Test Timeline

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one more chance for humans?

I’ve been following with interest the “Jeopardy!” programs featuring Watson, the IBM supercomputer designed to play the game. On the first program Monday Watson took an early lead over the human “Jeopardy!” champs, Ken Jennings and Brad Rutter, but it seemed stumped when the high-dollar questions were reached, and the game ended in a tie between Watson and Rutter. In the second game Watson ran away with the lead.

So what caught my attention this morning was the headline of the article in International Business Times: “Round Two Goes to Watson; Humans Have One More Chance.” So how did the article’s author, Gabriel Pena, mean “one more chance for humans”? One more chance to win “Jeopardy!” ? Or does it mean something more existentially ominous: one more chance for humans before we’re replace by machines smarter than we are?

I don’t think it’s time to panic. And I’m a real skeptic of ideas like the “singularity”: a time in the not-too-distant-future at which computers become so intelligent and superior at controlling systems in our world that we’re irrelevant.

But my wife’s reaction to the prospect of Watson beating some really smart guys is telling. She asked, “So who’s going to loose their job?” Ah, yes! Haven’t we learned a few things during the so-called “Great Recession”? One of them is that people laid off are not being rehired; companies are investing in “productivity” tools rather than jobs. “Productivity” is a code word for doing the same work with fewer jobs.  If you are not the person running the new productivity devices then your job’s in jeopardy for sure. Implementing higher productivity has been a basic economic process for a long time, but Watson’s technology is enough to make the hair stand up on the back of your neck.

Technological productivity advances are like riding on the back of a tiger: if you stay on its back you’re okay, but if you fall off you’re chow. Watson is a productivity system that appears to have made a real stride in being able to take a English language question and parse it into a specific information request better than than earlier question-answering technologies. IBM calls it “open question answering.” The company is going to turn this into commercial procuct and apply it initially in medicine and medical law. It will help researchers or doctors plow through vast stores of unstructured information like journals to come up with answers to their questions more efficiently than anything before.  As and IBM exec, David McQueeney, said to the Washing Post this morning:

“Imagine taking Watson, and instead of feeding it song lyrics and Shakespeare, imagine feeding it medical papers and theses,” he said. “And put that machine next to an expert human clinician.”

With the computer intelligently processing a vast amount of data and the doctor using his or her own professional knowledge to guide and refine a search, McQueeney said, IBM thinks the quality of that diagnosis could be better than what the doctor comes up with alone.

Looks like doctors will be the first up on the back of this tiger.

I have been a skeptic about artificial intelligence for a long time. I’ve been hearing that AI is right around the corner since the ’50s. Lots of claims have been made but, like the rocket-belt, flying car, nuclear fusion, undersea cities, and the cure for cancer, the expected results haven’t been delivered. Watson is by no means and equivalent to human intelligence, but it appears to be an indicator that progress is being made. We’re not about to be made totally obsolete any time soon — if ever — but the “second chance” for many of us is to stay abreast of this emerging technology and use it as our tool rather than have it put us behind the 8-ball.


big, big health bills down the road

The other shoe dropped today. The first one dropped a couple of weeks ago when the Journal of the National Cancer Institute (JNCI) published: “Cancer Care Costs in the United States: 2010–2020.”
The estimated total cost of cancer care in the United States in 2020 is expected to be $158 billion assuming the most recent observed patterns of incidence, survival, and cost remain the same. This represents a 27% increase from 2010 due only to the projected aging and growth of the US population, according to a study published online January 12th in The Journal of the National Cancer Institute. However, the authors also note the cost of cancer care could rise even more quickly under some reasonable assumptions such as a 2% annual increase in costs of the initial and final phases of cancer care. [...] Under a different scenario of continuing trends in cancer incidence, survival, and costs of care, the total cost of cancer care in 2020 is expected to be $173 billion, an even larger increase (39% from 2010).
That was shoe #1. Shoe #2 slammed to the floor when I read on physorg.com today: “Cost to treat heart disease in United States will triple by 2030.”
“Despite the successes in reducing and treating heart disease over the last half century, even if we just maintain our current rates, we will have an enormous financial burden on top of the disease itself,” said Paul Heidenreich, M.D., chair of the American Heart Association expert panel issuing the statement. [...] Between 2010-30, the cost of medical care for heart disease (in 2008 dollar values) will rise from $273 billion to $818 billion, the authors predicted. “We were all surprised at the remarkable increase in costs that are expected in the next two decades,” Heidenreich said. “We need to continue to invest resources in the prevention of disease, the treatment of risk factors and early treatment of existing disease to reduce that burden.”
And, heck, there are more shoes to come. Some projections show Alzheimer’s disease increasing by 40% just between 2000 and 2025. The cost in dollars and in stress of that disease is huge. Just to round things out, an article in USA Today a couple of weeks ago put a big price-tag on obesity:

The total economic cost of overweight and obesity in the United States is $270 billion per year while the cost in Canada is about $30 billion a year, a new study shows. [...] The $300 billion total cost in the United States and Canada is the result of: increased need for medical care ($127 billion); loss of worker productivity due to higher rates of death ($49 billion); loss of productivity due to disability of active workers ($43 billion); and loss of productivity due to total disability ($72 billion), said the Society of Actuaries (SOA).

That’s not even counting the long-term cost of obesity on the upcoming generation. A Stanford Medical Center publication lists among the effects of obesity: high blood pressure, diabetes, heart disease, joint problems, cancer, sleep apnea, metabolic syndrome, psychological problems…among other things. Some project that the current generation my be the first in US history to actually live shorter lives, on average, than their parents.
I worked 40 years in public health, 35 of them in a cancer organization. Never in my career did I hear a serious discussion of the economics of cancer, the aggregate cost of research and treatment, nor what, if any, unintended consequences might result in the bigger picture of healthcare in society. No one raised the question of whether surviving one disease just make people candidates for other problems just as dire. In the cancer community the goal these days is not to get rid of the disease entirely — a goal that it took a long time to realize isn’t feasible in the foreseeable future — but to make cancer a disease that no one dies from. So the result will be that cancer “survivors” will be shifted over to die eventually of something else: heart disease, maybe, or Alzheimer’s. Just as long as death isn’t from cancer, it’s a victory…of sorts.
My point is not that relieving the burdens of disease is an unworthy goal. But during the 20th century medicine fragmented into dozens of specialized professions, advocacy groups, and agencies, all pushing the envelope of what they want to achieve. It’s time for all concerned to step back and determine what expectations are realistic and what the consequences are. We’re now in a huge political hassle over the cost of future health care and who’s going to pay it. The data above indicate the price will be great. It’s time for well-intended advocates to include in their mission wrestling with the real-world issue of making their ambitions feasible with finite resources.

the path to a new health paradigm takes one big step

Two or three years ago as the first direct-to-consumer DNA kits were being offered by companies like 23andMe and Navigenecs a big kerfuffle erupted when the California and New York departments of public health threatened to shut them down. The authorities claimed it was their duty to block the tests because the tests were offered online rather than through a licensed physician and because they were worried to death that the test results might be misinterpreted and cause unnecessary anxiety among recipients.

I was working with CA State Health Department people back at the time through my job in cancer public health. Nevertheless, I always suspected that the legal moves by the states were more to protect their statutory prerogatives and the medical profession than to protect the public. After all, I had been running into similar excuses to control cancer information among physicians for 30 years. Back in the ’70s some doctors would not tell their patients that they had been diagnosed with cancer for the ostensible reason that it would cause a lot of anxiety, and, besides, often there wasn’t much physicians could do about many cancers at the time. The situation improved after informed consent laws were passed forcing medical practitioners to explain diagnoses to patients before treating them. Also the organization I worked for would not give cancer patients professional-level pamphlets or journal reprints for fear of “confusing” patients and for fear of the docs who’d clobber us.

A lot of debate about the hypothesized impact of genetic information has been similar to the argument about the advisability of cancer information in years past. Fortunately some studies have been conducted to try to measure the emotional impact of genetic test information, especially genetic indicators for diseases like Alzheimer’s for which there is no treatment. The NY Times reported a couple of days ago about a study published recently in the News England Journal of Medicine that found essentially that news from the genetic tests didn’t cause a lot of anxiety in a study group of 2000. Many people didn’t take advantage of free genetic counseling offered or even discuss it with their doctors. Nor did the test affect behavior much in a positive way, such as changing lifestyle toward better eating habits. The surprising finding was how little impact the information had on people.

An author of one of the study stated:

“The medical field has been paternalistic about these tests,” says Peter J. Neumann, the lead author of the study, who is director of the Center for the Evaluation of Value and Risk in Health at Tufts Medical Center. “We’ve been saying that we shouldn’t give people this information because it might be wrong or we might worry them or we can’t do anything about it. But people tell us they want the information enough to pay for it.”

The author of the article, John Tierney, offers:

The traditional structure of American medicine gives control to doctors and to centralized regulators who make treatment decisions for everyone. These genetic tests represent a different philosophy, and point toward a possible future with people taking more charge of their own care and seeking treatments customized to their bodies. “What we have today is population medicine at the 30,000-foot level,” says Dr. Topol. “These tests are the beginning of a new way to individualize medicine. One of the most immediate benefits is being able to use the genetic knowledge to tweak the kind of drugs people take, like choosing among statins and beta blockers to minimize side effects.”

I agree with Tierney. This is a step toward a new way of medicine. As I write this the conflict over health care reform is on again. The health care model in the US is a mess and isn’t financially sustainable with about 8,000 baby boomers being added to Medicare each day. I think we need to shift a great deal of health responsibility to people, but it must be real, empowered responsibility with knowledge tools, decision making, and a support infrusturcture that’s available to all citizens. Conservatives use the term “responsibility” as a code word for blame. You know, “You’re  responsible (i.e., to blame) if you’re sick, not me. Don’t ask me for taxes to fix you up.”

If people are to take meaninful responsibility they need a system that provides them with meaninful information about their genetics, real time data about how they’re doing through, perhaps, mobile health monitoring, and a worldwide communication system that makes the latest scientific evidence about disease freely available in comprehensible, personalizable form. Putting up barriers to information like the results of DNA test through spurious fears of damaging effects is not the way to go about it. In the last century and a half we’ve created a huge, expensive scientific and medical system that restricts information and authority to an elite few gatekeepers. That’s got to change.


A slap on the side of the head

I’ve said before I’m grateful to Sputnik and the USSR for enabling me to get a good education back in the ’50s and ’60s. The US taxpayers were generous to education during that time mainly, it seems to me, because we were scared as hell the Soviets were going to surpass us.

Perhaps something similar is happening again. This time it’s the Chinese. All of a sudden they seem like the 900 lb. gorilla in the room. Back last December the results of the Organization for Economic Co-operation and Development (OECD) released the results of it’s international standardized education program (PISA) comparing 2009 test scores on math, reading, and science for 15-year-olds in 65 countries. The top four aggregate scores were, in order, Shanahai-China, Finland, Hong Kong-China and Singapore. The US teens in 24th place in math, 17th in reading and 23rd in science. The US students ranked down in the pack with many European countries.

That results have raised alarm in some quarters.

“We have to see this as a wake-up call,” Secretary of Education Arne Duncan said in an interview on Monday.

“I know skeptics will want to argue with the results, but we consider them to be accurate and reliable, and we have to see them as a challenge to get better,” he added. “The United States came in 23rd or 24th in most subjects. We can quibble, or we can face the brutal truth that we’re being out-educated.”

Well, in the US a sense of crisis seems to be needed to get any action on social issues. So perhaps another Chinese surprise–the quite visible test flight of a stealth fighter just as US Secretary of Defense Gates landed for a visit–will add the the sense of urgency.

Maybe it’s a question of whose “exceptionalism” will win. The US has proclaimed it’s exceptionalim for decades. Scholars say the Chinese have a sense of cultural exceptionalim that goes back a couple of millennia. So when is the chest thumping of exceptionalism a confidence-builder, and when is it a pair of foggy, rose-colored glasses that obscure a society’s perception of the capabilities of other people?


is synthetic life approaching?

By Richard Wheeler (Zephyris) 2007. Lambda rep...
Image via Wikipedia

There has always been a metaphysical aura about life. In addition to the material in a cell or other living thing, most people seem to think that when we say “life” we’re talking about a spark or energy that transcends the material constituents of that living thing.

But suppose that organisms that show all the properties of life can be created by off-the-shelf raw materials of our world and made to function as living through human-designed processes? At no point would some spark or energy be added to jump-start life processes although complex chemical reactions are central to synthesizing the constituent parts. (Is the term Frankenmolecules already taken?)

Researchers are working on just such approaches in an effort to understand the details of how living things get organized, and just recently another step was  taken. Princeton chemist Howard Hecht and his team built proteins from scratch, put them in bacteria, and the bacteria used them to grow and carry on just like the proteins they naturally generate. They demonstrated that there’s nothing mystical or magical about molecules generated in vivo. Actually, there were two artificial steps: they designed artificial DNA that then generated the synthetic proteins.

“What we have here are molecular machines that function quite well within a living organism even though they were designed from scratch and expressed from artificial genes,” said Michael Hecht, a professor of chemistry at Princeton, who led the research. “This tells us that the molecular parts kit for life need not be limited to parts — genes and proteins — that already exist in nature.”

“What I believe is most intriguing about our work is that the information encoded in these artificial genes is completely novel — it does not come from, nor is it significantly related to, information encoded by natural genes, and yet the end result is a living, functional microbe,” said Michael Fisher, a co-author of the paper who earned his Ph.D. at Princeton in 2010 and is now a postdoctoral fellow at the University of California-Berkeley. “It is perhaps analogous to taking a sentence, coming up with brand new words, testing if any of our new words can take the place of any of the original words in the sentence, and finding that in some cases, the sentence retains virtually the same meaning while incorporating brand new words.”

Although millions of proteins from evolved DNA already exist, the ones Nature has produced is only a small fraction of the proteins that could be produced by heretofore unseen DNA and protein combinations. The potential design space is vast. Some people think living things were produced by intelligent design from the beginning, but I think these experiments are getting us closer to the truth. Evolution of the world’s material into living things over a hell of a long time gave us what has gone before, but we’re getting closer and closer to true design of life forms from a huge set of possibilities that will become part of our world in the not-too-distant future.


life in the megacity

Scientific American had an article a few days ago about recent ideas about the future of “megacities.” Especially in the developing world millions upon millions of people are moving from the farm to the city. As these cities grow one of the big concerns is that the cities will build themselves so that high carbon transportation (a.k.a., automobiles) will be the only feasible way to get around. Los Angeles is the prototypical American city built almost exclusively for auto travel. For decades mass transport was rejected in LA in favor of spending the money on more freeways to accommodate the sprawl. Now mass transit is pretty much out of the question. If the rest of the growing world cities go down that road decreasing emissions will be nearly impossible.

Urban areas already account for about two-thirds of world energy use, and they’ll hit 73 percent by 2030, according to the International Energy Agency. The cities of the future will be bigger, and there will be more of them. According to the United Nations, there were 21 “megacities” in 2009 — urban agglomerations whose population exceeds 10 million. By 2025, there will be 29 — and they’ll hold one-tenth of humanity.

One group of thinkers has pegged four scenarios for urban development:

Sprawlville: cities do everything to accommodate cars in the city and to and from the burbs. But in the end the heart of the city simply succumbs to impenetrable gridlock.

Planned-opolis: where government does everything to automate commutes with self-driving cars and to computerize work so many people can work from home.

Renewabad: where cities build very dense centers with a lot of public transit.

Communi-city: in which city centers die and are replaced by lots of peripheral neighborhoods where people live and work. You can ride a bike to work.

The scenarios leave people unclear about what version or mix or versions will emerge.

But coincidentally two researchers (Adam Millard-Ball and LeeSchipper) published a preliminary copy of a paper titled: “Are We Reaching a Plateau or ‘Peak’ Travel? Trends in Passenger Transport in Six Industrialized Countries.”

In the last several years in the US, UK, Canada, Sweden, France, Germany, Japan and Australia there seems to be a plateau of travel.

Since 2003, motorized travel demand has leveled out or even declined in most of the countries studied, and travel in private vehicles has declined,” the authors wrote in their study. “Car ownership has continued to rise, but these cars are being driven less.

There are several factors that probably play a role: car market saturation, the recession, the price of gas, and aging population. But they assert that the main factor may be road congestion.

The researchers think that the biggest factor of the travel plateau may be traffic congestion. As Schipper said in an interview with Miller-McCune, “My basic thesis is, ‘There ain’t room on the road.’ You can’t move in Jakarta or Bangkok or any large city in Latin America or in any city in the wealthy part of China. I think Manila takes the prize. Yes, fuel economy is really important, and yes, hybrid cars will help. But even a car that generates no CO2 still generates a traffic problem. Sadly, what is going to restrain car use the most is that you can’t move.”

It could be that some problems work themselves out in the long run. The solution may not be what anybody wants, but it’s what you get when you hit the wall. Auto transport may just grind to a halt in the megacities mentioned above, opening the door to other alternatives.

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