HEALTH TRAIN EXPRESS Mission: To promulgate health education across the internet: Follow or subscribe to Health Train Express as well as Digital Health Space for all the updates for health policy, reform, public health issues. Health Train Express is published several times a week.Subscribe and receive an email alert each time it is published. Health Train Express has been published since 2006.
Listen Up
Friday, December 16, 2022
California has plenty of anti-COVID drugs, but few prescriptions -
Monday, December 12, 2022
Hope In The Post-Pandemic World. Part III
“Success in creating AI would be the biggest event in human history. Unfortunately, it might also be the last, unless we learn how to avoid the risks.”
Stephen Hawking, British theoretical physicist
Andrew Chang MD completes his synopsis of AI in the Era of Covid 19
The most obvious effects of the pandemic was the huge growth of telemedicine for clinicians. AI will be much more difficult with many more failures than success, much like the beginning of Space-X and the Falcon rockets. Nevertheless iterative engineering will ultimately succeed.
We conclude this series on the future of artificial intelligence in healthcare with a discussion on the more distant future of artificial intelligence. In our struggle against this menacing pandemic, we can look at the future with optimism and idealism, and with artificial intelligence as one of our essential resources in our portfolio.
Significant needs and advances for AI in medicine in the coming decades will mandate us to understand the potential, limitations, and perhaps dangers of this resource.
First, means of decreasing the human burden of labeling medical images will be in the form of innovations in artificial intelligence such as few shots learning and generative adversarial networks that can enable more automated interpretation in the future.
Second, there need to be AI systems that can perform real-time AI. For this to occur, AI architectures will need to be even more robust and will need to include AI tools such as anytime algorithms, decision-theoretic meta-reasoning, and reflective architecture. These new AI tools will also need to incorporate the nuances of complexity and chaos theory as biomedical phenomena often have complex rather than complicated elements.
The entire learning portfolio will need to be explored and orchestrated for biomedical work: transfer learning, unsupervised and self-supervised learning, predictive learning, apprenticeship learning, reinforcement learning, and other types of learning to come in the future.
Digital twins at the individual and population levels and federated learning of all health systems at the international scale are now part of healthcare.
Cognitive elements of artificial intelligence such as 1) Joseph Voss’ cognitive architecture (declarative and procedure learning and memory, perception, action selection, etc), 2) Geoff Hinton’s “capsule networks”, or 3) Jeff Hawkins’ “reference frames” described in his book A Thousand Brains: A New Theory of Intelligence, will need to be increasingly a broad motif in artificial intelligence in medicine and healthcare that will incorporate the insights, intuition, and intelligence of our clinicians. The phrase “artificial intelligence in medicine or healthcare” will no longer be used as it was decades before.
The future of artificial intelligence in healthcare and many other topics will be discussed at our in-person AIMed Global Summit, currently being rescheduled to a later date this year to navigate around the pandemic. An exciting final session will be on the future of artificial intelligence in healthcare including its role in digital twins, extended reality, and federated learning. We will see each other in the near future. Find more information here.
Hope for the post-pandemic world (part II) | MI10
Hope for the post-pandemic world (part I) | MI10
Precision Medicine, Use of Cell Therapy
Artificial intelligence and metaverse: future implications for clinical medicine and healthcare | MI10
Statiscal Methods in Clinical Medicine, or What to Believe ? Bayes’ Theorem
Elon Musk's Neuralink could begin human testing in six months |
Friday, December 9, 2022
CHD Files Motion to Prevent California From Punishing Doctors for COVID ‘Misinformation’ Until Lawsuit Is Settled •
Mission
The mission of the Medical Board of California is to protect health care consumers through the proper licensing and regulation of physicians and surgeons and certain allied health care professionals and through the vigorous, objective enforcement of the Medical Practice Act, and to promote access to quality medical care through the Board's licensing and regulatory functions
Friday, December 2, 2022
Amazon’s Creep Into Health Care Has Some Experts Spooked
Amazon’s Creep Into Health Care Has Some Experts Spooked
The concept is simple: The patient will select their condition, fill out a questionnaire, and Amazon will connect them with a doctor to get a treatment plan. The scheme does not accept insurance; the cost of seeing a doctor will be around that of the average copay for a doctor’s visit, the announcement says: “At Amazon, we want to make it dramatically easier for people to get and stay healthy.”
It’s also seemingly another move by the tech giant to know every last detail about your life—even down to whether you’re suffering from erectile dysfunction (one of the conditions that Amazon Clinic will cover). Yet given that Amazon doesn’t have the squeakiest track record when it comes to protecting data, handing the company the keys to people’s intimate health information raises red flags for privacy experts.
If this feels familiar, it’s because we’ve been here before. The launch of this new service comes hot on the heels of Amazon’s takeover of One Medical, a US company described as a “Netflix-for-healthcare subscription” with around 800,000 members. The acquisition proved controversial due to concerns about patient data privacy mostly centered on the simple fact that Amazon would have access to the data. (When news of the $3.9 billion deal broke in July, it prompted protests outside One Medical’s headquarters in San Francisco.)
Amazon Care, a telehealth service Amazon piloted among its employees and then rolled out to other customers, shows how things can go wrong. Its shutdown was announced a few months ago, with the senior vice president in charge of the program, Neil Lindsay, writing in an internal memo Amazon shared with WIRED: “Although our enrolled members have loved many aspects of Amazon Care, it is not a complete enough offering for the large enterprise customers we have been targeting and wasn’t going to work long-term.”
But it was plagued by other problems, too. A Washington Post investigation alleged that moving at top speed and efficiency sometimes conflicted with best practices in medicine: For example, nurses were asked to process patient blood samples in their personal cars, the paper reported, and to store and dispose of medical supplies at home, which they protested. (Amazon told the Post that they could not find records of complaints about these matters.)
“Amazon Care followed common practices for in-home care and knows them to be safe and appropriate,” Smith told WIRED. “For example, Amazon Care clinicians were always equipped with Stericycle medical waste return equipment to properly and securely return or dispose of supplies.”
For Sharon, a big concern is how reliant we risk becoming on big companies as mediators of fundamental public needs. “This is a dangerous situation—that we would become dependent on a handful of private actors for the distribution of very basic goods, like health, or education, or public services,” she says. For instance, as these companies increasingly fund and perform their own research, it’s possible they could influence how the research agenda is set. That could be a problem if tech founders’ penchant for wanting to live forever results in a focus on funding longevity research over, say, cancer treatments.
At the very least, Amazon Clinic will be bound by HIPAA, the Health Insurance Portability and Accountability Act, which means individual patient records will be protected as soon as a person begins a process with a health care provider. But all the information you provide prior to this—for instance while searching for a doctor—falls outside of the purview of HIPAA, and is technically open for Amazon to gobble up,
Tuesday, November 29, 2022
Covid is no longer mainly a pandemic of the unvaccinated. Here’s why. - The Washington Post
It’s no longer a pandemic of the unvaccinated
For the first time, a majority of Americans dying from the coronavirus received at least the primary series of the vaccine.
Fifty-eight percent of coronavirus deaths in August were people who were vaccinated or boosted, according to an analysis conducted for The Health 202 by Cynthia Cox, vice president at the Kaiser Family Foundation.
It’s a continuation of a troubling trend that has emerged over the past year. As vaccination rates have increased and new variants appeared, the share of deaths of people who were vaccinated has been steadily rising. In September 2021, vaccinated people made up just 23 percent of coronavirus fatalities. In January and February this year, it was up to 42 percent, per our colleagues Fenit Nirappil and Dan Keating.
“We can no longer say this is a pandemic of the unvaccinated,” Cox told The Health 202.
Being unvaccinated is still a major risk factor for dying from covid-19. But efficacy wanes over time, and an analysis out last week from the Centers for Disease Control and Prevention highlights the need to get regular booster shots to keep one’s risk of death from the coronavirus low, especially for the elderly.
Anthony Fauci, the nation’s preeminent infectious-disease expert, used his last White House briefing yesterday ahead of his December retirement to urge Americans to get the recently authorized omicron-specific boosters.
“The final message I give you from this podium is that please, for your own safety, for that of your family, get your updated covid-19 shot as soon as you’re eligible,” he said.
White House press secretary Karine Jean-Pierre:
Ratio shift
Cox, like many experts, says she’s not surprised by the ratio shift. There are a few reasons:
- Individuals at greatest risk of dying from a coronavirus infection, such as the elderly, are also more likely to have received the shots.
- Vaccines lose potency against the virus over time and variants arise that are better able to resist the vaccines, so continued boosters are needed to continue to prevent illness and death.
The BA.5 omicron subvariant became dominant in July and consistently accounted for the majority of new coronavirus infections across the United States until earlier this month. The highly transmissible strain fueled a surge of new infections, reinfections and hospitalizations throughout the summer.
Boosters
It’s still true that vaccinated groups are at a lower risk of dying from a covid-19 infection than the unvaccinated when the data is adjusted for age. An analysis released by the CDC last week underscores the protection that additional booster shots offer against severe illness and death as immunity wanes.
Let’s take a look at deaths in August, when the highly contagious BA.5 variant reached its peak:
- That month, unvaccinated people aged 6 months and older died at about six times the rate of those who had received their primary series of shots.
- People with one booster dose were even better protected. Unvaccinated people over the age of 5 had about 8 times the risk of dying from a coronavirus infection than those who received a booster shot.
- Among individuals who were eligible to receive additional booster shots, the gap is even more striking. Unvaccinated people 50 and up had 12 times the risk of dying from covid-19 than adults the same age with two or more booster doses.
David French, senior editor for the Dispatch:
3 Federal Agencies Hit With Lawsuits in Ongoing Quest to Uncover Origins of COVID • Children's Health Defense
Saturday, November 26, 2022
NOVARTIS---The secret city
A secret city, you say, along the eastern bank of the Rhine, bordering Germany. Switzerland is long known for neutrality and a haven for secret bank accounts also has NOVARTIS, a juggernaut of pharmaceutical research and innovation.
Until very recently this industrial park was a tightly guarded place, not unlike the CIA in the United States. The development of new drugs is a tightly guarded secret, much like the security of the United States. It is hard to monetize the value of classified documents or the names of spies the value of new medications is enormous running into the hundreds of billions of currencies worldwide.
In a very public document, Novartis invites the public to tour its campus in Basil Switzerland. The announcement coincided with the opening of the Novartis Pavillon.
The Pavillion at Novartis |