Medical Student Takes Detour to Understand the Potential of Artificial Intelligence

Interrupting your fourth-year medical studies is a bold decision. But that’s what Gabriel Marx did, immersing himself in the world of artificial intelligence (AI) through the Master of Science in Biomedical Data Science (MSBDS) program at the Graduate School of Biomedical Sciences at the Icahn School of Medicine at Mount Sinai.

Mr. Marx is working with Mount Sinai’s Neuropathology Brain Bank and Research CoRE and the Crary Lab on AI-based computer vision algorithms that use digitized brain slides to enhance understanding of neurodegenerative disease and aging. For his master’s thesis, he created a novel model that predicts a person’s age based on a post-mortem slide section of the individual’s hippocampus, an area of the brain important for memory yet vulnerable to the effects of aging and Alzheimer’s disease. John F. Crary, MD, PhD, is Director of the Neuropathology Brain Bank and Research CoRE, and Professor of Pathology, Molecular and Cell-Based Medicine; and Neuroscience.

“I envision myself becoming an ambassador between the clinical side and the engineers and technicians who are on the development side, or even developing tools myself. Either way, my goal is to be on the forefront of harnessing AI for the benefit of dementia patients.”

Mr. Marx then applied this model on a cohort of deceased professional athletes with confirmed chronic traumatic encephalopathy, a neurodegenerative disease caused by repetitive concussions. He found that these athletes’ brains exhibited marked accelerating aging. “These athletes who passed away in their 60’s had brains that looked like they belonged to a 90-year- old,” he says. “This is some of the first quantitative evidence that repeated concussions can cause your brain to age faster.”

In continuing his research, Mr. Marx plans to use this model to discover genes and other environmental factors that either accelerate or protect against the effects of aging in the brain. Mr. Marx is also working with Mount Sinai researchers on a project that uses sophisticated AI models to look at digitized slides and determine the areas of the brain that are most predictive of cognitive impairment. Areas of interest include white matter and the vasculature. “The whole scientific community is still in a place of discovery regarding dementia and neurodegenerative disease,” he says. “Tools like these can form the foundation for effective treatments by advancing our understanding of what is going on in the brain.”

After earning his MSBDS, anticipated in spring 2022, Mr. Marx will return to the medical school where he is pursuing his MD.

Mr. Marx intends to specialize in cognitive impairment and neurological disease and sees AI playing a key role in his efforts to advance therapeutic treatment. “I envision myself becoming an ambassador between the clinical side and the engineers and technicians who are on the development side, or even developing tools myself,” he says. “Either way, my goal is to be on the forefront of harnessing AI for the benefit of dementia patients.”

Advancing Artificial Intelligence Through Philanthropy

David Windreich

Thanks to the outstanding generosity of the Windreich Family Foundation, the Icahn School of Medicine at Mount Sinai will advance its vision of integrating Artificial Intelligence (AI) and machine learning into research and clinical practice to amplify patient-centered care. This multi-million dollar gift will establish the Windreich Department of Artificial Intelligence and Human Health at Mount Sinai.

By establishing one of the first departments devoted to AI in a medical school, this gift represents Mount Sinai’s exceptional commitment to integrating AI throughout the Mount Sinai Health System. It will enable the recruitment of dedicated faculty, novel research initiatives, and the acquisition of any equipment and software that are mission critical to ensuring Mount Sinai continues to lead bold initiatives that embrace the power of technology to accelerate advances in both scientific research and clinical care.

Oversight of the newly named Windreich Department of Artificial Intelligence and Human Health will fall under the purview of its inaugural Chair, Thomas J. Fuchs, Dr.sc, who is also the Co-Director of the Hasso Plattner Institute for Digital Health at Mount Sinai. The new department was formed under the vision and guidance of Dennis S. Charney, MD, the Anne and Joel Ehrenkranz Dean of the Icahn School of Medicine. “This gift will ensure Mount Sinai continues to be at the forefront of the AI-driven revolution of health care to the benefit of Mount Sinai’s diverse patient population,” says Dr. Charney.

“Our duty at the new department at Mount Sinai is to ensure that our patients are the main beneficiaries of the enormous impact AI will have on health care,” says Dr. Fuchs.  “To realize this vision, we are tremendously grateful for the gift from the Windreich Family Foundation. Mr. Windreich’s forward looking support will allow us to build a unique AI infrastructure at Mount Sinai and attract the world’s leading talent in this space.”

David Windreich, who serves on the Boards of Trustees at Mount Sinai, has a history of supporting AI and big data solutions in health care. His philanthropy extends to naming the Windreich Center for Bioinformatics at Mount Sinai. This Center is singularly focused on developing cutting-edge, web-based software tools and databases to facilitate the collection and analysis of diverse and complex data from human cells and tissues that will inform precise treatments for patients based on their unique genetic makeup. Mr. Windreich is also a former member of the Board of Directors for Sema4, a platform that uses machine learning and AI tools to analyze a database of more than 10 million patient genomic profiles and clinical records. Sema4 spun out of Mount Sinai in 2017 and went public at a $3 billion valuation in 2021.

“We have not yet reached the tipping point of how AI can play a major role in health care,” says Mr. Windreich. “My family is excited to play a role in supporting Mount Sinai’s initiative of being at the forefront of delivering technology solutions that will ultimately improve care and save lives.”

How Mount Sinai is Transforming Care for Patients with Brain, Spine, and Central Nervous System Disorders

Mount Sinai’s departments of Neurology and Neurosurgery are committed to innovation for the treatment of disorders of the brain, spine, and central nervous system. That commitment has been recognized now that The Mount Sinai Hospital’s Neurology and Neurosurgery departments were ranked for the first time among the top 10 in the nation by U.S. News & World Report.

Joshua B. Bederson, MD

For decades, the departments have expanded clinical and research programs offering ground-breaking treatments for patients with a wide range of conditions, including cancer, brain tumors, and strokes as well as neurological disorders such as Parkinson’s disease, epilepsy, and multiple sclerosis, and psychiatric disorders such as major depression.

“Over the years, this process has involved recruiting the best and brightest neurosurgeons who align with my vision of highly specialized care, centers of excellence, and programs within each subspecialty that are as deep and as broad as an entire neurosurgery department,” says Joshua B. Bederson, MD, Leonard I. Malis, MD / Corinne and Joseph Graber Professor of Neurosurgery and System Chair, Department of Neurosurgery. “It’s also been meaningful to collaborate with the Department of Neurology to support their own recruits and create joint programs that provide comprehensive, well-rounded care to patients with neurological conditions.”

Added Barbara G. Vickrey, MD, MPH, System Chair, Department of Neurology, and Henry P. and Georgette Goldschmidt Professor of Neurology: “Our ranking is an acknowledgement of the Neurology Department’s leadership in clinical care on a national basis. We excel in treating the most challenging neurological patients and providing high-quality care to all of our New York City communities, including those that are under-resourced.”

In this Q&A, Dr. Bederson and Dr. Vickrey discuss how changes they have made over the years have helped patients.

What are some of the most significant changes the Department of Neurosurgery has made?

Over the past several years, our focus has been on building our divisions that deal with different disease states such as brain tumors, vascular problems and stroke, pediatric neurosurgery, movement disorders, and epilepsy. We recruited the nation’s best and brightest leaders in each one of these areas, building programs around their expertise into very strong, and sometimes very large divisions, many of which rival the average neurosurgery department in other parts of this country.

What are some national and global accomplishments?

Some of our national and global accomplishments focus on the creation of the division sub-specializations. In the cerebrovascular space, we recruited one of the world’s great leaders, Dr. J Mocco, to direct our Cerebrovascular Center, and he’s turned it into a very large service line with 10 full-time faculty. We are making groundbreaking changes to clinical treatment, including reducing the “time to needle” and treatment from the onset of stroke down to very low numbers, meaning very fast treatment times. We are achieving results that are the best in the world.

We’ve created centers of excellence around movement disorders, with one of the great deep brain stimulation programs and neurostimulation for intractable epilepsy. We have one of the largest pituitary tumor, skull base surgery, and malignant brain tumor programs in the country, with numerous NIH-funded research studies, and a large number of novel clinical trials in each of these areas. Our Division of Neurocritical Care is a large, world-class division with a unique Neuro Emergencies Management and Transfers (NEMAT) program transferring more than 1,000 patients with critical neurological illness every year.

How does the Department of Neurosurgery advance industry and academia?

Neurosurgery is inherently a technological field, and we rely very heavily on advanced digital and other technologies in the operating room. Through a significant partnership with industry, we have innovated in many creative ways, including in the use of augmented and virtual reality and the use of artificial intelligence that support our advanced digital platforms. We’ve created a new division called Sinai BioDesign, which is an incubator for innovative device creation. Here, surgeons work together with bioengineers to create new solutions for fixing problems that we face in the operating room and turn those solutions into products and companies.

How do these accomplishments result in better outcomes for neurosurgical patients?

All of our activities are aimed at improving patient outcomes. By creating centers of excellence, we can take advantage of our large health system by concentrating normally rare diseases into high volume centers, giving surgeons and other health care professionals the experience they need to become experts. They leverage the high volume to develop clinical protocols and research protocols that allow us to advance care in each disease state. Sinai BioDesign is creating new solutions and devices to help us treat conditions that require new solutions through advanced technologies, improving safety for patients.

Barbara G. Vickrey, MD, MPH

What changes has the Department of Neurology made?

The Neurology Department has grown dramatically in education, research, and clinical care in the last five years. Our department has had an approximately two-and-a-half-fold increase in NIH funding over five years. We have recruited more than 70 new faculty, who have been recruited both internally from our talented Mount Sinai graduates and from major academic institutions around the United States.

What are some specific areas of success?

We strive to improve outcomes in multiple sclerosis, Parkinson’s disease, stroke, epilepsy, headache, neuropathies, brain and spinal cord tumors, dementia, and other neurological disorders in children and adults, and we have subspecialty fellowship training programs in all these areas.  We have well-regarded centers, programs, and divisions that are dedicated to this mission, such as the Corinne Goldsmith Dickinson Center for Multiple Sclerosis, which is known for providing the best available multiple sclerosis care, including access to a wide range of clinical trials and a wellness program.

How does this make a difference for patients?

The Department provides patients with a unique blend of personalized and coordinated care, groundbreaking research, and technology. This integrated approach is instrumental in our pursuit of improving outcomes.

Can you give some examples?

Patients who come to our Comprehensive Stroke Center experience better outcomes on average than those of other New York City hospitals and other comprehensive stroke centers. Our Epilepsy Program provides a spectrum of treatments from the latest medications to vagal nerve stimulation and coordinates with Neurosurgery when surgical intervention is needed, with the goal of living seizure-free. Our patients in any subspecialty can count on physicians who have experience with unusual disorders as well as more common ones. In short, patients can expect to experience the benefits of a large, academic medical center along with personalized care. It’s the best of both worlds.

New Division of Data Driven and Digital Medicine Within the Department of Medicine

We are pleased to announce the establishment of a new Division of Data Driven and Digital Medicine within the Department of Medicine at the Icahn School of Medicine at Mount Sinai. Led by Girish N. Nadkarni, MD, the Division’s mission is to create a data science and digital health hub to catalyze translational research.

Recognizing that so much of what we do is driven by data, we are establishing this division as a critical step toward integrating data science and digital tools into clinical practice. Creating a hub within the Department of Medicine that promotes data science and digital health resources will augment and empower translational research and clinical care. Another priority for this new Division will be exposing medical students, residents, and fellows to the world of data science and digital health. The division will collaborate with many Icahn Mount Sinai entities, including the Mount Sinai Clinical Intelligence Center, the Hasso Plattner Institute for Digital Health at Mount Sinai, the Clinical Data Science team, The Charles Bronfman Institute for Personalized Medicine, the Scientific Computing and Data Science team, and others.

Dr. Nadkarni has demonstrated his passion for and skill with data-driven science, most recently as co-director of the Mount Sinai COVID Informatics Center. Along with Alexander Charney, MD, and a transdisciplinary group of collaborators, Dr. Nadkarni led data-driven efforts to understand and address COVID-19, which led to clinical trials that have had an impact on clinical care.

Dr. Nadkarni’s scientific interests beyond COVID-19 are reflected in his role as Principal Investigator on several projects funded by the National Institutes of Health and his authorship of more than 200 peer-reviewed publications. Additionally, he is a named inventor on multiple patents. In 2018, Dr. Nadkarni was a scientific cofounder of RenalytixAI, an artificial intelligence-enabled in vitro diagnostics company that collaborates with Mount Sinai in seeking to improve chronic kidney disease detection, management, and treatment.

By creating the Division of Data Driven and Digital Medicine, the Department of Medicine now has one of the first data science and digital health divisions of Medicine in the country, putting us at the forefront of an emerging field. We are extremely proud that we are breaking new ground by its establishment.

Please congratulate Dr. Nadkarni on his leadership role in this initiative.

Dennis S. Charney, MD, Anne and Joel Ehrenkranz Dean, Icahn School of Medicine at Mount Sinai, President for Academic Affairs, Mount Sinai Health System

David C. Thomas, MD, MHPE, Acting Chair, Department of Medicine, Vice Chair of Education, Department of Medicine, Mount Sinai Health System

Artificial Intelligence Tools May Detect Abnormalities that Could Otherwise Be Missed

Mount Sinai radiologists are comparing machine-read patient discharge summaries with original, human-read reports.

A patient’s electronic health record typically contains a trove of information that can be used to help predict and manage their future health needs. But much of that information is often composed of unstructured or fragmented data that first must be translated into language that physicians are able to understand.

A new partnership between the Mount Sinai Health System’s Department of Radiology and an Israel-based start-up, Maverick Medical AI, is exploring how to accomplish that task through the use of artificial intelligence. In a proof-of-concept study, Maverick’s deep learning and natural language processing (NLP) algorithms are being used to accurately identify co-morbidities in 1.5 million patient discharge summaries and radiology reports. If it is successful, Maverick’s program could open the door for its use in an array of medical, research, and business opportunities at Mount Sinai.

David Mendelson, MD

David Mendelson, MD, Vice Chair of Radiology Information Technology at the Icahn School of Medicine at Mount Sinai, is playing a key role in the research. He says one of Maverick’s strengths is its ability to report on secondary abnormalities in nearby organ systems that are sometimes only partially seen or could possibly be overlooked in radiological screenings.

“If someone is screened for lung cancer and the findings are negative, that’s great news for the patient,” says Dr. Mendelson. “But if natural language processing could identify secondary indications like coronary artery calcification or abnormal density of the liver, which might suggest non-alcoholic fatty liver disease, that information could prove very useful to physicians and patients. Physicians might be able to take preventive steps to improve outcomes for patients and ultimately lower health care costs downstream.”

Determining whether Maverick’s propriety algorithm can provide that important information is the responsibility of Pamela Argiriadi, MD, Assistant Professor of Diagnostic, Molecular and Interventional Radiology at Mount Sinai. Dr. Argiriadi and a team of residents are spot-checking secondary co-morbidities extracted by the algorithm from an ocean of radiology reports and discharge summaries to determine how they compare to the original, human-read reports.

“Radiology reports contain a wealth of information and we hope our study will shed light on how key-word phrases in those documents can be mined to provide input into the well-being of patients,” Dr. Argiriadi says. “A major goal of ours is to improve communication with primary care providers by reporting secondary findings to them, which can result in follow-up treatment and preventive medicine.” The software can recognize these findings within the report, extract them, and flag them for the provider.

Yossi Shahak, Co-founder and Chief Executive Officer of Maverick Medical AI, estimates that as much as 80 percent of a patient’s health information remains untapped due to its unstructured format. Translating that raw, fragmented data into medical coding language would provide physicians with actionable clinical insights.

“We are starting with radiology and hope to expand the vocabularies across many medical subspecialties, like cardiology and gastroenterology,” says Mr. Shahak. “That expansion of our data sets could provide Mount Sinai physicians with significant value when they mine it for often overlooked chronic conditions and risk factors. In addition, the conversion from unstructured data into medical coding will help Mount Sinai improve their financial capabilities.”

Mount Sinai Researchers Streamline Patient Data to Find Patterns in COVID-19 Patients

Girish Nadkarni, MD

With the influx of patient data resulting from the SARS-CoV-2 pandemic, the Mount Sinai COVID Informatics Center is collaborating with London-based software company Clinithink to uncover key findings that can enable better treatment methods for COVID-19 patients.

Clinithink’s artificial intelligence platform, CLiX, processes large volumes of data from physician notes and documents within electronic health records, allowing providers to save time and effectively determine key information on patient conditions.

“We are currently using the platform to mine clinical documents in order to extract information to further our understanding of COVID-19 and its complexities, so we can determine the best course of action for individual patients,” said Girish Nadkarni, MD, Assistant Professor, Department of Medicine (Nephrology), Clinical Director of the Hasso Plattner Institute for Digital Health, and Co-Director of the Mount Sinai COVID Informatics Center.

Through the use of Clinithink’s platform “CLiXTM unlock,” the COVID Informatics Center is creating risk scores for COVID-19 patient symptoms, sifting through data that has been stripped of any personal information to find patterns that can ultimately lead to new discoveries in COVID-19 treatment.

“Clinithink is enabling us to identify and distinguish the symptoms in hospitalized COVID-19 patients during admission, in order to determine if and when new symptoms are appearing during their hospitalization,” Dr. Nadkarni said.

The Icahn School of Medicine at Mount Sinai was the first academic institution in the nation to partner with Clinithink in 2016, its original use to accelerate the prescreening process to identify eligible candidates for clinical trials.

“The collaboration between Clinithink and Mount Sinai represents how novel research can be translated into clinical practice,” Chris Tackaberry, CEO of Clinithink, said. “We are delighted to see Mount Sinai extend the use of our platform as they continue to make breakthrough discoveries in COVID-19.”

The collaboration was facilitated by Mount Sinai Innovation Partners (MSIP), the technology commercialization engine at Mount Sinai.

“Collaborating with Clinithink improves the way we understand and serve our patients,” said Erik Lium, PhD, President of MSIP and Executive Vice President and Chief Commercial Innovation Officer at the Mount Sinai Health System. “We look forward to seeing how Dr. Nadkarni’s team leverages Clinithink to extend our knowledge about COVID-19, and potentially improve treatment and patient outcomes.”

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