By gatekeeping health data, the AI Action Plan risks hardwiring bias into the future of American medicine. “the Trump administration has purged data from government websites, slashed funding for research on marginalized communities, and pressured government researchers to restrict or retract work that contradicts political ideology. These actions aren’t just symbolic—they shape what gets measured, who gets studied, and which findings get published. Now, those same constraints are moving into the development of AI itself. Under the administration’s policies, developers have a clear incentive to make design choices or pick data sets that won’t provoke political scrutiny. These signals are shaping … Read More
All posts by Anupam
“Patients arriving with researched information is not new. They have long brought newspaper clippings, internet search results, or notes from conversations with family. Potential solutions passed along in WhatsApp threads have at times been an integral part of my clinical conversations. Information seeking outside the health care setting has always been part of the landscape of care. But something about this moment feels different. Generative artificial intelligence (AI), with tools like ChatGPT, offers information in ways that feel uniquely conversational and tailored. Their tone invites dialogue. Their confidence implies competence. Increasingly, patients are bringing AI-generated insights into my clinic and … Read More
“Robust evidence shows that diabetes is preventable through lifestyle modifications aiming at weight loss. A meta-analysis including 19 randomized clinical trials confirmed the long-term beneficial effect of lifestyle interventions, even with modest weight loss. Most of these interventions targeted weight loss through an energy-reduced, healthy low-fat diet combined with increased physical activity. However, no previous trial has assessed the effect of energy reduction in the context of a relatively high-fat diet, such as the Mediterranean diet (MedDiet). The PREDIMED (Prevención con Dieta Mediterránea) trial demonstrated that an ad libitum MedDiet supplemented with either extra-virgin olive oil or mixed nuts reduced diabetes incidence … Read More
“Long-term routine laboratory toxicity monitoring (lt-RLTM) is used for management of patients with rheumatoid arthritis (RA) who are being treated with disease-modifying antirheumatic drugs (DMARDs). Intensive monitoring is recommended during the first 6 months due to higher risks for adverse reactions, followed by less frequent monitoring for the duration of DMARD use, which can last for decades. Laboratory parameters used for lt-RLTM typically include liver, renal, and hematologic toxicity markers. Despite high consistency in the types of tests ordered, the frequency of testing and responses to abnormal results vary widely across practices. [..] Typically, lt-RLTM is performed every 3 months … Read More
Artificial intelligence is ready to collaborate. Why fixate on automation? “We should insist on AI that can collaborate with, say, doctors—as well as teachers, lawyers, building contractors, and many others—instead of AI that aims to automate them out of a job. Radiology provides an illustrative example of automation overreach. In a widely discussed study published in April 2024, researchers at MIT found that when radiologists used an AI diagnostic tool called CheXpert, the accuracy of their diagnoses declined. “Even though the AI tool in our experiment performs better than two-thirds of radiologists,” the researchers wrote, “we find that giving radiologists access to AI … Read More
“like all A.I. systems, it [GPT-5] degrades as a conversation continues or as the chain of tasks becomes more complex (although in two years, the length it can sustain a given task has gone from about five minutes to over two hours). This is the first A.I. model where I felt I could touch a world in which we have the always-on, always-helpful A.I. companion from the movie “Her.” [..] In their paper “A.I. as Normal Technology,” Arvind Narayanan and Sayash Kapoor, both computer scientists at Princeton, argue that the external world is going to act as “a speed limit” on what A.I. … Read More
“A decent society should do all it reasonably can to reduce human suffering. It should not, however, do so by extinguishing the lives of those who suffer or the lives of those whom we believe might suffer in the future. [..] It is understandable and deeply human to want to bring all aspects of our health as much into our control as possible. Terminally ill patients often face horrifying levels of pain. We should try to treat that pain as best we can. Vulnerability is terrifying, but it is also inescapable. In our quest for health and fitness, we are … Read More
With Trump’s backing, the pharma industry is expanding the model, but experts expect its impact to be limited Excerpt – Selling drugs directly to consumers is unlikely to make most of them more affordable, even if doing so boxes out insurers and the “middlemen” known as pharmacy benefit managers, several health policy and drug pricing experts told STAT. The cash prices that pharma companies are willing to offer for their drugs (which currently stand at several hundred dollars per month) will never be as low as the prices patients can get through insurance. And if patients buy their drugs directly … Read More
“Recovery is still largely viewed as lifelong abstinence — not just forever avoiding the specific substances someone once relied on, but also typically steering clear of all nonmedical drug use besides caffeine and nicotine. Most public recovery stories — like Mr. [Robert F] Kennedy’s — are tales of total abstinence, often propelled by participation in 12-step programs like Alcoholics Anonymous. In reality, most people who resolve addictions [..] do not reject all substance use forever. For example, though I am in recovery from heroin and cocaine addiction, I still occasionally drink alcohol and use marijuana without issue. Though definitions vary, many experts now agree: If substance … Read More
David Wallace-Wells and Emily Oster argue that the effects of MAHA will be long-lasting. “[Economist and CEO of ParentData Emily Oster] There’s two really core issues for the future. One is that this [mRNA vaccines] is the fastest technology we have to generate vaccines, full stop. The difference in the amount of time it takes to make a vaccine in the traditional manner versus with this technology is very, very large. If you think about a future pandemic, having access to this technology is the difference between a vaccine and three months or four months or six months and a … Read More