible to a whole range of communities, and there’s constant vigilance to remove misinformation on platforms like YouTube—this includes videos or other information that could be harmful to people.

Search COVID GIF — COVID-19 information on Search.

What does it mean to be Google’s Chief Health Officer?
My role is to bring a holistic view of emotional, physical and social health and well-being to Google’s products and services, particularly under Google Health. During this pandemic, my team has also thought about how Google can assist public health efforts. This has meant anything from the Community Mobility Reports, a tool to help measure the impact of social distancing, to building playlists in partnership with YouTube geared towards clinicians, and showing testing sites for COVID-19 all over the world.

In the general public, what behaviors or mentalities have arisen that should continue in the future?
First, there are fundamental ways to reduce the transmission of communicable diseases like the flu or, in some communities, measles or tuberculosis. If you’re able to, it’s important to stay home if you’re sick, wash your hands, cough into your elbow—I call these the “Grandma rules.” Second, there are a lot of components to health: social health, emotional well-being, financial stability. Health is driven by more than just medical care, and this is a moment for us to remember that a holistic approach matters.

What should business owners consider for when restrictions begin to lift?
They need to prepare for a world in which employees can work remotely as much as possible. Policies will still recommend social distancing, but we also need to create an environment where people who are sick feel comfortable staying home. That’s not realistic for every small business, so paying attention to the basic hygiene stuff—Do the Five—is also important.

After Katrina, there was this time when the world was paying attention and trying to help, but the emotional and social impact on our community lasted for months. There will be some of that after this pandemic, because you can’t just flip a switch and have people go back to work. That’s the important thing—being patient as people put themselves back into a normal routine.

Health is driven by more than just medical care, and this is a moment for us to remember that a holistic approach matters.

Taking off your Chief Health Officer hat, how do you reassure friends and family when they’re worried about this situation?
Medically, we need to be patient and let the scientists do their thing. It’s probably going to take until summer or early fall in the northern hemisphere to get clarity on what therapeutics work. The end game is to develop a vaccine so we can make sure everybody is protected. This is going to be a long journey with many months ahead, so we need to pace ourselves.

Statistically, more people will have anxiety and depression from COVID-19 than will actually get COVID-19. To share tips on mental well-being, we recently launched the “Be Kind To Your Mind” PSA on Google Search.

Lastly, I remind those who are privileged to have a safe space to stay home when other people can’t. I think about my previous work with low income patients, and how this crisis impacts them as well as communities of color, non-native English speakers, and individuals with disabilities. Staying home is not safe, comfortable and financially feasible for everybody. We should all be doing what we can for our neighbors and our friends and the people who aren’t always seen.

Source: The Official Google Blog

Resources for mental health support during COVID-19

The coronavirus pandemic has disrupted lives around the world. In addition to the lives lost to the virus, as many communities enter the second and third month under stay-at-home orders, there is a rising mental health toll, too. In a national survey released by the American Psychiatric Association in March, 36 percent of respondents said that COVID-19 was seriously impacting their mental health; 48 percent were anxious about getting infected; and 57 percent reported concern that COVID-19 will seriously impact their finances.

As a trained psychiatrist, I know firsthand the importance of bringing out into the open the issue of mental health. While it might be years between the first onset of symptoms and someone seeking help, the internet is often the first place people turn to find out more about mental disorders. To help address the emerging mental health crisis we’re sharing “Be Kind to Your Mind," which includes resources on mental wellbeing from the Centers for Disease Control and Prevention (CDC). Whenever people in the U.S. search for information about coping with the pandemic, or on COVID-19 and mental health, we’ll show a public service announcement with tips to cope with stress during COVID-19. To raise awareness of the importance of mental wellbeing during these times, we'll highlight these resources on Google's homepage tomorrow.

be kind to your mind.jpg — Whenever people in the U.S. search for information about coping with the pandemic, we’ll show a public service announcement with tips to cope with stress during COVID-19.

With May being Mental Health Awareness Month, we want to highlight a few other resources and tools across Google and YouTube that promote mental wellbeing.

Self-assessment questionnaires for depression and PTSD

When people search on Google for information about mental health conditions we provide panels with information from authoritative sources like Mayo Clinic that detail symptoms, treatments, and provide an overview of the different types of specialists who can help. On the info panels for depression and post traumatic stress disorder (PTSD), we provide direct access to clinically-validated self-assessment questionnaires that ask some of the same types of questions a mental health professional might ask. Based on a person’s answers, these self-assessment tools provide information on risk, along with links to more resources. Results to these questionnaires are not logged. We hope they can provide insight and help people have a more informed conversation with their doctor. We will add more self-assessment questionnaires over time to cover more conditions.

Self-care content on YouTube

Over the last few months, YouTube has seen a 35 percent increase in views of meditation videos, and growing popularity of mindfulness and wellbeing content. YouTube is making videos like these and other mental health resources more widely available to anyone around the world, for free, by spotlighting channels and playlists that have wellbeing and mindfulness-focused content. Countless YouTube creators, like Dr. Mike and Kati Morton, educate their communities as they help reduce the stigma associated with mental health. YouTube is also launching relevant YouTube Originals, including a “BookTube” episode featuring top authors like Melinda Gates and Elizabeth Gilbert offering their best book recommendations.

Finding virtual care options, quickly

Because of stay-at-home orders and restrictions that limit in-person interactions, many mental health care providers (including therapists and psychiatrists) are now providing telehealth care, like conducting therapy sessions over video conference. To make these options easier to find, we now allow providers to highlight their virtual care services on their Google Business Profile. So now, when you search for a mental health provider in products like Search and Maps, you may see an “Online care” link that can take you to their virtual care page, or even schedule a virtual appointment.

While the stigma around mental health has lessened in recent years, many people still find it hard to reach out to get help. By providing access to mental health resources, services and information across our products, we hope to make it easier for people to seek help and receive proper care.

Source: The Official Google Blog

Healthcare AI systems that put people at the center

Over the past four years, Google has advanced its AI technologies to address critical problems in healthcare. We’ve developed tools to detect eye disease, AI systems to identify cardiovascular risk factors and signs of anemia, and to improve breast cancer screening.

For these and other AI healthcare applications, the journey from initial research to useful product can take years. One part of that journey is conducting user-centered research. Applied to healthcare, this type of research means studying how care is delivered and how it benefits patients, so we can better understand how algorithms could help, or even inadvertently hinder, assessment and diagnosis.

Our research in practice

For our latest research paper, "A Human-Centered Evaluation of a Deep Learning System Deployed in Clinics for the Detection of Diabetic Retinopathy," we built on a partnership with the Ministry of Public Health in Thailand to conduct field research in clinics across the provinces of Pathum Thani and Chiang Mai. It’s one of the first published studies examining how a deep learning system is used in patient care, and it’s the first study of its kind that looks at how nurses use an AI system to screen patients for diabetic retinopathy.

Over a period of eight months, we made regular visits to 11 clinics. At each clinic, we observed how diabetes nurses handle eye screenings, and we interviewed them to understand how to refine this technology. We did our field research alongside a study to evaluate the feasibility and performance of the deep learning system in the clinic, with patients who agreed to be carefully observed and medically supervised during the study.

A nurse operates the fundus camera, taking images of a patient’s retina.

The observational process

In our research, we provide key recommendations for continued product development, and provide guidance on deploying AI in real-world scenarios for other research projects.

Developing new products with a user-centered design process requires involving the people who would interact with the technology early in development. This means getting a deep understanding of people’s needs, expectations, values and preferences, and testing ideas and prototypes with them throughout the entire process. When it comes to AI systems in healthcare, we pay special attention to the healthcare environment, current workflows, system transparency, and trust.

The impact of environment on AI

In addition to these factors, our fieldwork found that we must also factor in environmental differences like lighting, which vary among clinics and can impact the quality of images. Just as an experienced clinician might know how to account for these variables in order to assess it, AI systems also need to be trained to handle these situations.

For instance, some images captured in screening might have issues like blurs or dark areas. An AI system might conservatively call some of these images “ungradable” because the issues might obscure critical anatomical features that are required to provide a definitive result. For clinicians, the gradability of an image may vary depending on one’s own clinical set-up or experience. Building an AI tool to accommodate this spectrum is a challenge, as any disagreements between the system and the clinician can lead to frustration. In response to our observations, we amended the research protocol to have eye specialists review such ungradable images alongside the patient’s medical records, instead of automatically referring patients with ungradable images to an ophthalmologist. This helped to ensure a referral was necessary, and reduced unnecessary travel, missed work, and anxiety about receiving a possible false positive result.

Finally, alongside evaluating the performance, reliability, and clinical safety of an AI system, the study also accounts for the human impacts of integrating an AI system into patient care. For example, the study found that the AI system could empower nurses to confidently and immediately identify a positive screening, resulting in quicker referrals to an ophthalmologist.

So what does all of this mean?

Deploying an AI system by considering a diverse set of perspectives in the design and development process is just one part of introducing new health technology that requires human interaction. It's important to also study and incorporate real-life evaluations in the clinic, and engage meaningfully with clinicians and patients, before the technology is widely deployed. That’s how we can best inform improvements to the technology, and how it is integrated into care, to meet the needs of clinicians and patients.

Source: The Official Google Blog

Connecting people to virtual care options

To prevent the spread of COVID-19, many healthcare providers are reducing or stopping in-person visits for a variety of patient needs, from the treatment of chronic conditions to mental health services to evaluating cough and cold symptoms. Yet, people need a way to continue getting medical care from the comfort and safety of their own homes. Since the beginning of the pandemic, we’ve seen interest in virtual care and telehealth rise dramatically. Health consultations over the phone or by video conference not only help alleviate strain on doctors’ offices and emergency rooms but are also recommended as an important way to protect patients and staff against COVID-19.

To help individuals and health care providers connect, we’re focused on providing individuals with access to high-quality and authoritative information and supporting them throughout their health journey. Over the coming week, we’re beginning to roll out two new features in Search and Maps that make it easier for people to connect to virtual healthcare options, whether it’s to a doctor’s office down the street, the hospital across town, or a national telehealth platform.

Local healthcare providers, now virtual

Healthcare providers like hospitals, doctors, and mental health professionals can now enter a virtual care offering in their Business Profile, so that people searching for their local provider, for instance, might see a “get online care” link on Search and Maps. Clicking this link will take people to that provider’s virtual care website where they can find more information, and in many cases, schedule a virtual healthcare visit with a provider.

The pandemic has affected many healthcare providers’ operating hours and walk-in visit policies. To help communicate changes that might affect someone’s visit, we’re automatically surfacing a link directly to health providers’ COVID-19 information page on Search and Maps, and we've assembled best practices on how healthcare providers can update their websites and provide COVID-19 information on Google My Business.

New health information about Hillview Hospital — With health providers limiting in-person visits due to COVID-19, we’re making it easier for people to discover virtual care options.

Find virtual healthcare, anywhere, anytime

Beginning as a pilot in the U.S., we’ll also begin showing widely-available virtual care platforms directly on Search so people can more easily access virtual visits. For example, when people search for “immediate care”, we’ll be able to also present available virtual care options and related information such as the out-of-pocket price charged for a visit (for those without insurance) and an easy way for people to directly connect with the virtual care platform. The visit between the patient and provider will take place on the healthcare provider’s platform of choice.

For healthcare providers, helping you keep up with demand

In addition to helping healthcare providers with information about how to keep their online business information up-to-date, Google Cloud is supporting providers with technology infrastructure and solutions to assist with care delivery and operations. This includes helping doctors support patients remotely with HIPAA-compliant G Suite products (including using Google Meet for telehealth or virtual visits),deploying virtual agents to field questions related to COVID-19, and helping with capacity-planning and demand forecasting of key medical supplies to better manage their supply chains.

The global COVID-19 pandemic and the response to prevent its spread has changed the way individuals access and connect to health care. Across our products, we’ll continue to ensure that healthcare providers have the tools to connect with patients, and that anyone can access the information and care they need to stay healthy.

Source: Google LatLong

Connecting people to virtual care options

Local healthcare providers, now virtual

Find virtual healthcare, anywhere, anytime

On Search, you can see information about virtual healthcare platforms — People will be able to see widely-available virtual healthcare platforms directly on Search as well as the out-of-pocket cost for a visit.

For healthcare providers, helping you keep up with demand

Source: Search

Support for public health workers fighting COVID-19

This week, we're beginning a series of Doodles to recognize the many people responding to COVID-19—from doctors and nurses caring for people on the front lines, to teachers and food service workers ensuring essential goods and services are still available. Coinciding with the start of National Public Health Week in the U.S., our first Doodle in the series shines a light on the public health workers who are at the forefront of fighting this disease.

Public health is what we do together as a society to create the conditions in which everyone can be healthy. Public health workers include leaders at organizations such as the World Health Organization (WHO), as well as scientists, like epidemiologists, field researchers, and lab scientists and technicians working to better understand the virus, find new cases, and track and predict and prevent its spread.

Community education and access to reliable information are critical parts of promoting and protecting public health. Over the last few months we’ve partnered with WHO, Centers for Disease and Prevention (CDC) and national health ministries to surface authoritative information on COVID-19. On Search, people can find official information on how to prevent COVID-19 transmission, with links to helpful resources from health authorities. On YouTube, we have a dedicated news shelf with COVID-19 news from authoritative sources, curated playlists with official information, and we’ve connected popular YouTube creators with public health leaders. We’ve also launched #StayHome #WithMe, a campaign that encourages people to practice social distancing with playlists on education, cooking, fitness and more.

Beyond this education effort, we’re proud to support the important work public health workers are doing behind the scenes to learn more about the virus, develop and deploy vaccines, and create evidence-based policy intended to reduce community transmission.

Scientists are critical to understanding and combating COVID-19. We’re supporting their work by providing Google Cloud research credits, including high performance computing to researchers. On Google Cloud’s Kaggle data science community, a coalition of leading research groups have gathered more than 44,000 COVID-19-related scholarly articles to share with data scientists.

To aid researchers, data scientists, and analysts, we’ve also made available a hosted repository of public datasets, like Johns Hopkins Center for Systems Science and Engineering, the Global Health Data from the World Bank, and OpenStreetMap data, free to access and query through our COVID-19 Public Dataset Program.

Just last week we published an early release of our COVID-19 Community Mobility Reports: aggregated, anonymized data on movement trends across places such as retail and recreation, groceries and pharmacies, to give public health workers insights to make more data driven policy. These reports are designed to inform public health officials as they implement and refine social distancing measures designed to prevent the spread of the virus, while protecting essential movement.

Today we salute public health workers who are playing an important role in responding to this pandemic. Over the next two weeks, our Doodles will honor other essential frontline workers, including healthcare workers, first responders and the many people keeping services like sanitation, food service, public transit, schools, and more up and running. Thank you to all the people who are working to save lives and keep communities safe during this pandemic.

Source: The Official Google Blog

Helping public health officials combat COVID-19

As global communities respond to the COVID-19 pandemic, there has been an increasing emphasis on public health strategies, like social distancing measures, to slow the rate of transmission. In Google Maps, we use aggregated, anonymized data showing how busy certain types of places are—helping identify when a local business tends to be the most crowded. We have heard from public health officials that this same type of aggregated, anonymized data could be helpful as they make critical decisions to combat COVID-19.

Starting today we’re publishing an early release of our COVID-19 Community Mobility Reports to provide insights into what has changed in response to work from home, shelter in place, and other policies aimed at flattening the curve of this pandemic. These reports have been developed to be helpful while adhering to our stringent privacy protocols and policies.

The reports use aggregated, anonymized data to chart movement trends over time by geography, across different high-level categories of places such as retail and recreation, groceries and pharmacies, parks, transit stations, workplaces, and residential. We’ll show trends over several weeks, with the most recent information representing 48-to-72 hours prior. While we display a percentage point increase or decrease in visits, we do not share the absolute number of visits. To protect people’s privacy, no personally identifiable information, like an individual’s location, contacts or movement, is made available at any point.

We will release these reports globally, initially covering 131 countries and regions. Given the urgent need for this information, where possible we will also provide insights at the regional level. In the coming weeks, we will work to add additional countries and regions to ensure these reports remain helpful to public health officials across the globe looking to protect people from the spread of COVID-19.

Navigate and download a report for your region of interest

In addition to other resources public health officials might have, we hope these reports will help support decisions about how to manage the COVID-19 pandemic. For example, this information could help officials understand changes in essential trips that can shape recommendations on business hours or inform delivery service offerings. Similarly, persistent visits to transportation hubs might indicate the need to add additional buses or trains in order to allow people who need to travel room to spread out for social distancing. Ultimately, understanding not only whether people are traveling, but also trends in destinations, can help officials design guidance to protect public health and essential needs of communities.

A Community Mobility Report example for State of Louisiana, United States

In addition to the Community Mobility Reports, we are collaborating with select epidemiologists working on COVID-19 with updates to an existing aggregate, anonymized dataset that can be used to better understand and forecast the pandemic. Data of this type has helped researchers look into predicting epidemics, plan urban and transit infrastructure, and understand people’s mobility and responses to conflict and natural disasters.

Privacy protections

The Community Mobility Reports are powered by the same world-class anonymization technology that we use in our products every day. For these reports, we use differential privacy, which adds artificial noise to our datasets enabling high quality results without identifying any individual person.

The insights are created with aggregated, anonymized sets of data from users who have turned on the Location History setting, which is off by default. Users who have Location History turned on can choose to turn the setting off at any time from their Google Account, and can always delete Location History data directly from their Timeline.

These are unprecedented times and we will continue to evaluate these reports as we get feedback from public health officials, civil society groups, local governments and the community at large. We hope these insights will add to other public health information that will help people and communities stay healthy and safe.

Source: The Official Google Blog

Helping public health officials combat COVID-19