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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The End of Alzheimer’s – by Dr. Dale Bredesen
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This one didn’t use the “The New Science Of…” subtitle that many books do, and this one actually is a “new science of”!
Which is exciting, and/but comes with the caveat that the overall protocol itself is still undergoing testing, but the results so far are promising. The constituent parts of the protocol are for the most already well-established, but have not previously been put together in this way.
Dr. Bredesen argues that Alzheimer’s Disease is not one condition but three (medical consensus agrees at least that it is a collection of conditions, but different schools of thought slice them differently), and outlines 36 metabolic factors that are implicated, and the good news is, most of them are within our control.
Since there’s a lot to put together, he also offers many workarounds and “crutches”, making for very practical advice.
The style of the book is on the hard end of pop-science, that is to say while the feel and tone is very pop-sciencey, there are nevertheless a lot of words that you might know but your spellchecker probably wouldn’t. He does explain everything along the way, but this does mean that if you’re not already well-versed, you can’t just dip in to a later point without reading the earlier parts.
Bottom line: even if you only implement half the advice in this book, you’ll be doing your long-term cognitive health a huge favor.
Click here to check out The End of Alzheimer’s, and keep cognitive decline at bay!
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Spinach vs Kale – Which is Healthier?
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Our Verdict
When comparing spinach to kale, we picked the spinach.
Why?
In terms of macros, spinach and kale are very similar. They are mostly water wrapped in fiber, with very small amounts of carbohydrates and protein and trace amounts of fat.
Spinach has a lot more vitamins and minerals—a wider variety, and in most cases, more of them.
Kale is notably higher in vitamin C, though. Everything else, spinach is higher or close to equal.
Spinach is especially notably a lot higher in B vitamins, as well as iron, calcium, magnesium, and zinc.
One downside to spinach, though, which is that it’s high in oxalates, which can increase the risk of kidney stones. If your kidneys are in good health and you eat spinach in moderation, this is not a problem for most people—but if your kidneys aren’t in good health (or you are, for whatever reason, consuming Popeye levels of spinach), you might consider switching to kale.
While spinach swept the board in most categories, kale remains a very good option too, and a diet diverse in many kinds of plants is usually best.
Want to learn more?
Spinach and kale are very both good sources of carotenoids; check out:
Enjoy!
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Safe Effective Sleep Aids For Seniors
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Safe Efective Sleep Aids For Seniors
Choosing a safe, effective sleep aid can be difficult, especially as we get older. Take for example this research review, which practically says, when it comes to drugs, “Nope nope nope nope nope, definitely not, we don’t know, wow no, useful in one (1) circumstance only, definitely not, fine if you must”:
Review of Safety and Efficacy of Sleep Medicines in Older Adults
Let’s break it down…
What’s not so great
Tranquilizers aren’t very healthy ways to get to sleep, and are generally only well-used as a last resort. The most common of these are benzodiazepines, which is the general family of drugs with names usually ending in –azepam and –azolam.
Their downsides are many, but perhaps their biggest is their tendency to induce tolerance, dependence, and addiction.
Non-benzo hypnotics aren’t fabulous either. Z-drugs such as zolpidem tartrate (popularly known by the brand name Ambien, amongst others), comes with warnings that it shouldn’t be prescribed if you have sleep apnea (i.e., one of the most common causes of insomnia), and should be used only with caution in patients who have depression or are elderly, as it may cause protracted daytime sedation and/or ataxia.
See also: Benzodiazepine and z-drug withdrawal
(and here’s a user-friendly US-based resource for benzodiazepine addiction specifically)
Antihistamines are commonly sold as over-the-counter sleep aids, because they can cause drowsiness, but a) they often don’t b) they may reduce your immune response that you may actually need for something. They’re still a lot safer than tranquilizers, though.
What about cannabis products?
We wrote about some of the myths and realities of cannabis use yesterday, but it does have some medical uses beyond pain relief, and use as a sleep aid is one of them—but there’s another caveat.
How it works: CBD, and especially THC, reduces REM sleep, causing you to spend longer in deep sleep. Deep sleep is more restorative and restful. And, if part of your sleep problem was nightmares, they can only occur during REM sleep, so you’ll be skipping those, too. However, REM sleep is also necessary for good brain health, and missing too much of it will result in cognitive impairment.
Opting for a CBD product that doesn’t contain THC may improve sleep with less (in fact, no known) risk of long-term impairment.
See: Cannabis, Cannabinoids, and Sleep: a Review of the Literature
Melatonin: a powerful helper with a good safety profile
We did a main feature on this recently, so we won’t take up too much space here, but suffice it to say: melatonin is our body’s own natural sleep hormone, and our body is good at scrubbing it when we see white/blue light (so, look at such if you feel groggy upon awakening, and it should clear up quickly), so that and its very short elimination half-life again make it quite safe.
Unlike tranquilizers, we don’t develop a tolerance to it, let alone dependence or addiction, and unlike cannabis, it doesn’t produce long-term adverse effects (after all, our brains are supposed to have melatonin in them every night). You can read our previous main feature (including a link to get melatonin, if you want) here:
Melatonin: A Safe Natural Sleep Supplement
Herbal options: which really work?
Valerian? Probably not, but it seems safe to try. Data on this is very inconsistent, and many studies supporting it had poor methodology. Shinjyo et al. also hypothesized that the inconsistency may be due to the highly variable quality of the supplements, and lack of regulation, as they are provided “based on traditional use only”.
Chamomile? Given the fame of chamomile tea as a soothing, relaxing bedtime drink, there’s surprisingly little research out there for this specifically (as opposed to other medicinal features of chamomile, of which there are plenty).
But here’s one study that found it helped significantly:
The effects of chamomile extract on sleep quality among elderly people: A clinical trial
Unlike valerian, which is often sold as tablets, chamomile is most often sold as a herbal preparation for making chamomile tea, so the quality is probably quite consistent. You can also easily grow your own in most places!
Technological interventions
We may not have sci-fi style regeneration alcoves just yet, but white noise machines, or better yet, pink noise machines, help:
White Noise Is Good; Pink Noise Is Better
Note: the noise machine can be a literal physical device purchased to do that (most often sold as for babies, but babies aren’t the only ones who need to sleep!), but it can also just be your phone playing an appropriate audio file (there are apps available) or YouTube video.
We reviewed some sleep apps; you might like those too:
The Head-To-Head Of Google and Apple’s Top Apps For Getting Your Head Down
Enjoy, and rest well!
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Super Gut – by Dr. William Davis
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You may be wondering: what sets this book apart from the other gut health books we’ve reviewed? For this one, mostly it’s depth.
This is the most scientifically dense book we’ve reviewed on gut health, so if you’re put off by that, this might not be one for you. However, you don’t need prior knowledge, as he does explain things as he goes. The advice in this book is not just the usual “gut health 101” stuff, either!
A particular strength of this book is that it looks at a wide variety of gut- and gut-related disorders, and ways certain readers may need to do different things than others, to address those problems on the path to good gut health.
The style, for all its hard science content, is quite sensationalist, and that may take some getting used to for non-Americans. However, it doesn’t affect the content!
Bottom line: if you just want simple basic advice, then probably best to skip this one. However, if you are sincerely serious about gut health (or just like reading this sort of thing because learning is satisfying), then this book is packed with relevant and detailed information.
Click here to check out Super Gut, and get to know and improve yours!
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Ayurveda’s Contributions To Science
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Ayurveda’s Contributions To Science (Without Being Itself Rooted in Scientific Method)
Yesterday, we asked you for your opinions on ayurveda, and got the above-depicted, below-described, set of responses. Of those who responded…
- A little over 41% said “I don’t know what ayurveda is without looking it up”
- A little over 37% said “It is a fine branch of health science with millennia of evidence”
- A little over 16% said “It gets some things right, but not by actual science”
- A little over 4% said “It is a potentially dangerous pseudoscience”
So, what does the science say?
Ayurveda is scientific: True or False?
False, simply. Let’s just rip the band-aid off in this case. That doesn’t mean it’s necessarily without merit, though!
Let’s put it this way:
- If you drink coffee to feel more awake because scientific method has discerned that caffeine has vasoconstrictive and adenosine-blocking effects while also promoting dopaminergic activity, then your consumption of coffee is evidence-based and scientific. Great!
- If you drink coffee to feel more awake because somebody told you that that somebody told them that it energizes you by balancing the elements fire (the heat of the coffee), air (the little bubbles on top), earth (the coffee grinds), water (the water), and ether (steam), then that is neither evidence-based nor scientific, but it will still work exactly the same.
Ayurveda is a little like that. It’s an ancient traditional Indian medicine, based on a combination of anecdotal evidence and supposition.
- The anecdotal evidence from ayurveda has often resulted in herbal remedies that, in modern scientific trials, have been found to have merit.
- Ayurvedic meditative practices also have a large overlap with modern mindfulness practices, and have also been found to have merit
- Ayurveda also promotes the practice of yoga, which is indeed a very healthful activity
- The supposition from ayurveda is based largely in those five elements we mentioned above, as well as a “balancing of humors” comparable to medieval European medicine, and from a scientific perspective, is simply a hypothesis with no evidence to support it.
Note: while ayurveda is commonly described as a science by its practitioners in the modern age, it did not originally claim to be scientific, but rather, wisdom handed down directly by the god Dhanvantari.
Ayurveda gets some things right: True or False?
True! Indeed, we covered some before in 10almonds; you may remember:
Bacopa Monnieri: A Well-Evidenced Cognitive Enhancer
(Bacopa monnieri is also known by its name in ayurveda, brahmi)
There are many other herbs that have made their way from ayurveda into modern science, but the above is a stand-out example. Others include:
- Ashwagandha: The Root of All Even-Mindedness?
- Boswellia serrata (Frankincense) Against Pain and Depression/Anxiety
Yoga and meditation are also great, and not only that, but great by science, for example:
- NCCIH | Yoga for Health: Clinical Guidelines, Scientific Literature, Info for Patients
- The Neuroscience of Mindfulness: How Mindfulness Alters the Brain and Facilitates Emotion Regulation
Ayurveda is a potentially dangerous pseudoscience: True or False?
Also True! We covered why it’s a pseudoscience above, but that doesn’t make it potentially dangerous, per se (you’ll remember our coffee example).
What does, however, make it potentially dangerous (dose-dependent) is its use of heavy metals such as lead, mercury, and arsenic:
Heavy Metal Content of Ayurvedic Herbal Medicine Products
Some final thoughts…
Want to learn more about the sometimes beneficial, sometimes uneasy relationship between ayurveda and modern science?
A lot of scholarly articles trying to bridge (or further separate) the two were very biased one way or the other.
Instead, here’s one that’s reasonably optimistic with regard to ayurveda’s potential for good, while being realistic about how it currently stands:
Development of Ayurveda—Tradition to trend
Take care!
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Why We Get Sick – by Dr. Benjamin Bikman
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There’s a slightly buried lede here in that the title doesn’t offer this spoiler, but we will: the book is about insulin resistance.
However, unlike the books we’ve reviewed about blood sugar management, this time the focus is really and truly on insulin itself—and that makes some important differences:
Dr. Bikman makes the case that while indeed hyper- or hypoglycemia bring their problems, mostly these are symptoms rather than causes, and the real culprit is insulin resistance, and this is important for two main reasons:
- Insulin resistance occurs well before the other symptoms set in (which means: it is the thing that truly needs to be nipped in the bud; if your fasting blood sugars are rising, then you missed “nipping it in the bud” likely by a decade or more)
- Insulin resistance causes more problems than “mere” hyperglycemia (the most commonly-known result of insulin resistance) does, so again, it really needs to be considered separately from blood sugar management.
This latter, Dr. Bikman goes into in great detail, linking insulin resistance (even if blood sugar levels are normal) to all manner of diseases (hence the title).
You may be wondering: how can blood sugar levels be normal, if we have insulin resistance?
And the answer is that for as long as it is still able, your pancreas will just faithfully crank out more and more insulin to deal with the blood sugar levels that would otherwise be steadily rising. Since people measure blood sugar levels much more regularly than anyone checks for actual insulin levels, this means that one can be insulin resistant for years without knowing it, until finally the pancreas is no longer able to keep up with the demand—then that’s when people finally notice.
The book is divided into sections:
- The Problem: What Is Insulin Resistance
- The Cause: What Makes Us Insulin Resistant
- How We Can Fight Insulin Resistance
The first two parts are essential for the reader’s understanding, but the third part is the practical part, with appropriately practical advice on the most insulin-friendly ways to exercise, eat, fast, and more. He also talks drugs, and discusses the pros and cons of various interventions—but of course, far better is the lifestyle management of insulin.
The style is mostly very pop-science in overall presentation, and then occasionally gets very dense at times, but when that happens, he will then tend to follow it with an easier-to-understand explanation, to ensure that nothing remains opaque.
Bottom line: if you care about your metabolic health and don’t mind reading a book where you may have to read a paragraph or two twice sometimes, then this is a top-tier book on insulin resistance and how to prevent/reverse it.
Click here to check out Why We Get Sick, and stay well instead!
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