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The Making of ‘Thought Leader AI’

From inspiration to launch, Thought Leader AI, ParaPro’s medical education platform, was developed to raise awareness and educate practitioners efficiently, with the potential to eradicate a widespread public health issue.

“Two and a half years ago, the Shoah Foundation was highlighted on 60 Minutes. ICT’s [University of Southern California Institute for Creative Technologies’] technology allowed people to experience an interactive conversation with Holocaust survivors, so their stories could still be shared,” said Patrick O’Shea, vice president of marketing at ParaPRO. “A little alarm went off in my head—that’s what ParaPRO needs for these small disease areas where there’s little knowledge among many, many practitioners about diagnosis and treatment options.”

In early 2021, ParaPRO was working to gain FDA approval for an indication that would make topically applied Natroba (spinosad) the first new FDA-approved scabicide in more than 30 years and the only designated “complete cure” for a largely neglected condition. 

“The family practice doctors and pediatricians just don’t see scabies very often. Or they see a rash and they don’t have equipment to diagnose it, so they try multiple treatments—and when it’s not cured, they send the patient to a dermatologist or an infectious disease person. The physicians who were really struggling to cure scabies were contacting us to tell us to look at Natroba, which they had been prescribing off-label with positive outcomes,” said ParaPRO President Bill Culpepper.

“We knew Natroba wasn’t systemically absorbed, but we did discover that spinosad will penetrate the skin as far as the stratum corneum, which is the layer of the skin where scabies lives, allowing spinosad to kill the mite.”

As a small, privately held pharmaceutical company with modest budgets, ParaPRO faced the challenge of raising awareness of scabies infestations, while promoting a treatment with the potential to eradicate a widespread public health issue. 

“When we’ve had opportunities in the past to bring experts and put them in contact with their peers, it’s been great to watch the exchange and see the ‘a-ha’ moments. It was obvious to me that this is a way to do that on a bigger scale, and at the convenience of the physician who’s needing the information. At the end of the day, it’s the patient who’s going to get help,” said Culpepper.

The Tech Team

O’Shea initially connected with David Traum, PhD, director for natural language research at ICT, an Army University-Affiliated Research Center (UARC) that explores special capabilities in virtual reality, artificial intelligence (AI), storytelling, and more.

“When I explained the scenario that ParaPRO has in relationship to scabies, with all the knowledge in the hands of a few researchers, it made perfect sense to his team how the medical field could really benefit from the use of their technology,” said O’Shea.

With a background in dialogue systems and creating machines that can talk with people, Traum looked to create a conversational experience for ParaPRO viewers.

“It’s answering questions in the way a human interviewee would answer questions, not the way a question-answering system trying to retrieve information from the internet, like Google, might.”

Using machine learning, and based on training data, ICT creates a model that’s able to translate new and varied questions to return the ideal available answer. 

“When we’re putting the videos into an application, we’ve also transcribed all the answers. We’ll put in the text of questions, and then links to what would be good answers to these particular questions.”

That way, viewers can ask any question, in any order, and receive an answer from one or more of the experts—even an invitation to repeat themselves or acknowledge that their AI representation doesn’t know the answer.

The Three Experts

“We wanted this to be no different for colleagues who interact with the experts all the time, or for people who have never met them or haven’t seen them in a practice or institutional setting,” said O’Shea.

ParaPRO recruited three leading experts in the diagnosis and treatment of scabies:

  1. Christopher Belcher, MD, FAAP, the director of pediatric infectious disease at Peyton Manning Children’s Hospital, St. Vincent/Ascension
  2. Theodore Rosen, MD, FAAD, professor of dermatology at Baylor College of Medicine and chief of dermatology service at Michael E. DeBakey Veterans Affairs Medical Center
  3. Anthony J. Mancini, MD, FAAP, FAAD, division head and associate fellowship director in dermatology at Ann & Robert H. Lurie Children’s Hospital of Chicago, and professor of pediatrics and dermatology at Northwestern University Feinberg School of Medicine 

The ParaPRO team worked with the panel members to write a set of questions numbering into the hundreds, using related presentations from the last three years, and the TDD educational series on parasitic skin infections, as guides.

During filming in the ICT theater, each expert answered questions about case studies, observations, conclusions, and available treatment options. Most questions were posed to all three; some differed based on individual expertise. 

According to Dr. Mancini, “You have to put yourself in the mindset that ‘I am with a live audience,’ but I’m not. We had to make this seem like I was. Overall, it was a really fun day. But I will say it was work. You know, it’s much easier to give a live lecture in front of a thousand people than to record these sorts of things.”

Launching Thought Leader AI

The AI-based interactive medical education platform was initially launched in October 2022 at the American Academy of Pediatrics (AAP) conference in Anaheim, California. 

“We wanted pediatricians, nurse practitioners, PAs, and nurses at the conference to know that ParaPRO had the foresight to use this technology,” said O’Shea.

At the meeting, Dr. Belcher interacted with his colleagues using Thought Leader AI at the ParaPRO booth. Many attendees assumed they were viewing a live Zoom meeting until they learned that the life-sized experts on screen were not actually live in the moment. 

According to O’Shea, “It was received tremendously well—once the audience understood what was in front of them.”

Attendees who chose to converse with the avatars themselves expressed fascination with the experience.  

“The AAP fellows innately understood the benefit, and they had the foresight to understand Thought Leader AI can be used at institutions for higher learning and far beyond the specific way we used it in our exhibit,” said O’Shea.

Dermatologists can experience Thought Leader AI at Maui Derm 2023, in Maui, Hawaii, January 23-27. 

According to Dr. Mancini, “It’s a great way to bring the expert to the practitioners without literally having to bring the expert to the practitioners.” 

“This is going to change the way we look at educating practitioners from this point forward,” said Dr. Rosen.

Learn More About Thought Leader AI

Watch behind-the-scenes footage from the video shoot, request information about using the technology in your own setting, and—in early 2023—converse directly with Drs. Belcher, Rosen, and Mancini using Thought Leader AI at https://www.thoughtleaderai.org/.

References:

  1. 60 Minutes feature on Shoah Foundation:
  1. Natroba (spinosad) and its potential as a treatment for scabies:
  1. University of Southern California Institute for Creative Technologies (ICT):
  • University of Southern California Institute for Creative Technologies. “About ICT.” Accessed December 27, 2022. https://ict.usc.edu/about/.
  1. David Traum, PhD:
  1. Christopher Belcher, MD, FAAP:
  • Emory University School of Medicine. “Christopher Belcher, MD.”