59: Health & Care Technologies
UTC-Costech is an interdisciplinary laboratory of human and social sciences at UTC, dedicated to the study of the technical fact, part of the Health & Care Technologies cluster with the Biomechanics and Bioengineering (UTC-BMBI) Laboratory. This cross-disciplinary theme covers various fields such as the conservation of biological materials in biobanks, the design of bioartificial organs, perceptive substitution and artificial intelligence devices for diagnosis (cancers, Lyme’s disease).
Xavier Guchet, a professor of philosophy of technology, has been Director of UTC-Costech since 2019. With a staff of nearly 60 lecturer-cum-research scientists, PhD students, post-doctoral students, not counting associate research scientists — Costech is organised around three research teams.
Created in 1993, essentially by philosophers and cognitive science specialists, UTC-Costech was initially built around the following problem: the technically constituted dimension of human cognitive faculties. In other words, the fact that our cognitive abilities are only exercised through technical supplementation. A human and social science laboratory, it has since opened up to new disciplines. “Today, there are more than ten different specialist disciplines. They range from the philosophy of technology and cognitive sciences to epistemology, the history of technology, design, psychology, sociology, information and communication sciences, language sciences, political science, computer science and economics and management,” says Xavier Guchet. This makes it the most interdisciplinary laboratory dedicated to the study of technology in France. “Our aim is to study technology through the prism of all such disciplines,” he says.
UTC-Costech is structured around three research teams: the CRED team (Cognitive Research and Enactive Design), the EPIN team (Writing, Practice and digital Interactions) and last but not least the CRI team (Complexities, Networks and Innovation).
The first team, more oriented towards the humanities and cognitive sciences, includes philosophers, psychologists, historians of technology, researchers in cognitive sciences and language sciences, as well as epistemologists and computer scientists.
Among the CRED’s areas of research? “It is a team with different disciplinary profiles, but our work lies at the intersection of two major questions. The first concerns the study of technology from a historical, philosophical and epistemological point of view. We explore the thesis that technology is constitutive of the human being in the sense that it makes possible our way of being in the world. We are also interested in contemporary technologies and their ethical and social issues. The second concerns cognition and unfolds through experimental and theoretical research on perception, thought, language and the role of technical mediation. These two major questions end up crystallising in the issue of design, and in particular the design of perceptual support devices, which lies at at the heart of the technological research carried out by the team,” explains Vincenzo Raimondi, head of the CRED.
The second question, more oriented towards information and communication sciences and political science, is particularly interested in two issues: digital literacy and political transformations in the digital age.
Can you be more explicit? “We are working on digital issues in two main areas. On the one hand, a sociology of digital practices and uses, and on the other, the specificity of digital writing and literature. In the first case, we will study how digital technologies transform social dynamics and political practices with work that will focus, for example, on digital democracy or the regulation of Internet platforms and social media. In the second case, we will study how digital technology opens the door to new ways of creating or interacting with online creations. In this way, we observe that digital technology modifies the language and the medium of certain artistic practices. Some of the researchers in our team will thus combine research and creation by producing content that aims to show how digital technology allows us to create differently,” explains Anne Bellon, co-leader of the EPIN research team.
These issues under investigation have led to a number of projects, including one on “discoverability”, funded by the French Ministry of Culture. “The aim is to develop tools to study our online cultural practices and to see to what extent they are guided by the recommendation algorithms of cultural platforms, for example,” she adds.
To round up, the CRI team, with its 27 highly multidisciplinary research scientists, embraces various fields including sociology, economics and management, philosophy and mathematics. “The team size and disciplinary diversity allows us to explore various fields of research all linked to the study of technology in its socio-economic, organisational and collective dimensions. We are interested in three areas in particular. The first area concerns the ongoing digital transition, artificial intelligence and big data. The second area is concerned with the theme of organisation, innovation via collectives bodies and the governance of innovation, and the third explores ecological transition,” explains Hadrien Coutant, co-director of the CRI team.
Tell us about the projects linked to these themes? “We have several, including one on so-called “industry 4.0” and the digitalisation of industrial processes, and another on data intelligence and Lyme’s disease. For my part, I am conducting work on the regulation of public companies and their relations with the State authorities, while technological research on the uses of digital technology is conducted with the platform at our “Halle numérique”. Finally, we are conducting work on ecological thinking and the ecological commitment of engineers, photovoltaic charging stations and decentralised industrial models and their role in the ecological transition,” he concludes.
As an example of a cross-cutting theme, the “Health and Care Technologies” (H&CT) cluster is linked to Costech’s “Care Technologies” axis and is co-piloted by Costech and BMBI.
What initiated this multidisciplinary and cross-disciplinary project? “When I arrived at UTC, I took responsibility for the “Health Care Technologies” axis within Costech. Today, it is by getting involved in the H&CT cluster that I am contributing to the existence of this laboratory axis”, explains Xavier Guchet.
For Costech researchers, technology is a total fact. Can you expand in this? “The devices designed by engineers are intrinsically carriers of social, moral and political issues. The technical object aggregates, at a very early stage in the conception and design choices, issues that go far beyond it. In fact, society, ethics and politics are materialised in the choices that govern the design of objects,” he stresses.
Technology is therefore not neutral, as the human and social sciences (SHS) have amply demonstrated over the past 50 years. However, there is a gap between the theoretical knowledge accumulated on technology and the world of technological design. “If we wanted to draw the logical conclusion of these social studies of technology, any process of designing a technology should be deemed multidisciplinary. Professional engineers should be equipped with a culture of social sciences and humanities, just as the philosopher or anthropologist should be familiar with the constraints of conception or design, among other things. But it is not so easy to get these different communities to work together,’ he says.
Historically, UTC has always had the ambition to create spaces for interdisciplinary dialogue and to train, according to Professsor Guy Daniélou, founder of the university, what we can designate as ‘philosophical engineers’. That is to say, engineers with technical skills but also in social sciences (SHS). The H&CT cluster is designed to contribute to this objective.
A cross-disciplinary centre
Can you expand a bit, in concrete terms? “The idea is to defend the idea that technological design in bioengineering benefits from the contribution of philosophy and social and human sciences. The aim is not to provide engineers with an ‘extra soul’, a bit of ethics covering the engineer’s activity like a layer of varnish: the vocation of the H&CT cluster is to demonstrate the fruitfulness of engineering/SHS collaboration from the initial process of design, tackling the guiding concepts that orient engineers’ work, or by demonstrating the interest for engineers in replacing their activities in its history,” insists Xavier Guchet.
The idea caught on and, in 2016, the two laboratories launched a joint Annual Study Day on a wide range of themes. “Among other things, we organised a day dedicated to organ replacement using bioartificial devices, and another on 3D bioprinting, again in connection with organ replacement. Prof. Cécile Legallais and I are also co-directing a thesis on the history and epistemology of artificial organs. Manon Guillet, one of our PhD students, has also set up an ethical meeting within BMBI. And the underlying idea? To convince engineers of the importance of knowing the history of their own field, i.e., the history of the concepts and tools they use on a daily basis, but also to encourage them to reflect on their own practice from an ethical point of view,” he explains.
Since January 2023, these spaces for interdisciplinary dialogue have been enhanced by a monthly seminar.
The H&CT cluster’s cross-disciplinary approach has taken concrete form in three projects coordinated by Xavier Guchet.
Biobanks
The first project (acronym BiobanquePerso), launched in 2017 and financed by the Hauts de France Region (formerly Picardy) and the European Regional Fund (Feder), concerns biobanks, or Biological Resource Centres. “These infrastructures, mainly hospital-based in France, aim to support biomedical research by providing research teams with biological samples such as blood, tumour tissues, cell cultures, associated with the health data of the donors concerned, having received their informed consent beforehand. The collection, preparation and storage of these biological resources follow a very precise and standardized protocol to ensure their quality. Indeed, numerous studies have shown that the non-reproducibility of research results from one laboratory to another was often linked to the lack of homogeneity and quality of the samples made available to research scientists,’ he explains.
This shows the fundamental role of biobanks for biomedical research.
What are the cluster’s objectives in this area? “It seemed to me that, compared with the existing literature dominated by ethical, legal and sociological studies, two aspects were missing. Firstly, the historical aspect. Namely, how was this activity of biobanking – born as it was with the 20th century — made possible, what were its trajectories? The other aspect is strictly epistemological: how do these infrastructures and their evolution transform the way knowledge is produced in biology and medicine? The project involved the Picardie Biobank, one of the first in France, with historians of technology and philosophers of technology. I would add that we practice a philosophy of ‘fieldwork’, in the sense that we develop our analyses by feeding them with empirical investigation, in situ, by observing the activity of the actors as well as the objects they handle and produce, in order to understand the issues at stake,” he emphasises.
The “Organ” project
Launched in 2021, this second project is financed by the National Biomedical Agency, whose main field of competence concerns organ transplants and all related issues. This ranges from organ donation to organ graft assignment.
The characteristics of this project (acronym ITEGOREC)? “At UTC, our BMBI colleagues are working on the design of bioartificial organs, the aim of which is to design external or implantable devices capable of ensuring the functions of failing organs and/or of replacing them. These devices are one of the areas investigated by the project. It also explores two other organ technologies: firstly, perfusion technologies, the function of which is to ensure that organs are well preserved between the time they are removed from a donor and the time they are transplanted into a patient. These machines also allow the graft to be tested to assess its quality – all of which represents valuable information for the transplant surgeon. Secondly, the project is also interested in ‘organoids’ and organ-on-chips, i.e., 3D cell cultures that are designed to reproduce certain metabolisms and even functions of the target organ. These highly simplified versions of organs are the subject of much hope, particularly in clinical and toxicological research and potentially in regenerative medicine,’ explains Xavier Guchet. These new objects are thus at the crossroads of the field of cell culture, which dates back to the early 20th century, that of biomaterials and that of modelling. The idea is to understand when, how and why these different fields came together, giving rise to these new bioengineering sectors.
The project also aims to address the touchy ethical and regulatory issues raised by these organ technologies.
Artificial intelligence in oncology
Launched in 2022 and financed by the French National Cancer Institute, this project (acronym MaLO), which focuses on breast cancer, aims to shed multidisciplinary light on AI devices being developed in the field of cancerology.
More concretely? “As with the “Organs” project, it is first of all a question of placing these devices in a historic context. Indeed, history can be constructive in order to shed light on the present since it can teach us about the mistakes made earlier, plus some dead ends that were reached, for example by linking today’s devices to the history of expert systems in the 1970s/1980s which, on the whole, did not keep up their promises. It is also a question of understanding the extent to which these systems are transforming the manufacture of knowledge about cancer. Thus, 20 years ago, the rise of genomics changed the way we produce knowledge about cancer, define what cancer is, understand its mechanisms and ultimately how we treat it. Will AI have a similar impact on cancer classification and patient management? The project also intends to address the ethical and regulatory issues raised by these AIs when they are developed in medicine. Our approach is based on a conviction: these devices only make sense in context, it is not relevant to hold a general and off-the-wall discourse on medical AI. Finally, in a more exploratory approach, we want to experiment with partners — university hospitals, research centres — a process of co-design of devices, encouraging multidisciplinary reflection on the problems of AI in cancerology,” explains Xavier Guchet.
Today, the H&CT cluster appears as a successful example of interdisciplinary engineering/SHS research. “The ambition is to provide the cluster with a visibility going beyond the institution, especially through the special Study Days. At UTC, we want to be identified as important players in the reflection on the role of engineers in the evolution of medicine at the level of regional policy,” he concludes.
Marc Shawky is a university professor in computer engineering and is attached to the CRI team at Costech. He works, in particular, on two transversal axes “Care” and “Digital tools” including the Num4Lyme project.
Research that focuses on the analysis of massive data and automatic learning. This involves artificial intelligence. “I am particularly interested in health data and especially in long-term infectious diseases, including Lyme disease. Hence the Num4Lyme project,” he says.
Lyme disease is the most common infectious disease in France — 30 000 to 40 000 new infections per year — and is transmitted by tick bites, mainly in forest regions. This is the case, for example, in the Compiègne basin.
What is special about long-term infectious diseases? “People with a single infection may not have symptoms requiring treatment. On the other hand, those with several infections detected by serological tests and PCRs may have symptoms similar to auto-immune diseases and in some cases show no symptoms at all. The clinical signs of the first group are very few and far between — short memory loss, joint pain, etc. — often confusing general practitioners, causing patients to wander around trying to make the right diagnosis,’ he explains.
What can be done about it? “We need other diagnostic tools, particularly data analysis,” adds Marc Shawky.
What does this imply in practice? “We will start with the clinical signs and complaints as expressed by the patient, such as the frequency of a particular symptom, its intensity and also its evolution over time. The data collected includes the forms filled in by the patients under the supervision of hospital doctors, medical analyses, medical imaging reports, etc. We are working on 300 to 400 parameters per patient,” he says.
Partners for this project? “There are three centres of expertise on Lyme disease in France. We are going to sign an agreement with Dr Ahed Zedan of the Saint Côme clinic, one of the three centres, and discussions are underway with the one in Nantes and the one in Metz,” he says.
What is the role of Marc Shawky’s team in setting up these new tools? We are developing algorithms that will analyse the data using classification techniques. There are several of them, but we’ll start with the simplest ones. We’re building a learning database with patients we’re sure have Lyme disease, and then using this database we shall classify data from patients we don’t know. So we acquire data that has never been previously learned. The algorithms will then match each of the new patients with this learning set. Let’s not forget that we have almost 400 parameters per person and that all the data is not yet standardised. This is a real challenge in the analysis of massive data, anonymised data that comes, essentially, from our partners,” explains Marc Shawky.
A cross-disciplinary project that involves, in addition to Costech, the LMAC and the UTC-GEC Laboratory as well as the Saint Côme clinic.
