AI: The Doctor That Never Tires?
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AI: The Doctor That Never Tires?
We asked you for your opinion on the use of Artificial Intelligence (AI) in healthcare, and got the above-depicted, below-described set of results:
- A little over half of respondents to the poll voted for “It speeds up research, and is more methodical about diagnosis, so it’s at least a good extra tool”
- A quarter of respondents voted for “I’m on the fence—it seems to make no more nor less mistakes than human doctors do”
- A little under a fifth of respondents voted for “AI is less prone to fatigue/bias than human doctors, making it an essential new tech”
- Three respondents voted for “AI is a step too far in medical technology, and we’re not ready for it”
Writer’s note: I’m a professional writer (you’d never have guessed, right?) and, apparently, I really did write “no more nor less mistakes”, despite the correct grammar being “no more nor fewer mistakes”. Now, I know this, and in fact, people getting less/fewer wrong is a pet hate of mine. Nevertheless, I erred.
Yet, now that I’m writing this out in my usual software, and not directly into the poll-generation software, my (AI!) grammar/style-checker is highlighting the error for me.
Now, an AI could not do my job. ChatGPT would try, and fail miserably. But can technology help me do mine better? Absolutely!
And still, I dismiss a lot of the AI’s suggestions, because I know my field and can make informed choices. I don’t follow it blindly, and I think that’s key.
AI is less prone to fatigue/bias than human doctors, making it an essential new tech: True or False?
True—with one caveat.
First, a quick anecdote from a subscriber who selected this option in the poll:
❝As long as it receives the same data inputs as my doctor (ie my entire medical history), I can see it providing a much more personalised service than my human doctor who is always forgetting what I have told him. I’m also concerned that my doctor may be depressed – not an ailment that ought to affect AI! I recently asked my newly qualified doctor goddaughter whether she would prefer to be treated by a human or AI doctor. No contest, she said – she’d go with AI. Her argument was that human doctors leap to conclusions, rather than properly weighing all the evidence – meaning AI, as long as it receives the same inputs, will be much more reliable❞
Now, an anecdote is not data, so what does the science say?
Well… It says the same:
❝Of 6695 responding physicians in active practice, 6586 provided information on the areas of interest: 3574 (54.3%) reported symptoms of burnout, 2163 (32.8%) reported excessive fatigue, and 427 (6.5%) reported recent suicidal ideation, with 255 of 6563 (3.9%) reporting a poor or failing patient safety grade in their primary work area and 691 of 6586 (10.5%) reporting a major medical error in the prior 3 months. Physicians reporting errors were more likely to have symptoms of burnout (77.6% vs 51.5%; P<.001), fatigue (46.6% vs 31.2%; P<.001), and recent suicidal ideation (12.7% vs 5.8%; P<.001).❞
See the damning report for yourself: Physician Burnout, Well-being, and Work Unit Safety Grades in Relationship to Reported Medical Errors
AI, of course, does not suffer from burnout, fatigue, or suicidal ideation.
So, what was the caveat?
The caveat is about bias. Humans are biased, and that goes for medical practitioners just the same. AI’s machine learning is based on source data, and the source data comes from humans, who are biased.
See: Bias and Discrimination in AI: A Cross-Disciplinary Perspective
So, AI can perpetuate human biases and doesn’t have a special extra strength in this regard.
The lack of burnout, fatigue, and suicidal ideation, however, make a big difference.
AI speeds up research, and is more methodical about diagnosis: True or False?
True! AI is getting more and more efficient at this, and as has been pointed out, doesn’t make errors due to fatigue, and often comes to accurate conclusions near-instantaneously. To give just one example:
❝Deep learning algorithms achieved better diagnostic performance than a panel of 11 pathologists participating in a simulation exercise designed to mimic routine pathology workflow; algorithm performance was comparable with an expert pathologist interpreting whole-slide images without time constraints. The area under the curve was 0.994 (best algorithm) vs 0.884 (best pathologist).❞
About that “getting more and more efficient at this”; it’s in the nature of machine learning that every new piece of data improves the neural net being used. So long as it is getting fed new data, which it can process at rate far exceeding humans’ abilities, it will always be constantly improving.
AI makes no more nor less fewer mistakes than humans do: True or False?
False! AI makes fewer, now. This study is from 2021, and it’s only improved since then:
❝Professionals only came to the same conclusions [as each other] approximately 75 per cent of the time. More importantly, machine learning produced fewer decision-making errors than did all the professionals❞
See: AI can make better clinical decisions than humans: study
All that said, we’re not quite at Star Trek levels of “AI can do a human’s job entirely” just yet:
BMJ | Artificial intelligence versus clinicians: pros and cons
To summarize: medical AI is a powerful tool that:
- Makes healthcare more accessible
- Speeds up diagnosis
- Reduces human error
…and yet, for now at least, still requires human oversights, checks and balances.
Essentially: it’s not really about humans vs machines at all. It’s about humans and machines giving each other information, and catching any mistakes made by the other. That way, humans can make more informed decisions, and still keep a “hand on the wheel”.
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NADᐩ Against Aging
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Nicotinamide adenine dinucleotide, or “NAD” to its friends, is a coenzyme produced in the human body (amongst other places), and it is critical for cellular energy metabolism, but there’s more to it than that.
Today we’ll be looking mostly at NAD+, of which the + indicates the positive formal charge of one of its nitrogen atoms. We won’t get too much into the chemistry of this, but we will mention that it’s a cofactor with NADH—the former accepting electrons and the latter donating electrons.
Both NAD+ and NADH are critical to good health, but we’re going to focus on NAD+ for the simple reason that it gets depleted with aging.
Note: it gets depleted with aging.
Chronological age is not so important here, but there is a direct relationship between biological aging and NAD+ depletion.
For example, healthy centenarians tend not to have depleted NAD+ levels. Further, its depletion (in those in whom it is depleted) is then a causal factor for many age-related diseases:
❝Remarkably, ageing is accompanied by a gradual decline in tissue and cellular NAD+ levels in multiple model organisms, including rodents and humans.
This decline in NAD+ levels is linked causally to numerous ageing-associated diseases, including cognitive decline, cancer, metabolic disease, sarcopenia and frailty.
Many of these ageing-associated diseases can be slowed down and even reversed by restoring NAD+ levels.❞
~ Dr. Rosalba Perrone et al.
Read in full: NAD+ metabolism and its roles in cellular processes during ageing
As for restoring those NADᐩ levels, that does help in interventional trials, whether by supplementing directly, or with NAD precursors*:
❝NAD+ levels steadily decline with age, resulting in altered metabolism and increased disease susceptibility.
Restoration of NAD+ levels in old or diseased animals can promote health and extend lifespan, prompting a search for safe and efficacious NAD-boosting molecules that hold the promise of increasing the body’s resilience, not just to one disease, but to many, thereby extending healthy human lifespan.❞
~ Dr. David Sinclair et al.
Read more: Therapeutic Potential of NAD-Boosting Molecules: The In Vivo Evidence
*There are actually also other NAD-boosting molecules besides NAD itself and its precursors. For example, the liver will not produce NADᐩ unless it has aminocarboxymuconate-semialdehyde decarboxylase (or “ACMSD”, to its friends), which limits the production of NADᐩ. Why, you ask? The theory is that it is a kind of evolutionary conservativism, much like not lighting a fire without the ability to put it out. In any case, taking ACMSD-blockers will thus result in an increased endogenous production of NADᐩ.
You can read about this here:
De novo NAD+ synthesis enhances mitochondrial function and improves health
Nor is taking supplements or drugs the only way to get more of it; there’s an enzyme nicotinamide phosphoribosyltransferase (“NAMPT”, to its friends) involved in the synthesis of NADᐩ, and exercise boosts levels by 127% (i.e., it more than doubles the levels), based on a modest three-week exercise bike regimen:
Skeletal muscle NAMPT is induced by exercise in humans
And to underline that point, another study found that resistance training (so, a different kind of exercise from that of the previous study) boosts levels of NADᐩ itself by the same 127%:
One way to get more out of NADᐩ
We’ll get straight to the point: it works very well paired with a senolytic agent, i.e. something that kills aging cells so that they get recycled sooner:
NAD+, Senolytics, or Pyruvate for Healthy Aging?
To read more about senolytics, check out:
Fisetin: The Anti-Aging Assassin
Want to try some?
We don’t sell it, but here for your convenience is an example product on Amazon 😎
Enjoy!
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Resistance Beyond Weights
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Resistance, Your Way
We’ve talked before about the importance of resistance training:
Resistance Is Useful! (Especially As We Get Older)
And we’ve even talked about how to make resistance training more effective:
(High Intensity Interval Training, but make it High Intensity Resistance Training)
Which resistance training exercises are best?
There are two reasonable correct answers here:
- The resistance training exercises that you will actually do (because it’s no good knowing the best exercise ever if you’re not going to do it because it is in some way offputting to you)
- The resistance training exercises that will prevent you from getting a broken bone in the event of some accident or incident
This latter is interesting, because when people think resistance training, the usually immediate go-to exercises are often things like the bench press, or the chest machine in the gym.
But ask yourself: how often do we hear about some friend or relative who in their old age has broken their humerus?
It can happen, for sure, but it’s not as often as breaking a hip, a tarsal (ankle bones), or a carpal (wrist bones).
So, how can we train to make those bones strong?
Strong bones grow under strong muscles
When archaeologists dig up a skeleton from a thousand years ago, one of the occupations that’s easy to recognize is an archer. Why?
An archer has an unusual frequent exercise: pushing with their left arm while pulling with their right arm. This will strengthen different muscles on each side, and thus, increase bone density in different places on each arm. The left first metacarpal and right first and second metacarpals and phalanges are also a giveaway.
This is because: one cannot grow strong muscles on weak bones (or else the muscles would just break the bones), so training muscles will force the body to strengthen the relevant bones.
So: if you want strong bones, train the muscles attached to those bones
This answers the question of “how am I supposed to exercise my hips” etc.
Weights, bodyweight, resistance bands
If you go to the gym, there’s a machine for everything, and a member of gym staff will be able to advise which of their machines will strengthen which muscles.
If you train with free weights at home:
- Wrist curls (forearm supported and stationary, lifting a dumbbell in your hand, palm-upwards) will strengthen the wrist
- The farmer’s walk (carrying a heavy weight in each hand) will also strengthen your wrist
- A modified version of this involves holding the weight with just your fingertips, and then raising and lowering it by curling and uncurling your fingers)
- Lateral leg raises (you will need ankle-weights for this) will strengthen your ankles and your hips, as will hip abductions (as in today’s featured video), especially with a weight attached.
- Ankle raises (going up on your tip-toes and down again, repeat) while holding weights in your hands will strengthen your ankles
If you don’t like weights:
- Press-ups will strengthen your wrists
- Fingertip press-ups are even better: to do these, do your press-ups as normal, except that the only parts of your hands in contact with the ground are your fingertips
- This same exercise can be done the other way around, by doing pull-ups
- And that same “even better” works by doing pull-ups, but holding the bar only with one’s fingertips, and curling one’s fingers to raise oneself up
- Lateral leg raises and hip abductions can be done with a resistance band instead of with weights. The great thing about these is that whereas weights are a fixed weight, resistance bands will always provide the right amount of resistance (because if it’s too easy, you just raise your leg further until it becomes difficult again, since the resistance offered is proportional to how much tension the band is under).
Remember, resistance training is still resistance training even if “all” you’re resisting is gravity!
If it fells like work, then it’s working
As for the rest of preparing to get older?
Check out:
Training Mobility Ready For Later Life
Take care!
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Here’s To Getting Assuredly Good Health
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
An unusual amount of excitement in the health news world this week, with health insurance in the spotlight:
Deny, Delay, Depose?
Insurance company UnitedHealthcare, which used AI with a 90% error rate to deny insurance claims (of which, disproportionately denying insurance claims of the elderly), has come under extra public scrutiny this week for its recent-years business practices:
❝Nearly 1 in 5 insured adults experienced claim denials during a 12-month period.
Those with job-based insurance or Affordable Care Act policies ran into this problem about twice as often as those covered by Medicare or Medicaid❞
…although, the company has dramatically increased its care denials for Medicare Advantage enrollees, doubling the rate of denials as it implemented its new, automated denials process.
Anesthesiologist Dr. Brain Schmutzler noted:
❝We have a bigger issue with the insurance companies in general, who, essentially, it’s their job to make money, not to actually pay for health care❞
And in those cases where healthcare is not denied, it is often dangerously delayed, as insurance companies can stall for time to decide whether they’re going to pay or not.
One useful take-away from all of this is that if your insurance claim is denied, consider fighting it, as often they can be overturned.
Specifically, it can be good to insist on knowing who (named persons) was involved in the denial process, and their qualifications. Once upon a time, this was mostly unqualified interns, which prompted insurance companies to reverse the denial rather than admit that; nowadays it’s mostly AI, which many companies can hope will shield them from culpability—either way, fighting for one’s rights can often be successful.
Read in full: Killing of UnitedHealthcare CEO prompts flurry of stories on social media over denied insurance claims
Related: With Medical Debt Burdening Millions, a Financial Regulator Steps In to Help
Rest Easy
Health insurer Elevance Health (formerly Anthem Blue Cross Blue Shield), had last month announced plans to limit its coverage for anesthesia used in operations, whereby they would pay for only a certain amount of anesthetic, and if the procedure was still ongoing when that amount had been used, then well, you were on your own.
However, on Thursday afternoon and allegedly completely coincidentally in the wake of the Wednesday assassination of the CEO who oversaw the denial of so many health insurance claims, this decision to limit paying for anesthesia was reversed, retracted, and they are now doing their best to downplay what the proposal would have meant for anesthesiologists and patients:
Read in full: Insurance company halts plan to put time limits on coverage for anesthesia during surgery
Related: The Insider’s Guide To Making Hospital As Comfortable As Possible ← an anesthesiologist’s tips
Getting a good grip of your health
What’s the best indicator of good health when it comes to age-related health issues? It’s not BMI! Could it be blood pressure? It could, but the news presently is about grip strength.
While training to have an amazing grip (and neglecting all else) will not necessarily increase your general healthspan, having a weak or strong grip is strongly associated with, respectively, having weak or strong general health in later years.
This is because unless someone has been training very unnaturally, grip strength is a good general measure of overall muscle strength, which in turn is a good indicator of metabolic health, as well as bodily robustness.
Read in full: Handgrip strength is a reliable predictor for age-related disease and disability, finds study
Related: Resistance Is Useful! (Especially As We Get Older)
Take care!
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5 Ways To Beat Cancer (And Other Diseases)
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A Systematic Approach To Healthy Eating
This is Dr. William Li. He’s a physician, cancer researcher, and educator. He also founded the Angiogenesis Foundation back in 1994.
We recently reviewed one of his books, “Eat To Beat Disease”.
He has another book that we haven’t reviewed at time of writing, “Eat To Beat Your Diet“, which you might like to check out.
What does he want us to know?
He wants us to know how to eat to beat cancer and other diseases, by means of five specific angles:
Angiogenesis
This is about replacing blood vessels, which of course happens all the time, but it becomes a problem when it is feeding a cancer in the process.
Here, based on Dr. Li’s work, is what can be done about it:
A List of Anti-Angiogenic Foods for a Cancer-Fighting Diet
Regeneration
Generally speaking, we want to replace healthy cells early, because if we wait until they get damaged, then that damage will be copied forwards. As well as intermittent fasting, there are other things we can do to promote this—even, Dr. Li’s research shows, for stem cells:
Doctor’s Tip: Regeneration (stem cells)—one of your body’s five defense systems
Microbiome health
Healthy gut, healthy rest of the body. We’ve written about this before:
Making Friends With Your Gut (You Can Thank Us Later)
DNA protection
DNA gets unravelled and damaged with age, the telomere caps get shorter, and mistakes get copied forward. So there more we can protect our DNA, the longer we can live healthily. There are many ways to do this, but Dr. Li was one of the first to bring to light the DNA-protecting benefits of kiwi fruit:
Immunity
Paradoxically, what’s good for your immune system (making it stronger) also helps to protect against autoimmune diseases (for most people, for the most part).
In short: it’s good to have an immune system that’s powerful not just in its counterattacks, but also in its discerning nature. There are dietary and other lifestyle approaches to both, and they’re mostly the same things:
Beyond Supplements: The Real Immune-Boosters!
and thus see also:
Want to know more?
You might enjoy his blog or podcast, and here’s his TED talk:
Want to watch it, but not right now? Bookmark it for later
Enjoy!
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Jasmine McDonald’s Ballet Stretching Routine
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Why Jasmine’s Video is Useful
Jasmine McDonald is not only a professional ballerina, but is also a certified personal trainer, so when it comes to keeping her body strong and flexible, she’s a wealth of knowledge. Her video (below) is a great example of this.
In case you’re interested in learning more, she currently (privately) tutors over 30 people on a day-to-day basis. You can contact her here!
Other Stretches?
If you think that Jasmine’s stretches may be out of your league, we recommend checking out our other articles on stretching, including:
- 11 Minutes to Pain-Free Hips
- How to Permanently Loosen a Tight Psoas
- Stretching Scientifically
- Stretching & Mobility
- Stretching to Stay Young
Otherwise, let loose on these dancer stretches and exercises:
How did you find that video? If you’ve discovered any great videos yourself that you’d like to share with fellow 10almonds readers, then please do email them to us!
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Tilapia vs Cod – Which is Healthier?
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Our Verdict
When comparing tilapia to cod, we picked the tilapia.
Why?
Another case of “that which is more expensive is not necessarily the healthier”!
In terms of macros, tilapia has more protein and fats, as well as more omega-3 (and omega-6). On the downside, tilapia does have relatively more saturated fat, but at 0.94g/100g, it’s not exactly butter.
The vitamins category sees that tilapia has more of vitamins B1, B3, B5, B12, D, and K, while cod has more of vitamins B6, B9, and choline. A moderate win for tilapia.
When it comes to minerals, things are most divided; tilapia has more copper, iron, phosphorus, potassium, manganese, and selenium, while cod has more magnesium and zinc. An easy win for tilapia.
One other thing to note is that both of these fish contain mercury these days (and it’s worth noting: cod has nearly 10x more mercury). Mercury is, of course, not exactly a health food.
So, excessive consumption of either is not recommended, but out of the two, tilapia is definitely the one to pick.
Want to learn more?
You might like to read:
Farmed Fish vs Wild Caught: Know The Health Differences
Take care!
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