Forge Friday Roundup - July 30, 2021

July 30, 2021

After this Friday, the Forge Friday Roundup will be taking a brief pause, but we’ll be back with all the latest news in health data science, machine learning, biomedicine, health policy and more on Friday, August 20th.


In today’s Roundup: Epic sepsis algorithm under the microscope; embracing “pharmacoequity” to fight disparities; med student swashes, buckles, medals at Olympics; commercially available “anonymous” location data reveals identity; weighing the merits of telehealth; large numbers of health workers still unvaccinated; ad campaign for Alzheimer drug raises eyebrows; avoiding stigmatizing language in medical chart notes; misinformation tactics give the anecdotal a global reach; further dip in US life expectancy reflects the effects of COVID; much more:


DEEP BREATHS

Image of Lee Kiefer showing the gold medal she won in individual foil at the 2021 Tokyo Olympics

Lee Kiefer wins USA's first-ever gold medal in individual foil at the 2021 Tokyo Olympics. Image via YouTube

  • “I wish I could chop it up in little pieces and distributed it to everyone I love.” New York Post’s Elizabeth Karpen reports on 27-year-old Lee Kiefer, a fourth-year University of Kentucky medical student, defeating Russia’s defending champion Inna Deriglazova to become the first American and the first American woman to win an Olympic gold medal in individual foil fencing.
  • “We humans are famous for this sort of thing. The stars beckoned our species to cross seas and kindled the sciences that later let us putter up toward them in rockets. From culture to culture, the Milky Way served as backdrop and inspiration for stories about rivers, trees, gods, serpents and, of course, exploration….But we weren’t the only ones looking.” A lovely article by Joshua Sokol at the New York Times describes the emerging knowledge of how dependent many of the Earth’s species are upon dark skies and starlight – both rapidly vanishing commodities, as artificial glare overtakes more and more of the night sky.

AI, STATISTICS & DATA SCIENCE

  • “STAT’s investigation, based on interviews with data scientists, ethics experts, and many of Epic’s largest and most influential clients, underscores the need for extreme caution in using artificial intelligence algorithms to guide the care of patients. Errant alarms may lead to unnecessary care or divert clinicians from treating sicker patients in emergency departments or intensive care units where time and attention are finite resources.” STAT News’ Casey Ross returns to a story that emerged earlier this summer: that widely used predictive algorithms created by the ubiquitous Epic electronic health record vendor may be fundamentally flawed. Duke AI Health’s Michael Pencina is quoted in the article.
  • “Experts have warned for years that data collected by advertising companies from Americans’ phones could be used to track them and reveal the most personal details of their lives. Unfortunately, they were right. Data brokers and advertising companies have lied to the public, assuring them that the information they collected was anonymous. As this awful episode demonstrates, those claims were bogus—individuals can be tracked and identified.” Vice’s Joseph Cox investigates the recent case of ostensibly anonymous phone location data – purchased by an investigator via a third-party data broker – being used to expose sensitive personal information about an individual.
  • “Black Americans are generally diagnosed with kidney disease later than white Americans, which delays treatment and puts them at greater risk of developing kidney failure—yet an equation widely used to measure kidney function tends to estimate better function for Black patients relative to non-Black patients. Osteoporosis is underdiagnosed and undertreated in Black women, but a common bone fracture risk calculator places them, along with Asian and Hispanic women, at lower risk than white women.” Science’s Jyoti Madhusoodanan reports on American doctors and scientists rallying to halt the use of medical algorithms that include race as a variable to predict and calculate risk, but things are much more complicated than they might seem. 
  • Image of a female physician attending a telehealth visit
    Image credit: Tima Miroshnichenko via Pexels

    “If you’re talking about deep childhood trauma — having your connection time out then? It’s really frustrating when we’re paying for a service.” While telemedicine offered a lot of promise in terms of access to healthcare amid strict lockdowns in the midst of a widening coronavirus epidemic, the video service industry was not quite as ready for “the titanic influx in users,” reports Kaiser Health News’ Hannah Norman.

  • “Famously, in quantum mechanics a particle’s location, polarization and other properties can be indefinite until the moment they are measured. Yet measuring the properties of entangled particles yields results that are strongly correlated, even when the particles are far apart and measured nearly simultaneously.” If you’d like your brain to feel like it’s been wrung out like a sponge (in a good way), you want to try this Quanta article by Ben Brubaker, which explains how Bell’s Theorem proves one of the most head-scratching aspects of quantum physics – so-called “spooky action at a distance,” in which a change in state in an atom in one location can cause an instantaneous change in state for another distant but “entangled” atom.

BASIC SCIENCE, CLINICAL RESEARCH & PUBLIC HEALTH

  • “Nursing home workers certainly have the right to make decisions about their own health and welfare, but they don’t have the right to place vulnerable residents at risk. Nursing homes don’t just have the power to require vaccinations, they have the duty.” As many as 40 percent of the United States’ long-term healthcare and nursing home workers are yet to receive COVID-19 vaccinations due to vaccine refusal and hesitancy, despite an uptick in cases across the country due to the Delta variant, report ProPublica’s Jenny Deam, Ryan Gabrielson and Bianca Fortis.  
  • A group of marine scientists has recently made history by publishing one of the most detailed 3-D images of the intricately shaped spiral intestines of a shark ever recorded. Published recently in the Proceedings of the Royal Society B, their work reveals the complex inner geographies of more than 20 species of sharks, consisting of image acquired via a CT scanner, and provides (literal) insight into the species’ biological processes. New York Times’ Veronique Greenwood reports the story at the Trilobites column.
  • Speaking of sharks, Science News’ Bruce Bower reports on a recent study published in the Journal of Archaeological Science where a group of international archeologists have unearthed the world’s oldest known shark attack victim in Japan, rescued from a shark attack over 3,000 years ago.
  • The U.S. Centers for Disease Control and Prevention has identified several cases of Candida auris – a potentially pathogenic fungus that, when present as a drug-resistant strain can be nearly impossible to treat – in a long-term care center in Washington, D.C. and two health facilities in Texas. The federal agency has dubbed the fungus a serious emerging global health threat. The New York Times’ Andrew Jacobs reports on the recent developments.
  • “…the company's direct-to-patient marketing strategy has already drawn the ire of medical professionals. Experts note that the company's quiz website and other advertisements claim that ‘about 1 in 12 Americans 50 years and older’ has mild cognitive impairment, which is due to Alzheimer's. Experts say they know of no evidence to back up that ‘1 in 12’ statistic, however, and it appears to be a significant overestimate” Ars Technica’s Beth Mole reports on an ad campaign for Biogen’s controversial Alzheimer disease therapy, aducanumab (Aduhelm) that is raising some eyebrows. It also comes as news, reported here by Axios’ Bob Herman, comes that a manuscript reporting on Aduhelm’s clinical trial results has been withdrawn from consideration for publication at JAMA.
  • “You’re grinding up a piece of an extinct butterfly. You only get one chance.” At New York Times’ Trilobites column, Sabrina Imbler reports on a paper published recently in the journal Biology Letters where a group of American researchers has sequenced a near-complete genome of a 93-year-old museum specimen of the extinct Xerces blue butterfly — the first butterfly known to go extinct in North America because of human activities. The group’s findings suggest that this was a distinct species, a characteristic that could have contributed to its extinction.
  • Findings from a recent Lancet study by British researchers show the adverse cognitive effects of COVID-19, with people who have recovered from the virus as well as those no longer showing or reporting any residual symptoms exhibiting significant cognitive deficits.   
  • “Over the past century, sea surface temperatures have risen by an average of about 0.13 degrees Celsius (0.23 F) per decade as the oceans absorb the vast majority of greenhouse gas emissions from human activities. The temperature increase and changing ocean chemistry affects sea life of all kinds. The world has already lost 30% to 50% of its reefs in the last 40 years, and scientists have warned that most of the remaining reefs could be gone within decades.” In an article for The Conversation, marine biologist and Chair of the Department of Marine Sciences at the University of Miami, Professor Sam Purkis, echoes the urgent call by thousands of coral scientists who were part of the 2021 International Coral Reef Symposium, directed at governments of the world to do more to protect coral reefs that are essential to the very survival of marine life.
  • “In practice, the ability to excise nonworking genes and replace them with normally functioning ones may help blunt the worst effects of a wide variety of diseases. In real time, the hope is that genetic editing will provide a cure for a very common and debilitating inherited disease, sickle cell.” In an opinion piece for Scientific American, emergency department physician Carolyn Barber sheds light on the promise of designer DNA in the cutting-edge world of innovative genomic therapies.
  • Findings from a recent study by Johns Hopkins’ Xiaobin Wang and colleagues published recently in Circulation show that preeclampsia and other risk factors for heart disease are more common in Black women born in the United States, compared to Black women who immigrate to the United States. The study further highlights the role structural racism plays in compounding the disadvantages faced by Black communities. 
  • Image of a fork with an inch-tape wrapped around like a noodle
    Image credit: Diana Polekhina via Unsplash

    “In urban areas, about 40 percent of the land is paved, and that pavement absorbs solar radiation. It’s part of the reason cities are regularly a few degrees warmer in summer than nearby rural areas and leafy suburbs. Reflective materials on pavement can prevent that heat from building up and help counteract climate change by reflecting solar radiation back to the top of the atmosphere.” In a viewpoint for Undark, MIT researchers Hessam AzariJafari and Randolph Kirchain share intriguing findings from a recent report from MIT’s Concrete Sustainability Hub showing that pale-colored, reflective roads have the potential to reduce the frequency of heat waves by a whopping 41 percent in U.S. cities.

  • “It’s not entirely unexpected given what we have already seen about mortality rates as the year went on, but that still doesn’t stop it from being just horrific, especially for non-Hispanic Blacks and for Hispanics.” Washington Post’s Allyson Chiu, Lindsey Bever and Ariana Eunjung Cha report on early data released by the U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics, showing that life expectancy in the United States fell by a year and a half in 2020 primarily due to a major increase in the number of deaths due to the COVID-19 pandemic. According to the data, Black Americans lost 2.9 years of life expectancy while Latinx Americans saw a drop of 3 years. 
  • “…the way to fix the obesity crisis societally or [to lose and keep weight off] individually is not some big, drastic crash approach. You've got to go more sustainably than that because the body will just push back if you push too hard.” In conversation with NPR’s John Henning Schumann, Duke evolutionary anthropologist Herman Pontzer shares key insights into why crash diets tend not to work in the long term. 
  • “In 2001, there were just 36 strains of C. elegans available for research. Today, frozen in Andersen’s repository there are more than 1,000 strains of C. elegans and more than 2,000 from two related species, all with ecological data and complete DNA sequences, and all available for free. Not only is it the most diverse collection of these creatures in the world, Andersen said — it is the most diverse collection within a genus of any living thing.” At Undark, science and environmental journalist James Dinneen reports on how modern biologists and scientists are studying model organisms like Caenorhabditis elegans – a tiny, transparent worm that has been a mainstay of biological research – in the wild to gain crucial insights into their natural lives.

COMMUNICATIONS & DIGITAL SOCIETY

Image of a woman taking a selfie with her cell phone
Image credit: Cristina Zaragoza via Unsplash
  • “The face filters that have become commonplace across social media are perhaps the most widespread use of augmented reality. Researchers don’t yet understand [their] impact, but they do know there are real risks—and with face filters, young girls are the ones taking that risk. They are subjects in an experiment that will show how the technology changes the way we form our identities, represent ourselves, and relate to others. And it’s all happening without much oversight.” MIT Technology Review’s Tate Ryan-Mosley reports on how beauty filters on social media applications are changing the way girls and young women perceive themselves.
  • “…the international spread of misinformation contributes to the larger pervasiveness of anti-vaccine narratives and tropes. Local anti-vaccine groups and media outlets perpetuate narratives across borders. In particular, the collective experience around the COVID-19 pandemic makes local stories and pieces of misinformation salient to a global audience. This means that news of individual tragedy, which anti-vaccine influencers can strip of their context and use to undermine confidence in vaccines, can spread quickly across the globe.” At the Virality Project, Stanford’s Lindsay Hundley and Toni Friedman shed light on what has made COVID-19 misinformation and anti-vaccine narratives a global phenomenon, “prolonging the longevity” of fake news associated with COVID-19.
  • Twitter “influencers” in the field of critical care are predominantly males in U.S. academic institutions. However, few of them have received formal training in critical care and their academic productivity is not reflective of their following on social media. These findings were revealed in an analysis in the journal Critical Care by researchers at Harvard Medical School
  • “For many scientists, the transition from a PhD to a faculty position often happens when they are starting or building families. It’s no wonder that many early-career researchers make crucial, life-altering decisions based on institutions’ policies and attitudes around parenthood... Scientist-mothers face discrimination, drops in productivity and inequities in wages and promotion, all of which contribute to them dropping out of the full-time science, technology, engineering and mathematics workforce.” In a career feature for Nature, Kendall Powell sheds light on the many hurdles and barriers faced by scientist mothers at critical stages in their careers, forcing some to quit in order to better juggle family and professional lives (H/T @nataliexdean). 
  • “There is a lot of misinformation out there, and people often don’t know what information to trust. We try to provide reassurance and share facts. We are worried about anyone who is unvaccinated because they are much more likely to have severe complications that require hospitalization.” Duke Today’s Paul Grantham quotes Duke Employee Occupational Health and Wellness director Carol Epling, while crediting personalized employee engagement for Duke’s vaccination success, as the university boasts 82 percent of its staff and faculty being fully vaccinated against COVID-19, even as the state of North Carolina lags behind other major states across the country with only 56 percent of its adults fully vaccinated.
  • In light of findings from their recent JAMA Network Open investigation, researchers from Johns Hopkins are urging physicians to identify and avoid using stigmatizing language in patient notes, steering specially clear of terms of disapproval, discrediting, and stereotyping while typing or dictating notes, in order to contribute positively towards alleviating health disparities. 
  • The Chronicle interviewed several dozen experts on politics, extremism, hate groups, psychology, media and civic literacy, campus security and policing, and risk management. They predicted that campus political conflict could accelerate amid a worrisomely volatile mix of societal ingredients to which colleges should pay close attention.” An article at the Chronicle of Higher Education by Alexander C. Kafka offers some grim conjecture about the risk of politically motivated violence at college campuses this fall.

POLICY

Image of a person repairing electronics with a screwdriver
Image credit: Blaz Erzetic via Unsplash
  • “The FTC vote is another win for the Right to Repair movement in the US, which has been led by advocacy groups like the US Public Interest Research Group, as well as private companies like iFixit, the California-based company that sells gadget repair kits and publishes repair manuals for DIY tinkerers. Proponents of the Right to Repair have long argued that consumers should have access to the tools, parts, documentation, and software required to fix the products they own, whether it’s a smartphone or a tractor.” Wired’s Lauren Goode reports on the U. S. Federal Trade Commission voting unanimously to enforce “Right to Repair” laws, allowing consumers in the United States the access needed repair their own electronic and automotive devices.
  • “We have entered a new stage of erasure of children, of the disabled, and of the vulnerable. Healthism and its sibling, eugenics, have been unapologetically espoused during the COVID pandemic by our country’s leadership. …it is terribly sobering to see how inhumane our society is, to see how little we have learned from our past struggles, and to see us become more healthist, not less, in the face of widespread death, sickness, and suffering.” In a post for Harvard Law School’s Bill of Health blog, Jacqueline R. Fox, a professor of law at the University of South Carolina School of Law, underlines the United States’ failures – political, social and ethical – in managing the threat of COVID-19.
  • Although school boards do need to accommodate for other matters — from logistical to financial to cultural — they are mainly tasked with putting children’s needs first. As a consequence they should be required to seek out and act on expert scientific advice in order to make informed decisions.” In an opinion for Undark, University of Michigan pediatrician Kimberly Monroe laments the lack of initiative on the part of school boards in terms of getting kids safely back to school as COVID-19 cases significantly dropped this summer, despite a go-ahead and easily adaptable safety guidelines from the scientific community.
  • “The acute phase of this pandemic is far from over. Our moral obligation is to make vaccines available for as many people as possible and as fast as possible and to do everything we can to save the lives and health of people who don’t yet have that protection.” In a guest essay for The New York Times, University of North Carolina’s Zeynep Tufekci urges the U.S. government and health system to get their ducks in order to prepare for what is to come next in the fight against COVID-19’s highly contagious and deadly Delta variant.
  • “…insurance coverage is not enough, as it alone cannot address the breadth of patients’ pharmaceutical preferences or concerns. It’s time to think more broadly about what “access” means. This includes addressing the dearth of pharmacies in communities of color, now referred to as pharmacy deserts. It also includes advocating for improved health and language literacy in the U.S., including engaging patient pharmacy navigators who can aid with dosing instructions, managing multiple prescriptions, and more.” An opinion article by Utibe R. Essien at STAT News addresses the role of “pharmacoequity” in addressing US health disparities.