Diagnosed by Artificial Intelligence?

Trained pigeons are prodigious discriminators of complex visual stimuli. Capable of recalling more than 1,800 images, they are able to differentiate between letters of the alphabet, emotional expressions on human faces and even paintings by Monet or Picasso. They can generalize their discrimination performance to novel objects or scenes.¹¹ A very clever study recently tested whether operant conditioning procedures alone, without the availability of verbal instructions, could prove sufficient for teaching pigeons the intricate visual discrimination skills associated with diagnosing medically relevant images.

Deploying a system in which pigeons were rewarded with food pellets for pecking at the correct image, the investigators found that not only could they train pigeons to distinguish histopathology slides of benign from malignant breast tissue specimens, but the pigeons also successfully sorted through mammograms and identified those with microcalcifications that were indicative of tumors.¹¹

Stunning results. Who would ever have guessed? Interestingly, the researchers found that, to maintain the pigeons’ finely honed clinical skills, they needed to be kept lean, weighing just below their free feeding weight. I think the accreditors of graduate medical education would frown if we tried to extrapolate from these data!

Caring & Concern

Perhaps it’s a relief not to be one of those higher-paid specialists, such as a radiologist or pathologist. Let’s stick to rheumatology, in which part of our “payment” comes in the form of our patients’ gratitude for a job reasonably well done. Our empathy and understanding of their burden of living with a chronic disease are traits that neither pigeon nor robot can emulate. No devised set of algorithms will succeed in understanding these critical human concepts of caring and concern.

And as for having pigeons accompany us in the office, they will first need to work on some personal hygiene issues. Just a suggestion …

Simon M. Helfgott, MD, is associate professor of medicine in the Division of Rheumatology, Immunology and Allergy at Harvard Medical School in Boston.

References

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