Big data, information and communication technology, artificial intelligence, Internet of things: How important are they for gastroenterological surgery?

Abstract

In recent years, a paradigm shift on a global scale has occurred with respect to use of big data by information and communication technology (ICT). Key national strategies and legal systems are developed using artificial intelligence (AI), Internet of Things (IoT), and big data as the key, aiming to establish a data nation, also in Japan. Even in the medical field, the effect of using big data is highly expected. In addition, as a mechanism to support technology and research in the medical field, a bill concerning anonymous processing and medical information was submitted. Improvement of the social security situation is awaited not only for basic research and drug development, but also for realization of precision medicine. By using accumulated medical information, so-called big data, contribution to precision medicine that provides effective medical care to individual patients is also expected. In precision medicine, it is important to use genomic intelligence in addition to clinical information. The different genetic characteristics and constitutional personality of an individual patient can be grasped from the genomic information that constitutes an individual such as DNA sequence in addition to stored medical information. At the same time, it is necessary to secure high reliability of knowledge obtained by big data analysis in the medical field, particularly as precise knowledge is required for findings in analysis algorithms that realize precision medicine affecting human life. However, many of the production processes of knowledge obtained by machine learning are black boxes, and the basis is unclear. Therefore, it is necessary to ensure the reliability of the findings obtained by medical big data analysis. Currently, medical big data analysis technology handles only structured information represented by numerical values such as blood test results. In the future, it is necessary to treat unstructured information as an analysis target in order to deal with various diseases. We will also use AI for medical big data analysis technology. Unstructured information such as image information and text information is an area in which AI excels. In this edition of the Journal, nine articles were adopted, including three reviews and six original works. Of the original five clinical papers, two are based on the National Clinical Database (NCD),1 and one is the database of the Japan Society for Pancreatic Surgery. Thus, papers by retrospective studies based on nationwide data are rapidly increasing in the field of gastroenterological surgery. Such a trend may probably continue in the near future. However, it is not necessarily true that only big data reflect the correct medical situation. Among various data analyses, there is also strong opinion that quality data rather than big data are important in medical science; data should be secured not only in quantity but also in quality. In diversified medicine, large data are insufficient unless analysis based on high-quality data is carried out. The possibility that misunderstanding at the initial stage may adversely affect deep learning ICT cannot be denied. Nevertheless, how to master medical information in ICT analysis including AI and big data is a question to be answered. In such an era, personal characteristics of medical professionals are extremely important; valuable information gained from face-to-face interaction is the essence of medical treatment, as is the ability to discern the truth from few cases and an inquiring mind to determine its verity. It may be correct to use big data as a final screening or final confirmation in the clinical field of gastroenterological surgery. Conflicts of Interest: Authors declare no conflicts of interest for this article.

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