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科学进步与临床不确定性

Scientific progress and clinical uncertainty.

作者信息

Tavazzi Luigi

机构信息

Maria Cecilia Hospital, GVM Care & Research, Ravenna, Cotignola, Italy.

出版信息

Eur Heart J Suppl. 2020 Nov 18;22(Suppl L):L146-L150. doi: 10.1093/eurheartj/suaa155. eCollection 2020 Nov.

Abstract

In the path underway towards Precision Medicine, two areas are in rapid development: genetics and artificial intelligence. In the genetic area, there are two current problems, both of the highest social importance. The first concerns the project, emerging in some countries, of systematic sequencing of the genome in the whole population. The problem is that reading the genome is very complex, requires specific knowledge, and the medical class is now unprepared. The second problem concerns the now achieved ability to modify the genome, which might be applied in the treatment of genetic diseases previously considered incurable. The techniques that can be used today are extremely delicate and expose to high risks. Artificial intelligence (AI) is a branch of neuroscience ('computational neuroscience') and advanced computer science which aims to apply the operational models of the human mind with the mnemonic and calculating power of advanced cybernetics. It is applied by conventional smartphone 'apps' to the most advanced computers used in various areas of diagnostic and prognostic medicine, image reading, big data management, setting of new pharmacological molecules, up to completely different applications, such as spoken language, automatic driving of vehicles, insurance plans, financial strategies, etc. Of course, with enormously different degrees of complexity. Will the doctors' role survive?

摘要

在通往精准医学的道路上,有两个领域正在迅速发展:遗传学和人工智能。在遗传学领域,目前存在两个具有极高社会重要性的问题。第一个问题涉及一些国家正在出现的对全体人口进行基因组系统测序的项目。问题在于解读基因组非常复杂,需要特定知识,而目前医学领域还没有做好准备。第二个问题涉及目前已具备的修改基因组的能力,这可能会应用于治疗以前被认为无法治愈的遗传疾病。如今可使用的技术极其精细,且面临高风险。人工智能(AI)是神经科学(“计算神经科学”)和先进计算机科学的一个分支,旨在将人类思维的运作模式与先进控制论的记忆和计算能力相结合。它通过传统的智能手机“应用程序”应用于诊断和预后医学、图像解读、大数据管理、新药理学分子研发等各个领域所使用的最先进计算机,甚至应用于完全不同的领域,如语音、车辆自动驾驶、保险计划、金融策略等。当然,其复杂程度差异极大。医生的角色还能存续吗?

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