Forge AI Health Friday Roundup - October 8, 2021

October 8, 2021

In today’s Roundup: harnessing machine learning to improve shared clinical decision-making; assessing the viability of AI ethics teams; zebrafish help unlock inner workings of nervous systems; fixing errors in quantum computing; improving access to clinical research; intense scrutiny and Congressional hearings for Facebook; WHO approves African rollout for malaria vaccine; how COVID has upended the field of science writing; strategies for creating a more inclusive classroom; longtime NIH director Collins to step down; too much interest in a scientific field may actually slow progress; FDA orders a re-do for multiple clinical trials overseen by two CROs, astronomers witness planetary arabesques around a triple star system; much more:


DEEP BREATHS

  • “If a familiar life form could dwell on a gas giant like the one that would be orbiting GW Ori, it would not actually be able to see the three stars in its skies. Rather, they would see only a pair as the two innermost stars orbit so close as to appear like a single point of light. Yet as the planet rotated, its stars would rise and fall in fascinating sunrises and sunsets unlike any other known world.” We get dizzy just contemplating this one: the New York Times’ Jonathan O’Callghan reports on astronomers who have been studying a star system where the cause of unusual structures in a cloud of dust and gas seems to have finally been revealed – a planet that is looping an orbit around three stars, all tightly bound by gravity and in orbit around each other.

AI, STATISTICS & DATA SCIENCE

Photograph of an accidentally dropped ice cream cone lying on pavement. Image credit: Sarah Kilian/Unsplash
Image credit: Sarah Kilian/Unsplash
  • “Mistakes happen — especially in quantum computers. The fragile quantum bits, or qubits, that make up the machines are notoriously error-prone, but now scientists have shown that they can fix the flubs…Scientists used nine qubits to make a single, improved qubit called a logical qubit, which, unlike the individual qubits from which it was made, can be probed to check for mistakes.” Science News’ Emily Conover shares some findings from a paper by Egan and colleagues, recently published in Nature, that reports on a method for error correction in quantum computing.
  •  “…is it even possible to do real AI ethics work inside a corporate tech giant? And how can these teams succeed? To explore these increasingly important questions, VentureBeat spoke with a few of the women who pioneered such initiatives — including Gebru and Mitchell, among others — about their own experiences and thoughts on how to build AI ethics teams. Several themes emerged throughout the conversations, including the pull between independence and integration, the importance of diversity and inclusion, and the fact that buy-in from executive leadership is paramount.” A feature article by Sage Lazarro at Venturebeat’s The Machine examines the long-term viability and effectiveness of “ethical AI” programs in the tech industry, as seen from the perspectives of some of the women who led foundational efforts in the field.
  • “When it comes to solving problems in clinical care delivery, AI-driven clinical decision support (CDS) solutions are another animal altogether. But for those deep in the field, who have been studying, testing and developing AI and machine learning solutions in healthcare for decades, the increase in real-world evidence (RWE) and heightened focus on responsible AI development are reason enough to be hopeful about its future.” An article by Seth Joseph at Forbes presents a guardedly optimistic take on the near-term future prospects of AI in healthcare applications.
  • “Even when financial incentives are aligned with performance, expertise in change management and quality improvement are vital for implementation success. This is particularly important when establishing a learning health care system in which patient outcomes are tracked pre- and post-surgery and individual surgeon performance is disseminated department-wide. Executive leadership support and championing is vital to achieve buy-in and for successful implementation.” An article at NEJM Catalyst by Virji and colleagues presents a case study in the use of machine learning to inform shared decision-making in the setting of elective surgery.
  • “We argue that improving the quality, answerability, and use of data is deeply entrenched in the political nature of systems and reflects societal values. Showcasing high performance despite failures and complex pathways to success trickles down to various health systems and affects the reporting at the frontline. The prevalent culture that disincentivises accurate reporting and favours ‘managed’ data is detrimental to the system’s progress.” An opinion blog at PLOS by Parashar and colleagues critiques the management of public health data by Indian states during the COVID pandemic and proposes a number of changes.

BASIC SCIENCE, CLINICAL RESEARCH & PUBLIC HEALTH

  • “It may seem odd to devote all this attention to a pinprick of brain tissue in a tiny fish, but the tools and techniques the group is establishing and the deeper understanding of neural circuitry they will reveal create a foundation for subsequent investigation.” A feature article by Karl Leif Bates at the Duke School of Medicine’s online Magnify magazine profiles Duke neurobiologist Eva Naumann’s work on the neural circuitry of zebrafish and the pathways that transform stimuli into actions.
    Composite photo of a juvenile zebrafish with fluorescent “tagging” of anatomic features. Image credit: Daniel Castranova/NICHD
    Image credit: Daniel Castranova/NICHD
  • “During 15 months of the nearly 19-month COVID-19 pandemic, more than 120,000 U.S. children lost a parent or grandparent who was a primary provider of financial support and care, the study found. Another 22,000 children experienced the death of a secondary caregiver — for example, a grandparent who provided housing but not a child’s other basic needs.” A somber article by the Associated Press’ Mike Stobbe reports that the number of children orphaned (where “orphaned” is defined as losing one or both primary caregivers) is higher than previously thought – and the impact has not been evenly distributed.
  • “Putting all of it together with what we know about stress physiology, I would put my money on the lifetime experiences being so much more important than experiences during pregnancy. There isn’t enough known about preterm birth, but from what is known, inflammation is involved, immune dysfunction, and that’s what stress leads to. The neuroscientists have shown us that chronic stress produces inflammation and immune system dysfunction.” At Kaiser Health News, Anna Maria Barry-Jester interviews health equity researcher Paula Braveman about her ongoing research – work that points to systemic racism as a major contributor to the higher incidence of preterm birth in Black women.
  • “Physiologist David Julius at the University of California, San Francisco (UCSF), used capsaicin — the compound that gives chilli peppers their gustatory kick — to track down a protein called TRPV1 that responds to painful heat. Molecular neurobiologist Ardem Patapoutian at Scripps Research in La Jolla, California, identified receptors in skin and other organs that respond to mechanical forces, such as those generated by touch and pressure.”  Nature’s Heidi Ledford and Ewen Callaway profile this year’s winners of the Nobel Prize in Physiology and Medicine.
  • “School nurses have borne the brunt of these outbreaks. Almost entirely responsible for contact tracing and quarantine placement as well as their regular jobs, they’ve found themselves at the nexus of this crisis.” At The Cut, Sangeeta Singh-Kurtz reports on the pressures mounting on school nurses trying to keep students safe despite the onslaught of COVID delta variant infections and a frustrating churn of often contradictory policies.
  • “Data from a pilot rollout involving more than 800,000 children in three African countries convinced a panel of malaria and vaccine experts advising WHO that the vaccine, called RTS,S, or Mosquirix, is safe, and despite its modest efficacy should be offered widely to children in African regions that have moderate or high malaria transmission. (The vaccine only targets the malaria parasite Plasmodium falciparum, which is prevalent in Africa.)” Science’s Gretchen Vogel reports on a major development in global health: the World Health Organization has given the go-ahead to widespread deployment of malaria vaccine on the African continent.
  • “The new results stem from data from 775 nonhospitalized patients who joined the study within 5 days of symptoms starting and had at least one risk factor for developing severe disease. The patients received a 5-day course of the medication, which lab studies have shown disrupts the ability of the SARS-CoV-2 virus to replicate its genome. Merck had planned to include 1550 patients, but an independent data monitoring committee halted the study when it became clear the medicine was effective.”  At Science, Robert F. Service and Kai Kupperschmidt provide some additional detail on an antiviral drug whose early performance in clinical trials, as assessed by an interim analysis, has some experts excited about the possibility of adding an effective non-vaccine therapy for COVID to the clinical toolbox.

COMMUNICATIONS & DIGITAL SOCIETY

Photograph of an illuminated neon sign against a dark background showing a social media-like “like” readout with a heart and a zero. Image credit: Prateek Katyal/Unsplash
Image credit: Prateek Katyal/Unsplash
  • What a week it has been for Facebook: not only did an as-yet-unexplained network outage knock it completely off the internet for hours, but the company has had to contend with a flood tide of critical scrutiny as a highly place whistleblower – Facebook Product Manager Frances Haugen – stepped forward to reveal herself as a key source for the recent Wall Street Journal investigative series on the company and testifying before Congress about Facebook’s internal knowledge of the impact its algorithms have been having on users. Here’s a 60 Minutes interview with Haugen, a commentary from Tom Jones at Poynter that reflects on recent developments in the story, and finally a piece by the New York Times’ Kevin Roose that argues the recent spate of leaks and whistleblowing reveals, paradoxically, a company scrambling to maintain its relevance: “…if these leaked documents proved anything, it is how un-Godzilla-like Facebook feels. The documents…reveal a company worried that it is losing power and influence, not gaining it, with its own research showing that many of its products aren’t thriving organically. Instead, it is going to increasingly extreme lengths to improve its toxic image, and to stop users from abandoning its apps in favor of more compelling alternatives.”
  • “To the extent that the pandemic has been a science story, it’s also been a story about the limitations of what science has become. Perverse academic incentives that reward researchers primarily for publishing papers in high-impact journals have long pushed entire fields toward sloppy, irreproducible work; during the pandemic, scientists have flooded the literature with similarly half-baked and misleading research. Pundits have urged people to “listen to the science,” as if “the science” is a tome of facts and not an amorphous, dynamic entity, born from the collective minds of thousands of individual people who argue and disagree about data that can be interpreted in a range of ways.” An personal essay by The Atlantic’s Ed Yong looks at how the extraordinary events of the COVID-19 pandemic affected the field of science writing.
  • “Besides teaching content and skills in your discipline, your role is to help students learn. And not just some students. The changing demographics and circumstances of higher education mean that undergraduates come to you with a wide variety of experiences, cultures, abilities, skills, and personalities. You have an opportunity to take that mix and produce a diverse set of thinkers and problem-solvers.” An “Advice Guide” by Viji Sathy and Kelly A. Hogan at the Chronicle of Higher Education contains practical tips and strategies for college instructors looking to create a more inclusive environment in their classrooms.
  • “The results of the study showed math anxiety predicted a reduction in the STEM courses students chose to study, and the students’ attainment of lower STEM grades. However, these predictions were made independent of math ability, highlighting the need to develop interventions that target math anxiety to improve students’ academic outcomes in STEM courses.”  A blog post at NPJ Science of Learning highlights a recently published paper by Daker and colleagues that sheds light on the effects of “math anxiety” on the performance of college students taking STEM courses – as well as their willingness to take STEM courses at all.
  • “The researchers also found that location tracking was booming across the board. They found location tracking code in 450 apps, including 64 dating apps and 42 messaging apps. And despite the furor over the use of location data from the Muslim prayer app disclosed by Vice, they found location tracking code in another 10 Muslim religious and cultural apps….Of course, all this tracking of our movements is legal.” At The Markup, Julia Angwin discusses the growing phenomenon of mobile apps that often quietly track people’s locations, and then sell that information to data brokers as part of a large, profitable, but largely unregulated (in the United States, at any rate) commercial enterprise.
  • “The size of scientific fields may impede the rise of new ideas. Examining 1.8 billion citations among 90 million papers across 241 subjects, we find a deluge of papers does not lead to turnover of central ideas in a field, but rather to ossification of canon. Scholars in fields where many papers are published annually face difficulty getting published, read, and cited unless their work references already widely cited articles.” A research article by Chu and Evans published in the Proceedings of the National Academy of Sciences advances a seemingly paradoxical thesis: that greater size (as measured by research activity and output) in a given area of investigation may actually hinder scientific progress in that field.
  • “…many observers remarked that they had either never heard of Ozy or seen any of its journalism shared by a real human—a narrative that elicited some pushback from real journalists who worked at Ozy and insisted that their work there was meaningful.” At Columbia Journalism Review, Jon Allsop documents the downfall of media startup Ozy, whose abrupt collapse this week unleashed an avalanche of hard-to-believe details about the company, including one episode that involved Ozy’s COO apparently impersonating a YouTube executive on a call with potential investors.
  • “Much has been written over the years about de Grey’s ideas, but precious few words have been devoted to the methods by which he pursued them or the people he may have harmed on the warpath to life everlasting. STAT has assembled a different kind of portrait, one that details previously unreported allegations of abusive and lecherous behavior; explores how de Grey built a loyal cult of personality that insulated him from accountability, even as his exploits became more outrageous; and explains why, after so long, it all finally caught up to him.” A long, winding, and frequently bizarre story unfolds as STAT News’ Megan Molteni and Mario Aguilar unfold the events behind the recent ouster of noted longevity researcher Aubrey de Grey.
  • “This kind of reporting is vital. Right now, no systematic government oversight exists for these platforms, which play an increasingly dominant role in our economic and political life. Meanwhile, the platforms’ own efforts at self-governance have repeatedly fallen short. News organizations are essential to filling this oversight gap.” In a blog post for Duke University’s Medium channel, Duke professor Philip M. Napoli reflects on the recent uproar over the practices of social media companies, and why robust and independent scrutiny of them remains essential.

Portrait of NIH Director Francis Collins, MD, PhD. Image credit: National Institutes of Health
Image credit: National Institutes of Health

POLICY

  • “It’s remarkable that the reputation of the National Institutes of Health has remained mostly intact through the covid-19 pandemic, even as other federal science agencies, including the Food and Drug Administration and Centers for Disease Control and Prevention, have come under partisan fire….That is in no small part due to NIH’s soft-spoken but politically astute director, Dr. Francis Collins.” The news that Francis Collins, the much-lauded genetics researcher who has helmed the National Institutes of Health through 12 years and across 3 presidential administrations, is planning to step down from his post has rocked the biomedical world and triggered an outpouring of appreciation for his work. Kaiser Health News’ Julie Rovner has the story, and at Science, Jocelyn Kaiser has some additional perspective.
  • “Engaging community clinicians in clinical research could have multiple benefits. These clinicians are dedicated to the populations they serve and committed to addressing the health issues of those populations. The clinicians’ established, trusting patient relationships allow for transparency and open dialogue, as well as sharing knowledge about the benefits and risks of trial participation. Incorporating community clinicians into the clinical research enterprise would also address accessibility challenges faced by patients: these clinicians are in the same neighborhoods as their patients, who might therefore face fewer difficulties with adjustments to work schedules and transportation.” A perspective article by acting FDA Commissioner Janet Woodcock and colleagues makes a case for opening wider the door to participation in clinical research through community engagement outside of the large academic medical centers that conduct the lion’s share of recruitment for clinical trials.
  •  “At times, McKinsey consultants helped those drugmaker clients fend off costly FDA oversight — even as McKinsey colleagues assigned to the FDA were working to bolster the agency’s regulation of the pharmaceutical market. In one instance, for example, McKinsey consultants helped Purdue and other opioid producers push the FDA to water down a proposed opioid-safety program. The opioid producer ultimately succeeded in weakening the program, even as overdose deaths mounted nationwide.” A remarkable piece of investigative reporting by Ian MacDougall at ProPublica reveals that consulting giant McKinsey was working simultaneously with the FDA and with opioid manufacturers (including Oxycontin maker Purdue Pharma) – without the FDA being aware of the situation.
  • “…the FDA is requiring companies with drugs that were approved, tentatively approved, or currently under review to repeat bioequivalence and bioavailability studies — when those studies are essential for approval — with other CROs. An agency spokesperson wrote us that the FDA is aware of slightly more than 100 drug applications that were affected by the data integrity issues. “ Pharmalot’s Ed Silverman has some startling regulatory news to report: serious data irregularities, including outright misconduct, at a pair of contract research organizations have prompted the agency to order multiple clinical trials to be run again.