“In this Viewpoint, we question traditional approaches to teaching clinical reasoning that focus primarily on illness scripts and pattern recognition. We argue that, while pattern recognition comes naturally to humans, it is susceptible to cognitive biases that lead to diagnostic errors. Instead of emphasizing illness scripts, educators should aim to enhance diagnostic acumen by teaching learners to engage in critical thinking—in other words, reasoning from foundational principles of human pathophysiology. The importance of moving beyond pattern recognition will become increasingly urgent as generative artificial intelligence (AI) becomes central to the practice of medicine. Illness Scripts: Fast, but Risky As the … Read More
All posts in Artificial intelligence
Large language models are transforming medicine—but the technology comes with side effects. “Surveys have suggested that many people are more confident in A.I. diagnoses than in those rendered by professionals. Meanwhile, in the United States alone, misdiagnosis disables hundreds of thousands of people each year; autopsy studies suggest that it contributes to perhaps one in every ten deaths. [..] One recent study found that OpenAI’s GPT-4 answered open-ended medical questions incorrectly about two-thirds of the time. In another, GPT-3.5 misdiagnosed more than eighty per cent of complex pediatric cases. Meanwhile, leading large language models have become much less likely to … Read More
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
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
“There has been less focus on AI [artificial intelligence] trained on clinician data that health care systems and insurers could use to manage clinicians’ practice. But clinicians have reason to worry about becoming AI “data subjects.” Quantification of clinician practice could help health care systems improve quality of care and facilitate documentation to support transparency and utilization review, and physicians should take the lead in helping to achieve those aims (one of us holds equity in medical AI companies). But medical AI tools, including those that are introduced with a goal of improving patient care, also create a glide path … Read More
A disease doesn’t have to be real to cause worldwide damage “While I am deeply concerned about the long-term existential threat of AI and synthetic biology to create new or modified pathogens, my extensive experience detecting and controlling outbreaks around the world makes me fear a more immediate threat: a rogue actor using existing AI tools to simulate a bioterrorism attack that would destabilize a region or the world. [..] Freely available AI tools now permit people to create “deepfakes” that are almost impossible for a person to differentiate from reality without special tools. It’s not simply a question of whether … Read More
“A wave of new ventures is no doubt poised to deliver fresh possibilities in DTC [direct-to-consumer] health care. However, Big Tech is uniquely positioned to scale their own DTC health care services rapidly and efficiently or can choose to provide the technological backbone for traditional HCOs [health care organizations] or new entrant startups. Big Tech platforms have hundreds of millions of users and access to hyperpersonalized data from search, social media interactions, mobility data, and LLM [large language model] engagement. Google Search has long been a de facto patient decision support tool for diagnosis and more, well before being tuned … Read More
“To paraphrase health policy expert Timothy Hoff, there is a fight going on for the soul of health care, and primary care is at the center of the struggle. In the United States, we face an unresolved tension between two conflicting visions: Does our society want an empathetic, highly relational care delivery system built around primary care and trusting relationships, or, as Hoff puts it, “a more efficient, convenient, and highly transactional care delivery system, impersonal and built on algorithms, health care corporations, and technology”? [..] Increasingly, health care organizations and information technology vendors, recognizing the need to better support … Read More
Experts predicted that artificial intelligence would steal radiology jobs. But at the Mayo Clinic, the technology has been more friend than foe. Excerpt – radiologists [..] are still in high demand. A recent study from the American College of Radiology projected a steadily growing work force through 2055. [..] in recent years, they [radiologists] have begun using A.I. [artificial intelligence] to sharpen images, automate routine tasks, identify medical abnormalities and predict disease. A.I. can also serve as “a second set of eyes.” “But would it replace radiologists? We didn’t think so,” said Dr. Matthew Callstrom, the Mayo Clinic’s chair of radiology, … Read More