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CONFLITOS DE INTERESSE
•Gestor Médico do Grupo Fleury
•Sócio / mentor: Ambra Saúde, Datalife.ai, I2A2,
AI2 e Brightmed
• IPF Advisory Board na Boehringer-Ingelheim
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Por que inovar?
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Setembro, 2017
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•Automatização de processos
•Ganho de eficiência
•Redução de erros
•Aumento da qualidade
•Enobrecimento da profissão
OPORTUNIDADES
INTELIGÊNCIA ARTIFICIAL
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•Dependência das máquinas
•Desvalorização do ser humano
•“Deskilling”
•Desemprego
•Estagnação econômica
AMEAÇAS
INTELIGÊNCIA ARTIFICIAL
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Levenson RM et al. PLoS One 2015;10(11):e0141357
“Our results suggest that pigeons can be used as suitable
surrogates for human observers in certain medical image
perception studies, thus avoiding the need to recruit, pay, and
retain clinicians as subjects for relatively mundane tasks.”
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LudismoRevolução Industrial (Inglaterra, século XIX)
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Neoludismo4ª. Revolução Industrial, XXI
1. Nanotecnologia
2. Impressão 3D
3. Inteligência artificial
4. Big data
5. Biotecnologia
6. Internet das coisas
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IMPACTO FINANCEIRO DA
INTELIGÊNCIA ARTIFICIAL
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https://www.theverge.com/2018/8/13/17670156/deepmind-ai-eye-disease-doctor-moorfields
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Hosny A et al. Nat Rev Cancer 2018;18(8):500-510
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http://www.myforesight.my/wp-content/uploads/2017/11/Jobs-at-Risk.pdf
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I don’t think humans, at the
highest level, are playing the
machines anymore. It’s useless
because you know the
outcome.
Garry Kasparov
“Centaur chess”
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Verghese A, Shah NH, Harrington RA. JAMA 2018;319(1):19-20
DIAGNÓSTICO
COGNITIVO
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Detecção automática de pneumonias
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• Objetivo: avaliar o Rx de tórax e classificar com acurácia
> 82% se o pulmão está normal ou se existe pneumonia
Classe RSNA Mendeley Shenzhen and
Montgomery
Total
Com pneumonia 6.012 4.273 0 10.285
Normal 8.851 1.583 406 10.840
Anormal e sem
pneumonia
11.821 0 394 12.215
Total 26.684 5.856 800 33.340
• Treinamento: 80% do dataset
• Validação: 20% do dataset
• Teste da rede: imagens (2000 exames) do Fleury
• Acurácia atual: 87,7%
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Análise automática de achados de imagem
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Detecção e priorização de achados urgentes
42F, Sjogren e traço falciforme.
Fisgadas na perna D e dor torácica.
Dois episódios de TEP no passado.
D-dímero: 2400 (Normal < 500)
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Singletary B. JAMA Surg 2017;152(12):1169-1170
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Hill Jr. RG, Sears LM, Melanson SW. Am J Emerg Medicine 2013;31:1591-4
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Overhage JM, McCallie Jr. JD. Ann Intern Med 2020;172(3):169-174
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The Doctor, Sir Luke Fildes, 1887
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Toll E. Jama 2012;307(23):3497-8
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Robert Watcher. The Digital Doctor:
Hope, Hype, and Harm at the Dawn of
Medicine’s Computer Age
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• O radiologista isolado (telerradiologia)
• O radiologista disponível (reativo)
• O radiologista ativo
• O radiologista inserido
• Encontrar o equilíbrio
INOVAÇÃORADIOLOGISTA DO FUTURO PRESENTE
Gunderman RB, Chou HY. Radiology 2016;281:6-9
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“The innovation will come from
people who are able to link
beauty to engineering, humanity
to technology, and poetry to
processors”
Walter Isaacson