AUA 2018: Artificial Intelligence, Robotics and the Future of Urology- Presidential Address

San Francisco, CA ( Dr. Thrasher, the current President of the AUA, shared his vision of Artificial Intelligence (AI), Robotics and the Future of Urology. First, urology is a growing field with the brightest minds. We continue to be early adopters of new technology. We need to stay ahead of the game in terms of new technology.

Urology Resident Programs:
  • Urology Match 2017 – latest round of residency match
  • 61% match rate
  • Lowest of all the major surgical fields
  • As a result, we get the cream of the crop – and we can be selective with who we take
  • 130 residency programs – each gets ~250 applicants and interviews ~36
  • Each urology applicants applies to ~68 programs and interviews at ~14
Yet, urology remains one of the oldest specialties. Many urologists remain in practice into the 50-70’s, including many current active urologists. With the introduction of new technology, many physicians and urologists are reporting higher rates of burnout.

  • Use of electronic medical records (EMRs) is a common reason cited for burnout – there is very low satisfaction amongst practicing urologists
  • Yet, many of the younger housestaff find it to be much more efficient!
  • Hence, it may still be more effective – in the hands of the new generation
The greatest resource of the future is not natural – its big data! Besides its impact on economics, business, etc, it will heavily impact medicine in the future as well. 

  • It may be used in diagnosis, treatment planning, monitoring patients, online consultation, data mining
  • It has its own set of challenges, but it is the way of the future!
He went through the role of Big Data in many of the sectors listed above – I highlight some of the more interesting situations below.

  • A few studies have not demonstrated the utility of machine learning in diagnostic algorithms in the field of radiology – computers can learn to read and diagnose scans, often times with better accuracy than human readers
  • Memorial Sloan Kettering Cancer Center is working with IBM Watson to guide cancer treatment, identify cancer early, and conduct genomic analysis
  • Use of machine learning can help integrate imaging data, genomics, molecular markers, and clinical data for precision medicine
  • Patient monitoring is drastically changing
  • Wearable impants and biosensors, connected by Bluetooth or the cloud to our EMR, may provide real-time data on patients and help with early diagnosis
  • Online consultation: Babylon Health (British company) has developed a medical AI app to triage user’s health complaints – 92% accuracy when tested in 2006 in terms of the medical advice it gave (not diagnosis, but rather what the patient should do!)
Challenges include:

1. Security
2. Need for exchange and integration of databases
3. Ethical issues and privacy
4. EMR’s continue to have free-text, inaccuracies, wrong diagnoses, etc. 

Highlights on the potential of the robotics of the future:

  • Teaching and telementoring
  • Telemedicine, telerounding
  • New technology – haptic feedback, microrobots, nanorobots
  • Repetitive tasks such as phlebotomy
  • Operating room sterilization
Some of these are closer to reality than others. Some have already reached the real world and are in practical use.

The AUA, whose aim is to keep the community informed and ahead of the curve, continues to invest in big data, AI and robotics. Of 29 research scholar awards, 7 have used big data. Recent instructional courses have also started to focus on how to use big data. The future is bright, but change is coming. We have to stay ahead of the curve!

Presented by: J. Brantley Thrasher, Department of Urology, University of Kansas Health System

Written by: Thenappan Chandrasekar, MD, Clinical Fellow, University of Toronto, @tchandra_uromd, at the 2018 AUA Annual Meeting - May 18 - 21, 2018 – San Francisco, CA USA