12. September 2024

Snart vil kunstig intelligens analysere kroppen din! Fra nrk.no. Pass på! (Nå også innenfor patologi)

Egne bemerkninger:

Hvor er fornuftig innspill fra “ekte fagfolk” innen medisin- legespesialister? Eller skal ingeniører/ realister/ IT- folk o.l. overta diagnostisering via kunstig intelligens!

Nå også innen patologi!!! Se stillingsannonse her på slutten av innlegget!

Se nedenfor.

Fra nrk.no: https://www.nrk.no/rogaland/xl/snart-vil-kunstig-intelligens-analysere-kroppen-din_-_-vi-er-for-darlig-forberedt-1.16553955

 

 

Med ny teknologi kan norske sykehus spare tid og penger.

Dette bruddet ble ikke påvist av en lege.

Men av kunstig intelligens.

Eksperter advarer mot at det går altfor fort.

Er vi forberedt på å la maskinene behandle oss?

– Fremtiden er nå!

Prosjektleder Bjørn Anton Graff løfter armene og ser begeistret ut mot de frammøtte journalistene. Vi er samlet på et møterom på Bærum sykehus.

Bjørn Anton Graff
Bjørn Anton Graff, prosjektleder ved Vestre Viken, under lanseringen av kunstig intelligens ved Bærum sykehus.FOTO: ROLV CHRISTIAN TOPDAHL / NRK

Et mellomstort sykehus i norsk sammenheng, men Graff mener det som skjer her er historisk og vil endre norsk helse for alltid:

Sykehuset har akkurat tatt i bruk kunstig intelligens i behandlingen av pasienter.

Det betyr følgende:

Hvis du i dag havner på Bærum sykehus fordi du tror du har brukket noe og må ta røntgen, vil kunstig intelligens (KI) analysere røntgenbildet.

Det er altså et dataprogram som vil være med på å avgjøre om du har brudd, eller om du kan sendes hjem.

Programmet har trent seg opp ved å analysere hundretusener av beinbrudd verden over. Nå leter algoritmen etter brudd hos norske pasienter.

En løsning for unødvendige undersøkelser?

Og dette er bare begynnelsen. Helse-Norge venter spent erfaringene fra Bærum.

For kunstig intelligens kan løse noe som i lang tid har vært en hodepine for norske sjukehus og helsemyndigheter:

Regnestykket går bare ikke opp.

Det er forventet et stort underskudd på helsepersonell i årene frem mot 2040. Samtidig krever nordmenn stadig mer av legene sine. Det blir for eksempel tatt flere og flere MR- og CT-undersøkelser.

Bare ved Bærum sykehus øker antallet bilder med 12,5 prosent årlig.

Og mange av disse bildene er unødvendige.

Bare i helseforetaket Vestre Viken, som Bærum sykehus er en del av, viser over seks av ti røntgenundersøkelser at pasienten ikke har brukket noe. Denne avklaringen tar ofte lang tid.

Det er her kunstig intelligens kommer inn i bildet. Datamaskinen kan analysere bilder i rekordfart, og avlaste travle leger og radiografer.

– Det er derfor vi må ta denne teknologien i bruk, sier Bjørn Anton Graff til journalistene på møterommet.

Han er leder for KI-prosjektet i Vestre Viken.

Kunstig intelligens er i bruk på andre norske sykehus allerede, men ikke på en så omfattende måte som i Bærum. Ingen andre bruker KI til å analysere røntgenbilder.

– Kjempestort ute i verden

Mai 2020. Koronaviruset hadde akkurat veltet om på hele samfunnet. Det meste var stengt ned. Folk holdt avstand og isolerte seg.

Men i Vestre Viken satt en gruppe og jobbet med hvordan de kunne bedre arbeidsflyten på avdeling for bildediagnostikk. Det var da en av dem skjøt inn: Hva med å bruke kunstig intelligens?

Ledelsen i Vestre Viken ble gira og satte som mål at helseforetaket skulle være fremst på området. Helse Sør-Øst ga dem 1,5 million kroner til å starte prosjektet.

– Kunstig intelligens har blitt kjempestort ute i verden. Også Danmark og Sverige var tidligere ute enn oss. Vi stilte spørsmålet «hvorfor» og prøvde å gjøre noe med det, sier Bjørn Anton Graff.

Så langt har prosjektet fått 7 millioner kroner i tilskudd fra Helse Sør-Øst – det regionale helseforetaket som Vestre Viken er en del av.

Men for å kunne utnytte KI fullt ut, er Vestre Viken avhengig av en lovendring.

Babycall og kunstig intelligens

Du kjenner dem best som produsenter av TV-er, barbermaskiner og babycall, men teknologiselskapet Philips leverer også såkalte KI-plattformer til sykehus – noe Vestre Viken har kjøpt.

KI-plattformen inneholder flere 

 som helseforetaket kan velge mellom. Hver enkelt er skreddersydd til ett bestemt område på kroppen.

Den algoritmen som nå settes i arbeid på Bærum sykehus, heter Boneview og finner beinbrudd på røntgenbilder.

Røntgenbilde av skulder analysert av KI

Etter å ha vandret gjennom noen lange sykehuskorridorer, vises vi til røntgenlaben. Et behandlingsbord, en røntgenmaskin og en bås med vinduer hvor alt styres.

Radiograf Jonas Vatle peker på røntgenbildet på PC-skjermen. Tåen på bildet tilhører en av de første pasientene i landet som blir analysert ved hjelp av kunstig intelligens.

– Her ser vi en oransje boks som viser bruddet hos pasienten. Det som skjer nå, er at pasienten blir sendt til ortopedisk mottak for videre behandling for bruddet, sier han.

Radiograf Jonas Vatle på røntgenlabben på Bærum sykehus.
Radiograf Jonas Vatle viser oss det nye KI-verktøyet Boneview på røntgenlaben på Bærum sykehus.FOTO: ROLV CHRISTIAN TOPDAHL / NRK

Algoritmen har brukt to minutter på analysen, noe som skal bety mindre ventetid på pasientene.

Men enkelte eksperter mener utviklingen går altfor fort. Det er nemlig flere fallgruver med å la datamaskinene – eller algoritmene – analysere røntgenbildene dine.

Må trene for å bli god

For det første fungerer ofte KI-systemene dårligere når de tas ut av testlaboratoriet og settes i drift. Uten at noen egentlig helt vet hvorfor.

For det andre: Algoritmene må – i likhet med idrettsutøvere – trene for å bli god. Problemet er bare at de har trent på data fra pasienter i utlandet, der forholdene og pasientene kan være ganske ulike norske forhold og pasienter.

I utlandet kan visse sykdommer og kreftformer være vanligere eller sjeldnere enn i Norge.

Det kan også hende at enkelte sykdommer blir oppdaget seinere i andre land enn det som er vanlig her.

Risikoen er at algoritmen dermed ikke har fått tilstrekkelig trening på lidelsene som pasienter i Norge pleier å ha.

Løsningen på dette problemet er å la algoritmen trene mens den jobber. Altså at den lærer av de norske pasientene som den analyserer bildene til.

Men dette er ikke lov.

Algoritmer som Boneview må få en såkalt

for å kunne brukes i Norge. Og for å få CE-merking, må algoritmen være ferdig trent når den blir tatt i bruk.

Disse problemene med KI er grunnen til at EU jobber med en egen KI-lov, eller «AI-act». Den vil stille krav til KI-tjenester for i størst mulig grad unngå slike problemer med trening og representasjon.

Men loven er ikke ferdig.

– Det betyr at vi per i dag risikerer å få tjenester som ikke oppfyller disse kravene, sier stipendiat ved Universitetet i Tromsø, Mathias K. Hauglid.

Mathias K. Hauglid, stipendiat ved Universitetet i Tromsø
– Innføringen av kunstig intelligens innebærer et enormt ansvar for sykehusene, sier stipendiat ved Universitetet i Tromsø, Mathias K. Hauglid.FOTO: TRUDE HAUGSETH MOE/UNIVERSITETET I TROMSØ

Flere fordeler med KI

Stipendiaten understreker at han ikke er bekymret for KI i seg selv. Ifølge Hauglid er det er flere fordeler:

  • KI kan være mer nøyaktig enn mennesker.
  • KI kan i noen sammenhenger gi mer helsehjelp for mindre penger.
  • KI kan gi spesialistbehandling på steder der det ikke finnes leger med den spisskompetansen.

Men Hauglid er bekymret for at helsevesenet ikke gjør nok for at kunstig intelligens brukes på en god måte. Helsevesenet vil gjerne lene seg på CE-merkingen, men hva er dagens CE-merking egentlig verdt, spør stipendiaten.

EU har funnet det nødvendig å innføre en lang rekke krav som ikke finnes i dagens regelerk.

– Disse kravene skal ivareta vår sikkerhet og våre rettigheter. Hvis man på grunnlag av det nåværende CE-systemet tar i bruk KI til å gjøre viktige kliniske vurderinger, er det bekymringsverdig, sier han.

Og stipendiaten er ikke alene med å være urolig for farten på utviklingen.

NRK får kontakt med en lege som jobber med KI på et sjukehus i Sør-Norge. Han ønsker å være anonym. Legen mener at særlig Vestre Viken går altfor fort fram, og at de ikke tar hensyn til farene ved teknologien.

– Vestre Viken jobber hardt for å spinne det som en utelukkende positiv helseinnovasjon, mener han.

Gevinster foran alt?

På møterommet på Bærum sykehus får vi høre om «innovasjon» og «tverrfaglighet», om «høykompetent» og «kvalitetsbevisst».

– Foreløpig er dette bare den første applikasjonen, det første skrittet inn i en verden der helse og KI kommer til å bli viktig, sier Jon Haakon Malmer-Høvik, som er avdelingssjef for bildediagnostikk ved Vestre Viken.

Jon Haakon Malmer-Høvik
Jon Haakon Malmer-Høvik, avdelingssjef for bildediagnostikk ved Vestre Viken.FOTO: ROLV CHRISTIAN TOPDAHL / NRK

I løpet av året skal sykehuset nemlig starte testingen av ytterligere to bruksområder: En algoritme som leser røntgenbilder av brystkassen, og en algoritme som heter Icobrain MS, som leser MR-bilder tatt av hodet til MS-pasienter.

Denne KI-algoritmen markerer flekker (lesjoner) i hjernen til MS-pasienter.

Det gule er flekker som vokser.

De røde er nyoppståtte flekker.

Og poenget: Å høste «gevinster».

I styredokumenter fra 27. februar skriver ledelsen i Vestre Viken rett ut at slike hensyn kommer foran det rent medisinske.

«Tydelighet på at målet ikke primært er å bedre diagnostisk nøyaktighet, men å forbedre pasientflyt og frigjøre radiologressurser.»

Den kritiske KI-legen reagerer på det han leser i styrepapirene:

– Her stilles det aldri spørsmål ved pasientsikkerhet eller at ingen har satt dette i drift før. De vet altså ikke hvor «flinke» algoritmene er, men tar det for gitt at alt går bra, sier han.

Ifølge prosjektleder Bjørn Anton Graff vet de veldig godt hvordan algoritmen jobber.

– Den løsningen vi tar i bruk nå, er statisk. Den lærer ikke av våre data, den endrer seg ikke, så vi har full kontroll. Og så er den testet på fryktelig mange undersøkelser på global basis, sier han.

– Ikke forberedt

Ifølge en fersk forskningsartikkel er problemet at ingen vet hvordan en slik algoritme vil oppføre seg, siden algoritmen har blitt trent på en annen befolkning enn befolkningen den skal brukes på.

– Det norske helsevesenet er ikke forberedt på å ta i bruk kunstig intelligens enda, sier stipendiat Mathias K. Hauglid.

Han hevder at ledere i Helse-Norge ikke i tilstrekkelig grad har tatt innover seg problemene og farene ved kunstig intelligens.

Dessuten har ikke norske leger den kompetansen som trengs for å håndtere KI, mener Hauglid.

– Det er begrenset forståelse for feilkilder og hva som kan gå galt når man bruker kunstig intelligens i klinisk sammenheng, sier Hauglid og fortsetter:

– Det er et stort behov for kompetanseoppbygging for å lære opp dem som faktisk skal bruke systemene i praksis, sier stipendiaten, som uttaler seg på generelt grunnlag.

Ifølge prosjektleder Bjørn Anton Graff skal Vestre Viken bare ta i bruk algoritmer som allerede er i drift på andre europeiske sykehus.

– Og Boneview er i bruk på veldig mange sykehus, sier han.

Administrasjon- og forskningskonsulent i Vestre Viken, Line Tveiten.
Administrasjon- og forskningskonsulent i Vestre Viken, Line Tveiten, leder omvisningen på røntgenlaben på Bærum sykehus.FOTO: ROLV CHRISTIAN TOPDAHL / NRK

Graff sier også at algoritmen har vært gjennom en omfattende kvalitetssikring før den ble satt i arbeid.

– Hittil har over 2000 undersøkelser vært analysert av KI, og legene våre har brukt cirka 500 av dem som del av kvalitetssikringen, sier Graff.

Resultatene fra dette arbeidet skal om kort tid publiseres og offentliggjøres

– Men det jeg kan si, er at løsningen er nesten like god som en radiolog.

Skal kutte ut menneskene

På Bærum sjukehus skal en radiograf se gjennom resultatene fra algoritmen. Og dagen etter skal en radiolog undersøke om datamaskinen har gjort ting riktig.

Men det er bare foreløpig. Planen er å kutte ut menneskene helt – i alle fall på en del av analysene.

KI-prosjektleder Bjørn Anton Graff viser en figur på lerretet. Den viser målet for Vestre Viken:

Allerede neste år er planen at enkelte analyser skal skje helt uten menneskelig innblanding.

I 2025 er målet at 10 prosent av KI-analysene skjer autonomt, og denne andelen skal økes til 20 prosent i 2030.

For det er først når datamaskinen jobber alene at sykehuset virkelig kan spare tid og penger.

I løpet av høsten skal Bærum ta i bruk algoritmen som analyserer røntgenbilder av lunge og bryst. I Danmark brukes en slik algoritme allerede uten menneskelig innblanding.

Graff legger ikke skjul på at det også er planen i Norge.

– Det er en type undersøkelse det gjøres uhorvelig mange av på sykehuset hvert år. I Vestre Viken er det snakk om mellom 30.000 og 40.000 undersøkelser. Når en andel av disse kan svares ut automatisk, da begynner det å monne, sier prosjektlederen.

Graff forventer at KI-prosjektet vil gå med overskudd allerede neste år, men legger raskt til at det ikke er hovedmålet.

Det handler om å bruke ressursene på en måte som gir mest mulig helse for pengene, ifølge prosjektlederen.

– I fremtiden skal våre leger bruke mindre tid på friske pasienter og mer tid på syke pasienter, sier han.

Problemet er bare at det ikke er lov å slippe algoritmene løs. Per i dag krever norsk lov at undersøkelsen – enten det er røntgen, CT eller MR – er innom et menneske før det kan gjøres noen endelig vurdering.

Planene til sykehuset er med andre ord avhengig av at politikerne endrer loven.

– Hva tenker dere om at det vil kreve en lovendring?

– Når det gjelder om det kreves lovendring for å kunne ta i bruk KI helautomatisk er jeg usikker. Det krever litt mer tid å sette seg inn i, sier administrasjon- og forskningskonsulent i Vestre Viken, Line Tveiten.

– Har dere noen dialog med politikerne angående lovendring?

– Nei, per i dag så har vi ikke det. Å ta i bruk applikasjonen autonomt er noe vi skal begynne å tenke på utover høsten, sier hun.

 

Administrasjonssjef og forskningskonsulent i Vestre Viken, Line Tveiten.
Administrasjonssjef og forskningskonsulent i Vestre Viken, Line Tveiten, under presentasjonen ved Bærum sykehus.FOTO: ROLV CHRISTIAN TOPDAHL / NRK

Late leger?

Videre inn i gangen på Bærum sykehus treffer vi Jonas Vardal.

Han er en av tre radiologer som skal jobbe med KI. Det «medisinske alibiet» som skal passe på at risikoen ikke blir for stor.

Vardal vil altså stå midt i det som kan bli en revolusjon i helsevesenet.

Kunstig inteliggens vil kunne endre arbeidsrutinene radikalt på sykehuset. Det mener eksperter NRK har snakket med.

Professor Brent Savoie ved Vanderbilt University i Nashville peker på at KI kan gjøre legene mindre skjerpet, siden det er roboten som gjør grovarbeidet.

Vardal på Bærum sykehus sier at han forstår bekymringen.

– Det er en fare for at vi blir for sedate og ikke gransker like nøye som før.

Radiolog Jonas Vardal ved Bærum sykehus.
Jonas Vardal, radiolog ved Bærum sykehus.FOTO: ROLV CHRISTIAN TOPDAHL / NRK

Og det kan være skummelt. De samme ekspertene er nemlig enige om én ting:

KI kommer til å gjøre feil. Algoritmene vil kanskje bli dyktigere enn kollegene sine av kjøtt og blod, men også maskinene vil overse svulster og alvorlig sjukdom.

Det erkjenner også prosjektleder Bjørn Anton Graff. Han skal egentlig spise kake for å markere at KI-applikasjonen er i gang i Bærum, men rekker en siste prat med NRK.

Før de setter i gang full automatikk og kutter ut menneskene, sier Graff at de vil godta at algoritmen gjør omtrent like mye feil som et menneske gjør i dag.

Men hva skjer da? Hvem har egentlig skylden dersom roboten overser en kreftsvulst i kroppen din?

I Vestre Viken peker pilene mot avdelingssjefen for bildediagnostikk.

– Vi vil ende opp med at han godkjenner dette som et system og godkjenner risikoen. Da er det han som leder som vil sitte med det ansvaret, sier Graff.

Svart boks-problemet

EU har sendt et forslag til direktiv om kunstig intelligens ut på høring.

Målet med direktivet er å sikre at noen har erstatningsansvar når datamaskinene gjør noe galt.

Dette skal også gjelde i de tilfellene der KI-algoritmene gjør ting som vi rett og slett ikke forstår. Det som kalles «svart boks-problemet».

Men direktivet kommer trolig ikke på plass før tidligst 2026.

Svart boks-problemet gjør at det blir desto viktigere å prøve ut algoritmene skikkelig ved Bærum sykehus før teknologien overføres til andre sykehus – for tanken er at hele landet skal lære av Bærum.

Det mener Jonathan Adams, som er stipendiat i medisinsk etikk ved Universitetet i Oslo.

Han vil ha konsekvent overvåking av KI på alle nivåer i norsk helsevesen.

– Dette for å sikre at radiologer hele tiden er klar over hva de ikke vet om KI, selv om teknisk ekspertise sprer seg i hele systemet, sier Adams.

Gruppebilde ved Bærum sykehus
De involverte i KI-prosjektet ved Bærum sykehus tok seg tid til et gruppebilde etter lanseringen.FOTO: ROLV CHRISTIAN TOPDAHL / NRK

Vestre Viken har også planer om å utvide bruken av KI til andre områder enn bare bildediagnostikk. Dette skal de finne ut av først etter at de har «høstet erfaringer» fra radiologien.

– Det vi vet helt bombesikkert, er at dette vil gi store gevinster i framtiden, sier Bjørn Anton Graff.

(Hvor er patologene?)

Annonse:

Vi søker Norges mest utviklingsorienterte bioingeniør med interesse for kunstig intelligens

Offentlig forvaltning

Hvorfor jobbe i Vestre Viken?

Som medarbeider blir du del av et solid og ambisiøst faglig miljø med varierte arbeidsdager. Vi vektlegger at fagmiljøene skal samarbeide om pasientbehandlingen, utnytte teknologiske muligheter og dele kunnskap og kompetanse mellom de forskjellige behandlingsstedene. Gjennom kvalitet, trygghet og respekt jobber vi sammen for å gi gode og likeverdige helsetjenester til de som trenger det!

Avdeling for klinisk patologi skal bli ledende nasjonalt på å ta i bruk ny teknologi og kunstig intelligens. Dette skal bidra til utvikling av patologi som spesialitet, til et spennende arbeidsmiljø med fremtidsrettet drift, og dermed til enda bedre diagnostikk for våre pasienter. Vi søker derfor bioingeniør med erfaring fra patologi som vil bidra til en slik satsning.

Vi blir blant de første foretakene som digitaliseres på regional løsning. Samtidig skal vi innføre nytt laboratoriesystem og i 2025 flytte inn i et nytt Drammen sykehus. Vestre Viken er nasjonalt ledende på å ta i bruk kunstig intelligens innen bildediagnostikk, og vi planlegger en lignende satsing innen patologi. I tillegg må vi vurdere andre teknologiske muligheter som kan bidra til bedre drift. Vi er derfor på jakt etter bioingeniør som kan bidra i prosjekter for å transformere avdelingen slik at vi kan møte fremtiden på en bærekraftig måte.

En del av stillingen vil være dedikert til prosjektarbeid, mens den andre delen vil være i drift. Stillingsbrøkene vil kunne endres avhengig av behovet fremover.

Ved spørsmål om stillingsbrøk knyttet til kunstig intelligens og prosjektarbeid:

kontakt forsknings- og innovasjonsansvarlig Bjørn Anton Graff, tlf 473 43 108.

Ved spørsmål om driftsdelen av stillingen: kontakt seksjonsleder Reidun Moskvil, tlf 468 34 842.

Vestre Viken ønsker at våre ansatte skal gjenspeile befolkningens mangfold. Vi oppfordrer derfor alle som er kvalifisert til å søke hos oss, uansett kjønn, alder, etnisitet, religion, livssyn, funksjonsnedsettelse og seksuell orientering. Det samme gjelder dersom du har hatt opphold i arbeidslivet.

Arbeidsoppgaver:

  • Delta i planlegging av Avdeling for klinisk patologi 2.0
  • Delta som prosjektleder eller prosjektmedarbeider i utviklingsprosjekter
  • Delta i den daglige driften

Kvalifikasjoner:

  • Autorisert bioingeniør med erfaring fra patologi
  • Interesse og kunnskap om kunstig intelligens er ønskelig
  • God formidlingsevne på norske eller annet skandinavisk språk er en forutsetning, gode engelskkunnskaper er en fordel
  • Gode kommunikasjonsevner
  • Erfaring fra prosjektarbeid er en fordel

Personlige egenskaper:

  • Nysgjerrig og entusiastisk
  • Gode samarbeidsevner, initiativrik, løsningsorientert og utviklingsorientert
  • Evne til å jobbe selvstendig, strukturert og ansvarsbevisst, men med velutviklet lagånd
  • Ønske om videreutvikling – personlig og for foretaket

Personlig egnethet vektlegges.

Vi tilbyr:

  • En unik mulighet til å være en nasjonal spydspiss for videreutvikling av patologifaget.
  • Usedvanlig trivelige kolleger og arbeidsmiljø.
  • Tett dialog med andre avdelinger og andre foretak.
  • Medlemskap i Vestre Vikens Velferdsforening med gode rabattordninger på aktiviteter, kulturarrangement og leie av ferieboliger i inn- og utland!
  • Ansettelse i en trygg offentlig virksomhet med gode pensjonsordninger.
  • Dagtid

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