Medical AI – You Reap What You Sow
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This thoughtful review illustrates how human biases and ethical assumptions impact medical AI models, as outputs are based on the training data ingested, human fine-tuning to optimize responses, and the nature and perspective of prompts used. As such, the authors recommend caution in the application of AI to medical decision making.
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Medical Artificial Intelligence and Human Values. N Engl J Med. 2024 May 30;390(20):1895-1904. doi: 10.1056/NEJMra2214183. PMID: 38810186.
Which Physician Specialists Are Behaving Badly?
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Unprofessional behaviors were reported most often among surgeons when comparing physician specialty subgroups.
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Physician Specialty Differences in Unprofessional Behaviors Observed and Reported by Coworkers. JAMA Netw Open. 2024;7(6):e2415331. doi:10.1001/jamanetworkopen.2024.15331
A Path to U.S. Health Insurance Reform?
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To fulfill a societal obligation to provide healthcare to all, two things must be done: healthcare insurance must be universal, basic, and free, while also providing supplemental care in a healthcare market.
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A Blueprint for U.S. Health Insurance Reform. Ann Intern Med. 2024 May 14. doi: 10.7326/M24-0091. Online ahead of print. PMID: 38739923
Inequities in Hallway Bed Placement
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In the absence of a standardized approach, patients placed in hallway beds were more likely to be male, have Medicaid/self-pay payer status, and elope in this single health system study.
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Inequities among patient placement in emergency department hallway treatment spaces. Am J Emerg Med. 2024 Feb;76:70-74. doi: 10.1016/j.ajem.2023.11.013. Epub 2023 Nov 11.
Private Equity Acquisition May Be Dangerous for Patients
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In a self-described “quasi-experimental” analysis of Medicare claims data, private equity owned hospitals were associated with a 25% increase in hospitalization-acquired adverse events when compared with non-private equity hospitals. Notably, there was a 27% increase in falls, a 38% increase in the volume of central line-associated infections, despite the placement of 16% fewer central lines, and a doubling of surgical site infections despite 8% fewer surgical procedures being performed (underpowered assertion).
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Changes in Hospital Adverse Events and Patient Outcomes Associated With Private Equity Acquisition. JAMA. 2023 Dec 26;330(24):2365-2375. doi: 10.1001/jama.2023.23147.
Making PROGRESS – Pediatric Emergencies and Healthcare Disparities
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This systematic review and meta-analysis identified multiple social determinants of health that were related to increased utilization of ED services by children from racial minority and lower socioeconomic status (SES) groups.
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Social Determinants of Health and Pediatric Emergency Department Outcomes: A Systematic Review and Meta-Analysis of Observational Studies. Ann Emerg Med. Published online December 6, 2023. doi:10.1016/j.annemergmed.2023.10.010
Snarky Sign-outs – How to Avoid Bias During Handoff
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Our words during handoff can bias our colleagues against our patients. Here's how it happens and what we can do to improve.
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Patient Factors Associated With Biased Language in Nightly Resident Verbal Handoff. JAMA Pediatr. 2023 Oct 1;177(10):1098-1100. doi: 10.1001/jamapediatrics.2023.2581.
Do We Need to Reconsider the Word… Need?
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Need in medicine describes what is missing and the necessary corrective action (i.e. you need a transfusion), but this wording allows little latitude for discussion with patients and families. However, saying, "Can we talk about what this means and what to do next?" allows for dialogue without presuming the desired course of action.
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Reconsidering the Language of Serious Illness. JAMA. 2023 Aug 15;330(7):587-588. doi: 10.1001/jama.2023.11409.
Pregnancy and Residency – Laboring for Equity
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Though incremental progress has occurred over the last several decades, inequities loom for people that wish to become pregnant during medical training.
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Pregnancy and Residency - Overdue for Equity. N Engl J Med. 2023 Mar 16;388(11):966-967. doi: 10.1056/NEJMp2215288. Epub 2023 Mar 11.
Can ChatGPT Write Journal Articles?
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ChatGPT is an artificial intelligence software that is being explored for scientific writing. While there is great potential for utilizing this in the medical field, it should not be used in isolation and requires human oversight for both concept proof and personalization.
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Can artificial intelligence help for scientific writing? Crit Care. 2023 Feb 25;27(1):75. doi: 10.1186/s13054-023-04380-2.