Watson’s first application is highly focused: recommending the best drug treatment options for patients with late-stage cancers called lung adenocarcinomas, said Mark Kris, MD, of Memorial Sloan-Kettering Cancer Center. The New York City hospital is developing the tool with IBM and Wellpoint, the managed care company.
The supercomputer has compiled a mountain of data from thousands of sources including journal articles, national guidelines, hospital best practices, clinical trials, and textbooks.
Watson provides evidence-based and individualized treatment recommendations immediately after a doctor enters case notes into an electronic medical record.
Doctors only make the correct treatment recommendations 50% of the time in lung cancer, a Wellpoint official said at a recent press event.
“This is not an easy task,” says Kris. Programming Watson for Jeopardy! took four years to complete, he says.
Watson interfaces with a patient’s electronic medical record. Individual treatment recommendations are updated as case notes become more detailed over time.
Watson can aid humans in doing the increasingly complex job of being a cancer doctor, says H. Jack West, MD, of the Swedish Medical Center in Seattle.
“A computer can incorporate a nearly infinite amount of new data coming out, while the human brain can’t attend to so much and integrate it,” West says.
West, who is not involved with Watson, sees two problems with its use in cancer care: that cancer varies from person to person and that clinical decisions are often matters of judgment.
Even the most complex algorithms rely, to some degree, on “classic presentation,” he says. Medical practice is less orderly, he says. “The truth is that just about every cancer case is special and has some unique aspects to it, or at least there are so many extenuating factors that it’s hard to be rule-based.”
West applauds Watson’s developers at IBM who have admitted, he says, that “there is no substitute for the most expert input when it is available.” Computers will never replace doctors, West says.
Kris says Watson is not a replacement for doctors and will require a “long, long time” to fully develop.
But Kris does say that Watson can help doctors with some decisions.
For instance, the list of potential chemotherapies available for treatment is long. Guidelines do not fully show which chemotherapy is best or specify dose, length of treatment, or other specifics, he says.