Human doctors could soon see one of their most essential roles – disease diagnosis – done by artificial intelligence.
A study published in April found that a large language model (LLM) used by the chatbot ChatGPT, can outperform doctors training in ophthalmology – a surgical speciality that deals with the diagnosis and treatment of eye disorders – when it comes to answering questions used to assess the abilities of doctors.
In an assessment, GPT-4 achieved a score of 69 per cent, compared to an average of 59 per cent for doctors training in ophthalmology.
GPT-4 was much improved over earlier iterations of the technology and outperformed some expert ophthalmologists, although on average they scored more highly.
“LLMs are approaching expert-level knowledge and reasoning skills in ophthalmology,” the study authors wrote in Plos Digital Health.
AI allows us to extract information that just otherwise wouldn’t be available and makes things faster
Prof Stefan Neubauer,
professor of cardiovascular medicine at the University of Oxford
As a result, they said, LLMs like GPT-4 “may provide useful medical advice and assistance where access to expert ophthalmologists is limited”.
The researchers said that ChatGPT had “attracted significant attention in medicine” after being shown to be able to pass medical school exams and to provide “more accurate and empathetic messages than human doctors in response to patient queries on a social media platform”.
GPT-4 can be trained on, the researchers noted, hundreds of billions of words – more than a person could read.
In terms of looking at images to assess disease, AI systems can be trained on millions of pictures and may be able to detect abnormalities more accurately than clinicians.
Reports indicate that Google’s AI technology has been able to match or outperform clinicians at spotting breast cancer in mammograms or eye disease in retinal scans.
When looking at MRIs, AI was recently shown to be better than experts at detecting new or growing brain lesions in multiple sclerosis patients.
Typically, doctors analyse CT scans to determine if the arteries that supply the heart with blood have become narrower due to a build-up of fatty plaque deposits.
About one in five of at least 200,000 people who have a cardiac CT scan in Britain each year have significant narrowing of their coronary arteries and are selected for preventive and interventional treatment due to their increased risk of a heart attack, or to treat anginal symptoms.
However, some of the remaining 80 per cent of patients, who do not have significant narrowing of the coronary arteries, will also be at risk of a heart attack, but this will not be obvious from a CT scan.
Cutting the risk of heart attacks
AI technology from a British company, Caristo Diagnostics, can analyse CT scans and detect inflammation in fat tissue around the coronary arteries.
Patients with this inflammation, even though they do not have narrowing of their coronary arteries, can be selected for treatment thanks to Caristo’s technology, called CaRi-Heart.
“This group of patients needs more refined and individualised risk management and this is what the CaRi Heart device allows us to achieve,” Prof Stefan Neubauer, professor of cardiovascular medicine at the University of Oxford and chief translational officer of Caristo Diagnostics, said.
“We really have a technique that should allow us to greatly improve risk prediction in cardiovascular disease.”
The signals of inflammation “have always been there on cardiac CT scans,” he said, but no one knew they existed or was able to determine them from scans.
“We cannot only do this analysis prospectively in patients who have these CT scans now, but we can also go back to old cardiac CT scans from the archive and do this analysis retrospectively without the patient needing to repeat the CT scan,” he said.
The technology takes into account, among other things, which coronary artery is assessed, the particular characteristics of each patient and the type of scanner used, to give a standardised score that indicates a person’s heart-attack risk, independent from the traditional risk factors such as high blood pressure, cholesterol and smoking.
Regulatory clearance for the technology has been given in the EU, the UK and Australia and it is already being used in some hospitals. Caristo aims to secure approval for a US launch from the US Food and Drug Administration next year.
Redefining medical treatment
Prof Neubauer said AI “very much refines the way we can do medicine” and is a step towards precision or personalised medicine, in which treatments are tailored much more closely to the patient rather than a disease label.
While AI can improve performance when it comes to medical diagnosis, it is crucial that the decisions it makes remain comprehensible, according to researchers at the University of Cambridge, Addenbrooke’s Hospital, also in Cambridge, and SAS Institute, an AI company in the US.
In the Journal of the American Society of Nephrology, they wrote that the deployment of “black box AI” – AI where the user cannot see the AI’s inputs and operations – is “fraught with risk”.
“Determining the optimal design for AI systems depends on factors beyond performance, with considerations of interpretability and the nature of the intended human-AI interaction also informing many design and engineering choices,” wrote the researchers, who looked at the use of AI to analyse kidney tissue.
Unlocking the eye
Another application of AI in medical diagnostics involves the analysis of photographs of the retina. These images can highlight conditions such as diabetic retinopathy, in which the retina is damaged by high blood sugar levels caused by diabetes.
A US medical AI company, Eyenuk, has developed this technology, which is now being used in 27 countries, including the US and Saudi Arabia.
Dr Kaushal Solanki, Eyenuk’s founder and chief executive, said the technology, which uses a fully robotic camera, offers higher more accurate results in testing than standard methods. These traditional approaches involve an ophthalmologist analysing an image of the patient’s dilated eye.
“Even when patients are going to an ophthalmologist and they undergo dilated ophthalmoscopy, a lot of disease is missed, whereas with our test they don’t need to go to an ophthalmologist – this test can be conducted at the point of care, for example, primary care or even a pharmacy,” Dr Solanki said.
“They don’t need dilation, it’s much more sensitive. It saves cost, it improves the care and it improves access significantly for these patients with diabetes.”
Dr Solanki said retinal imaging using AI was “set to become the diagnostic platform of tomorrow” as there were myriad potential applications beyond detecting vision-threatening conditions such as macular degeneration and glaucoma.
Analysing the eye may also shed light on the risk of heart disease, stroke or Alzheimer’s disease.
“When we detect any issues with microvasculature in the eye, one can be sure that similar issues are happening in the heart or the kidneys. Scientists have found already a lot of correlation between the two,” Dr Solanki said.
“This gets even more powerful as we take multiple images over time and look at smaller changes that are happening between successive visits. That can correlate with the risk of progression of heart disease or stroke or chronic kidney diseases.”
Dr Solanki said ophthalmologists welcome the AI screenings because they reduce care bottlenecks.
“Now, rather than spending precious time screening healthy patients, ophthalmologists are referred more patients who are in need of further management, including treatment,” he said.
Similar to the way that Eyenuk's technology may be able to highlight a range of conditions, Caristo’s approach is being adapted to be used in future to highlight conditions such as diabetes or strokes.
Prof Neubauer, who has 40 years’ experience in medicine, said AI offered great strides in diagnosis similar to those that came from the introduction of echocardiography, CT scans and MRI scans decades ago.
“I witnessed how the advent of these techniques completely transformed how we assessed, diagnosed or treated the patients and now this really is the next stage of revolution,” he said.
“AI allows us to extract information that just otherwise wouldn’t be available and makes things faster, more objective and probably cheaper in the long run.
“AI will not make physicians redundant, but it make things much harder for the physicians that don’t know how to use AI.”
Arab Health 2024 showcases medical technology of the future – in pictures
COMPANY PROFILE
Name: Lamsa
Founder: Badr Ward
Launched: 2014
Employees: 60
Based: Abu Dhabi
Sector: EdTech
Funding to date: $15 million
What the law says
Micro-retirement is not a recognised concept or employment status under Federal Decree Law No. 33 of 2021 on the Regulation of Labour Relations (as amended) (UAE Labour Law). As such, it reflects a voluntary work-life balance practice, rather than a recognised legal employment category, according to Dilini Loku, senior associate for law firm Gateley Middle East.
“Some companies may offer formal sabbatical policies or career break programmes; however, beyond such arrangements, there is no automatic right or statutory entitlement to extended breaks,” she explains.
“Any leave taken beyond statutory entitlements, such as annual leave, is typically regarded as unpaid leave in accordance with Article 33 of the UAE Labour Law. While employees may legally take unpaid leave, such requests are subject to the employer’s discretion and require approval.”
If an employee resigns to pursue micro-retirement, the employment contract is terminated, and the employer is under no legal obligation to rehire the employee in the future unless specific contractual agreements are in place (such as return-to-work arrangements), which are generally uncommon, Ms Loku adds.
THE BIO:
Sabri Razouk, 74
Athlete and fitness trainer
Married, father of six
Favourite exercise: Bench press
Must-eat weekly meal: Steak with beans, carrots, broccoli, crust and corn
Power drink: A glass of yoghurt
Role model: Any good man
Company Profile
Name: Thndr
Started: 2019
Co-founders: Ahmad Hammouda and Seif Amr
Sector: FinTech
Headquarters: Egypt
UAE base: Hub71, Abu Dhabi
Current number of staff: More than 150
Funds raised: $22 million
The specs
Engine: 2.0-litre 4cyl turbo
Power: 261hp at 5,500rpm
Torque: 405Nm at 1,750-3,500rpm
Transmission: 9-speed auto
Fuel consumption: 6.9L/100km
On sale: Now
Price: From Dh117,059
What is type-1 diabetes
Type 1 diabetes is a genetic and unavoidable condition, rather than the lifestyle-related type 2 diabetes.
It occurs mostly in people under 40 and a result of the pancreas failing to produce enough insulin to regulate blood sugars.
Too much or too little blood sugar can result in an attack where sufferers lose consciousness in serious cases.
Being overweight or obese increases the chances of developing the more common type 2 diabetes.
Results
5pm: Maiden (PA) Dh80,000 (Turf) 1,000mm, Winners: Mumayaza, Fabrice Veron (jockey), Eric Lemartinel (trainer)
5.30pm: Wathba Stallions Cup Handicap (PA) Dh70,000 (T) 2,200m, Winners: Sharkh, Pat Cosgrave, Helal Al Alawi
6pm: The President’s Cup Prep - Conditions (PA) Dh100,000 (T) 2,200m, Winner: Somoud, Richard Mullen, Jean de Roualle
6.30pm: Handicap (PA) Dh90,000 (T) 1,600m, Winner: Harrab, Ryan Curatolo, Jean de Roualle
7pm: Abu Dhabi Equestrian Gold Cup - Prestige (PA) Dh125,000 (T) 1,600m, Winner: Hameem, Adrie de Vries, Abdallah Al Hammadi
7.30pm: Al Ruwais – Group 3 (PA) Dh300,000 (T) 1,200m, Winner: AF Alwajel, Tadhg O’Shea, Ernst Oertel
8pm: Maiden (TB) Dh80,000 (T) 1,400m, Winner: Nibras Passion, Bernardo Pinheiro, Ismail Mohammed
Key facilities
- Olympic-size swimming pool with a split bulkhead for multi-use configurations, including water polo and 50m/25m training lanes
- Premier League-standard football pitch
- 400m Olympic running track
- NBA-spec basketball court with auditorium
- 600-seat auditorium
- Spaces for historical and cultural exploration
- An elevated football field that doubles as a helipad
- Specialist robotics and science laboratories
- AR and VR-enabled learning centres
- Disruption Lab and Research Centre for developing entrepreneurial skills
Match info
Liverpool 3
Hoedt (10' og), Matip (21'), Salah (45 3')
Southampton 0
Company profile
Company: Verity
Date started: May 2021
Founders: Kamal Al-Samarrai, Dina Shoman and Omar Al Sharif
Based: Dubai
Sector: FinTech
Size: four team members
Stage: Intially bootstrapped but recently closed its first pre-seed round of $800,000
Investors: Wamda, VentureSouq, Beyond Capital and regional angel investors
Dhadak 2
Director: Shazia Iqbal
Starring: Siddhant Chaturvedi, Triptii Dimri
Rating: 1/5
Quick%20facts
%3Cul%3E%0A%3Cli%3EStorstockholms%20Lokaltrafik%20(SL)%20offers%20free%20guided%20tours%20of%20art%20in%20the%20metro%20and%20at%20the%20stations%3C%2Fli%3E%0A%3Cli%3EThe%20tours%20are%20free%20of%20charge%3B%20all%20you%20need%20is%20a%20valid%20SL%20ticket%2C%20for%20which%20a%20single%20journey%20(valid%20for%2075%20minutes)%20costs%2039%20Swedish%20krone%20(%243.75)%3C%2Fli%3E%0A%3Cli%3ETravel%20cards%20for%20unlimited%20journeys%20are%20priced%20at%20165%20Swedish%20krone%20for%2024%20hours%3C%2Fli%3E%0A%3Cli%3EAvoid%20rush%20hour%20%E2%80%93%20between%209.30%20am%20and%204.30%20pm%20%E2%80%93%20to%20explore%20the%20artwork%20at%20leisure%3C%2Fli%3E%0A%3C%2Ful%3E%0A
A MINECRAFT MOVIE
Director: Jared Hess
Starring: Jack Black, Jennifer Coolidge, Jason Momoa
Rating: 3/5
Specs
Engine: Duel electric motors
Power: 659hp
Torque: 1075Nm
On sale: Available for pre-order now
Price: On request
Benefits of first-time home buyers' scheme
- Priority access to new homes from participating developers
- Discounts on sales price of off-plan units
- Flexible payment plans from developers
- Mortgages with better interest rates, faster approval times and reduced fees
- DLD registration fee can be paid through banks or credit cards at zero interest rates
Email sent to Uber team from chief executive Dara Khosrowshahi
From: Dara
To: Team@
Date: March 25, 2019 at 11:45pm PT
Subj: Accelerating in the Middle East
Five years ago, Uber launched in the Middle East. It was the start of an incredible journey, with millions of riders and drivers finding new ways to move and work in a dynamic region that’s become so important to Uber. Now Pakistan is one of our fastest-growing markets in the world, women are driving with Uber across Saudi Arabia, and we chose Cairo to launch our first Uber Bus product late last year.
Today we are taking the next step in this journey—well, it’s more like a leap, and a big one: in a few minutes, we’ll announce that we’ve agreed to acquire Careem. Importantly, we intend to operate Careem independently, under the leadership of co-founder and current CEO Mudassir Sheikha. I’ve gotten to know both co-founders, Mudassir and Magnus Olsson, and what they have built is truly extraordinary. They are first-class entrepreneurs who share our platform vision and, like us, have launched a wide range of products—from digital payments to food delivery—to serve consumers.
I expect many of you will ask how we arrived at this structure, meaning allowing Careem to maintain an independent brand and operate separately. After careful consideration, we decided that this framework has the advantage of letting us build new products and try new ideas across not one, but two, strong brands, with strong operators within each. Over time, by integrating parts of our networks, we can operate more efficiently, achieve even lower wait times, expand new products like high-capacity vehicles and payments, and quicken the already remarkable pace of innovation in the region.
This acquisition is subject to regulatory approval in various countries, which we don’t expect before Q1 2020. Until then, nothing changes. And since both companies will continue to largely operate separately after the acquisition, very little will change in either teams’ day-to-day operations post-close. Today’s news is a testament to the incredible business our team has worked so hard to build.
It’s a great day for the Middle East, for the region’s thriving tech sector, for Careem, and for Uber.
Uber on,
Dara
LOS ANGELES GALAXY 2 MANCHESTER UNITED 5
Galaxy: Dos Santos (79', 88')
United: Rashford (2', 20'), Fellaini (26'), Mkhitaryan (67'), Martial (72')
Key findings of Jenkins report
- Founder of the Muslim Brotherhood, Hassan al Banna, "accepted the political utility of violence"
- Views of key Muslim Brotherhood ideologue, Sayyid Qutb, have “consistently been understood” as permitting “the use of extreme violence in the pursuit of the perfect Islamic society” and “never been institutionally disowned” by the movement.
- Muslim Brotherhood at all levels has repeatedly defended Hamas attacks against Israel, including the use of suicide bombers and the killing of civilians.
- Laying out the report in the House of Commons, David Cameron told MPs: "The main findings of the review support the conclusion that membership of, association with, or influence by the Muslim Brotherhood should be considered as a possible indicator of extremism."
Sheer grandeur
The Owo building is 14 storeys high, seven of which are below ground, with the 30,000 square feet of amenities located subterranean, including a 16-seat private cinema, seven lounges, a gym, games room, treatment suites and bicycle storage.
A clear distinction between the residences and the Raffles hotel with the amenities operated separately.
GAC GS8 Specs
Engine: 2.0-litre 4cyl turbo
Power: 248hp at 5,200rpm
Torque: 400Nm at 1,750-4,000rpm
Transmission: 8-speed auto
Fuel consumption: 9.1L/100km
On sale: Now
Price: From Dh149,900
The flights: South African Airways flies from Dubai International Airport with a stop in Johannesburg, with prices starting from around Dh4,000 return. Emirates can get you there with a stop in Lusaka from around Dh4,600 return.
The details: Visas are available for 247 Zambian kwacha or US$20 (Dh73) per person on arrival at Livingstone Airport. Single entry into Victoria Falls for international visitors costs 371 kwacha or $30 (Dh110). Microlight flights are available through Batoka Sky, with 15-minute flights costing 2,265 kwacha (Dh680).
Accommodation: The Royal Livingstone Victoria Falls Hotel by Anantara is an ideal place to stay, within walking distance of the falls and right on the Zambezi River. Rooms here start from 6,635 kwacha (Dh2,398) per night, including breakfast, taxes and Wi-Fi. Water arrivals cost from 587 kwacha (Dh212) per person.
UAE currency: the story behind the money in your pockets
The years Ramadan fell in May
Mohammed bin Zayed Majlis
The specs: 2018 Mercedes-Benz GLA
Price, base / as tested Dh150,900 / Dh173,600
Engine 2.0L inline four-cylinder
Transmission Seven-speed automatic
Power 211hp @ 5,500rpm
Torque 350Nm @ 1,200rpm
Fuel economy, combined 6.4L / 100km
