In this week’s Duke AI Health Friday Roundup: Duke’s Cynthia Rudin on transparent AI; Black Americans face “cardiology deserts”; marked jump in proportion of youth emergency visits for mental health reasons; considering AI for infectious disease surveillance; problems emerge with nation’s organ donation systems; share of US oncology clinics owned by private equity grows; language may affect musical perceptions; much more:
AI, STATISTICS & DATA SCIENCE
- “If you want to trust a prediction, you need to understand how all the computations work. For example, in health care, you need to know if the model even applies to your patient. And it’s really hard to troubleshoot models if you don’t know what’s in them. Sometimes models depend on variables in ways that you might not like if you knew what they were doing.” Quanta’s Allison Parshall interviews Duke AI professor Cynthia Rudin, whose work explores explainable machine learning.
- “…over the course of the Covid-19 pandemic, our current methods have been put to the test, and their performance has been highly variable. The success of the next generation of AI-driven surveillance tools will depend heavily on our ability to unravel the shortcomings of our algorithms, recognize which of our achievements are generalizable, and incorporate the many lessons learned into our future behavior.” A review article by Brownstein and colleagues, published in the New England Journal of Medicine, examines the state of the art in the use of artificial intelligence for infectious disease surveillance and ponders lessons from the COVID pandemic.
- “In this cross-sectional study within the context of patient questions in a public online forum, chatbot responses were longer than physician responses, and the study’s health care professional evaluators preferred chatbot-generated responses over physician responses 4 to 1. Additionally, chatbot responses were rated significantly higher for both quality and empathy, even when compared with the longest physician-authored responses.” A research article published in JAMA Internal Medicine by Ayers and colleagues describes findings from a study that compared the quality and empathetic values (but not the accuracy) of chatbot responses to medical questions with those generated by human physicians.
- “Dr. Hinton’s journey from A.I. groundbreaker to doomsayer marks a remarkable moment for the technology industry at perhaps its most important inflection point in decades. Industry leaders believe the new A.I. systems could be as important as the introduction of the web browser in the early 1990s and could lead to breakthroughs in areas ranging from drug research to education…But gnawing at many industry insiders is a fear that they are releasing something dangerous into the wild.” The New York Times’ Cade Metz talks with neural network pioneer Geoffrey Hinton, whose recent departure from Google was occasioned by concerns about the direction and implications of recent advances in generative AI applications.
BASIC SCIENCE, CLINICAL RESEARCH & PUBLIC HEALTH
- “…we used web-based citizen science to assess music perception skill on a global scale in 34,034 native speakers of 19 tonal languages (e.g., Mandarin, Yoruba). We compared their performance to 459,066 native speakers of other languages, including 6 pitch-accented (e.g., Japanese) and 29 non-tonal languages (e.g., Hungarian). Whether or not participants had taken music lessons, native speakers of all 19 tonal languages had an improved ability to discriminate musical melodies on average, relative to speakers of non-tonal languages. But this improvement came with a trade-off: tonal language speakers were also worse at processing the musical beat.” An article published in the journal Current Biology by Liu and colleagues suggests that a person’s native language may shape how they perceive music – including how acutely they register melody and rhythm.
- “Over the last 10 years, the proportion of pediatric ED visits for mental health reasons has approximately doubled, including a 5-fold increase in suicide-related visits. These findings underscore an urgent need to improve crisis and emergency mental health service capacity for young people, especially for children experiencing suicidal symptoms.” A research article published this week in JAMA by Bommersbach and colleagues reports a marked increase in youth visits to emergency services that are prompted by mental health crises.
- “Even as they tighten performance reporting, though, regulators largely overlook a crucial part of the organ donation process: how exactly organ procurement organizations do their jobs. Documents obtained by The Markup and interviews with industry veterans show vast differences in performance standards, poor federal monitoring, and shortfalls in training.” The Markup’s Malena Carlo reports on data from the Centers for Medicare and Medicaid Services that show serious cracks in the foundation of the nation’s organ-donation infrastructure. In other, more positive news: Scientific American’s Caren Chesler reports on the first successful drone delivery of a lung for transplantation – a demonstration that reduced a potentially 25-minute trip to 5 minutes.
- “About 16.8 million Black Americans — roughly 1 in 3 — live in counties with little or no access to heart specialists, according to a report from GoodRx, a telehealth company that provides drug discounts and also researches health trends. When zooming in on counties that have sizable Black populations, the analysts found that 72% of these counties are “cardiology deserts,” most of them concentrated in southeastern states.” STAT News’ Elaine Chen reports on findings published by telehealth company GoodRx showing the extent of “cardiology deserts” – counties without services from physician specialists in heart disease – in areas with sizeable proportions of Black residents.
COMMUNICATION, Health Equity & Policy
- “For days now, the library has become a scene of occupation. Students have filled it with tents, sleeping bags and air mattresses in a last-ditch effort to save the 67-year-old institution dedicated to anthropology, which encompasses the study of humanity, societies and cultures….For the student occupiers, the fight is as much a battle over a library as it is over humanities and social sciences in an age when the world is obsessed with technology and seems eager to replace the physical world with virtual experiences driven by A.I.” Rage against the machine: the New York Times’ Tim Arango reports on students at UC Berkley who are staging an occupation in protest of the planned shuttering of an anthropology library, even as the university celebrates groundbreaking on an enormous data sciences facility.
- “…we estimated that 340B program eligibility was associated with a 22.9-percentage-point reduction in biosimilar adoption. In addition, 340B program eligibility was associated with 13.3 more biologic administrations annually per hospital and $17,919 more biologic revenue per hospital. Our findings suggest that the program inhibited biosimilar uptake, possibly as a result of financial incentives making reference drugs more profitable than biosimilar medications.” An investigation of federal drug pricing incentives, published in Health Affairs by Bond, Dean, and Desai, finds that the 340B drug pricing program may have thwarted the wider use of less expensive alternatives to biologic drugs.
- “There has been a marked increase in PE [private equity] acquisition and consolidation of oncology practices over the past 2 decades. Similarly, PE-backed platform companies have undergone substantial consolidation through mergers and acquisitions. The number of medical and radiation oncologists identified at PE-affiliated practices was estimated to constitute 10% to 15% of practicing oncologists in the US. Given that we focused only on clinics involved in PE-backed transactions and excluded clinics that were newly opened, our results likely underestimate the true total footprint of PE-backed involvement in oncology clinics.” A research article by Tyan and colleagues, published this week in JAMA Internal Medicine, tracks the growth of private equity ownership of US oncology clinics.
- “This was the first global pandemic that the scientific publishing industry had ever faced—while journals existed, no organised industry did when the 1918 flu pandemic occurred—and the first in a new digital age of internet communication and publishing. An estimated 1.5 million articles were added to the global literature in 2020—the largest single year increase in history, says Vincent Larivière, who studies bibliometrics at the University of Montreal, Canada.” A feature article in BMJ by Jocalyn Clark examines the effects of the COVID-19 pandemic on the biomedical publishing world.