Third-wave AI in Medicine:

From Test-free Screening of Complex Diseases

to

Digital Twins of Microbiomes and Pandemics

Ishanu Chattopadhyay, PhD

Assistant Professor of Medicine

University of Chicago

ishanu@uchicago.edu

MEDIA

Cohort Selection and Risk Analysis Testbed

https://paraknowledge.ai/zcor-testbed/

https://paraknowledge.ai/zcor-demo/

Misleading Diagnosis of Idiopathic Pulmonary Fibrosis: A Clinical Concern
Javier Ramos-Rossy, MD, Onix Cantres-Fonseca, MD, Ginger Arzon-Nieves, Yomayra Otero-Dominguez, MD, Stella Baez-Corujo, MD, and William Rodríguez-Cintrón, MD

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6248220/

The Paraknowledge API

curl -X POST -H "Content-Type: application/json" -d '[{"patient_id": "P28109965201", "sex": "M", "age": 89, "fips": "35644", "DX_record": [{"date": "12-16-2011", "code": "R09.02"}, {"date": "12-30-2011", "code": "H04.129"}, {"date": "12-30-2011", "code": "H02.109"}], "RX_record": [], "PROC_record": [{"date": "09-28-2012", "code": "71100"}]}]' "https://us-central1-pkcsaas-01.cloudfunctions.net/zcor_predict?target=IPF&api_key=7eea9f70d79c408f2b69847d911303c"

Current Targets

IPF
ADRD
CKD
MELANOMA
CANCER_PANCREAS
CANCER_UTERUS
SISA

performance tables

Out-of-sample Results

specificity ~99%

NPV >99.9%

IPF

ILD

Comorbidity Spectra

False Positives: 

  • Heathcare Capacity

Ethics:

  • Risk from Imaging Tests

For every 20-30 flags,

1 is positive

  • General likelihood ratio 60-80
  • PPV 3.5-5%
  • Notifying patients 4 years early?
  • No cure, why screen

minimal

acceptable?

Better outcomes

  • early anti-fibrotic therapy seems increasingly promising
  • better shot at lung transplant
  • early dx reduces  hospital-izations by a factor of 1-3

Collard, Harold R., Alex J. Ward, Stephan Lanes, D. Cortney Hayflinger, Daniel M. Rosenberg, and Elke Hunsche. "Burden of illness in idiopathic pulmonary fibrosis." Journal of medical economics 15, no. 5 (2012): 829-835.

Application to Suicide Attempts and Ideation (SISA)  , PTSD*: 

perhaps surprising connection between mood disorders and physiological comorbidities

Gibbons RD, Kupfer D, Frank E, Moore T, Beiser DG, Boudreaux ED. Development of a Computerized Adaptive Test Suicide Scale-The CAT-SS. J Clin Psychiatry. 2017 Nov/Dec;78(9):1376-1382. doi: 10.4088/JCP.16m10922. PMID: 28493655.

* in press

Predictions at the Point-of-Diagnosis

Can my patient continue taking anti-fibrotics over long term?

Digital Twins for Health trajectories

}

\rho_1
\rho_2
\rho_i
\rho_m

1M parameters

1M parameters

Predicts disorders across the disease specturm

Pre-empting Effectiveness of Antifibrotics at the point of diagnosis

~78% AUC

26-32 out of 100 discontinued 

4-5 out of 100 discontinued

Prognosis at Point-of-Diagnosis 

  • Optimizing Management

Patient Journey 

  • Continuous Risk Monitoring

Early Diagnosis

  • Universal Screening
  • Cohort Selection

Reduce screen failure rates

Holistic health surveillance

Predict antifibrotics continuation

improve outcomes

3

2

1

Feeding Variables added

\rho_t(x) \triangleq -\log \min_{y \in H^t} \sqrt{\theta_{\text{HA}}^{[t]}(x,y) \cdot \theta_{\text{NA}}^{[t]}(x,y)}

A Math Solution to a Hard Biological Problem

we can tell if new strain will adapt to humans

bck

By Ishanu Chattopadhyay

bck

Predictive modeling of crime and rare phenomena using fractal nets

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