5/7/23, 2:15 PM To Make a Difference in Health Care, AI Must Learn Like We Do | Time

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To Make a Real Difference in Health Care, AI Will Need

to Learn Like We Do

Getty Images/iStockphoto

BY VIJAY PANDE MAY 3, 2023 2:37 PM EDT

IDEAS Pande, PhD, is a general partner at Andreessen Horowitz, where he focuses on investments in
biopharma and healthcare

M illions of people, many of whom have never thought much about

computer science, are experimenting with generative AI models such as
the eminently conversational ChatGPT and creative image generator DALL-E.
While these products reflect less of a technological breakthrough than AI’s
emergence into the public consciousness, the traction they have found is
guiding massive investment streams—investment shaping how this technology
will be applied for years to come.

For those of us who have long been bullish on AI’s potential to transform
society, especially in key areas such as health and medicine, recent months
have felt very much like science fiction has come to life.

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However, as delightful as it is to explore these capabilities—GPT-4 for example

exceeded the passing score by 20 points on the U.S. medical licensing exam—
the results of doing so mainly serve to highlight their shortcomings. The ability
to read, retain and regurgitate all such data on demand makes today’s AI good
at everything—but great at nothing.

There’s no question that AI is poised to irrevocably change how we look to

prevent and treat illness. Doctors will cede documentation to AI scribes;
primary care providers will lean on chatbots for triage; near-endless libraries of
predicted protein structures will supercharge drug development. However, to
truly transform these fields, we should invest in creating an ecosystem of
models—say, “specialist” AIs—that learn like our best physicians and drug
developers do today.

Getting to the top of a field typically begins with years of intensive information
upload, often via formal schooling, followed by some form of apprenticeship;
years devoted to learning, mostly in person, from the field’s most accomplished
practitioners. It’s a nearly irreplaceable process: Most of the information a
medical resident gleans by listening and watching a high-performing surgeon,
for example, isn’t spelled out in any textbook.

It’s particularly challenging to gain the intuition, often acquired through

schooling and experience, that helps determine the best answer in a complex
situation. This is true for artificial intelligence and people alike, but for AI, the
issue is exacerbated by the way it currently learns and how technologists are
currently approaching the opportunity and challenge. By studying thousands to
millions of labeled data points—examples of “right” and “wrong”—current
advanced neural network architectures are able to figure out what makes one
choice better than another. Rather than learning solely from massive amounts
of data and expecting a single generative model to solve all problems, we
should train AI by using models that stack on top of each other—first biology,
then chemistry, then layer on top of those foundations data points specific to
health care or drug design, for example.

Pre-med students aim to become doctors, but their coursework starts with the
basics of chemistry and biology rather than the finer points of diagnosing
disease. Without those foundational courses, their ability to one day provide
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high-quality health care would face significant limits. Similarly, a scientist who
designs a new therapeutic undergoes years of studying chemistry and biology,
followed by PhD studies, followed by working under the tutelage of expert drug
designers. This style of learning can help develop a sense for how to navigate
decisions involving subtle differences, which, especially at the molecular scale,
really matter. For example, estrogen and testosterone differ only slightly, but
have dramatically different impacts on human health.

Developing these stacked AI models with hierarchies of latent spaces—

simplified maps of complex data to help AI models understand patterns and
relationships—would reflect an understanding or predictive capability for each
foundational element. I believe this may initially parallel human education and
educational paradigms, but will likely in time specialize to develop new types
of expertise in AI learning. These stacked models could develop in ways
analogous to cortexes in the human brain. But, whereas humans have a visual
cortex and a motor cortex, AI could have a biology cortex and a drug design
cortex—in both cases, neural architectures specialized for specific tasks.

Ironically, creating an AI that specializes in a particular domain such as health

care may be easier to create than something more akin to HAL 9000, with
typical human-level knowledge across fields. And, in fact, we need specialist
AIs in specific domains more than an overarching AI that can do anything an
average human can do. I anticipate the creation of not a single specialist AI but
many, with a diversity of approaches in coding, data, and testing, such that
these models could provide a second (or third, or fourth) opinion when
necessary.

In parallel, we must rip AI from its online moorings and plunge it into the
world of atoms. We should be equipping our most skilled human specialists
with wearables to gather nuanced, real-world interactions for AI to learn from,
just as our up-and-coming academic and industry stars do. The most complex
and uncertain aspects of addressing health and medicine simply don’t exist
fully in the world of bits.

Exposing these specialist AIs to the perspective of a diverse range of top

practitioners will be a must to avoid replicating dangerous biases. But AI is less
of a black box than popular imagination suggests; the human decision-making
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we depend on today, as I’ve noted previously, is arguably more opaque. We

can’t let fear of perpetrating human biases limit our willingness to explore how
AI can help us democratize the expertise of our human specialists, who are
unfortunately unscalable.

Given the neural networks underpinning artificial intelligence, these specialist

AIs may gain knowledge even faster than we’d expect through meta-learning—
or learning to learn—and take us humans along for the ride. The nature of AI
lets us do something we simply can’t with people; take them apart piece by
piece and study each little bit. By building systems to plumb the inner works of
specialist AIs, we’ll create a learning flywheel. Eventually, specialist AIs could
shift beyond the role of domain expert into teachers to the next generation of
specialists—human and AI alike.

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