Consulo Indicium - 10/10/24
Information for your Consideration…
The Slippery Slope – A recent 2024 Gallup poll offered a somber outline on the perspective of Americans towards the medical and health system. Specifically, only 34% of Americans still trust the medical system! If only 34% TRUST the MEDICAL SYSTEM, the collective WE have our work cut out for us!!
Aging And Friendly Care Delivery – A new report released by the John A Hartford Foundation and completed in collaboration with Age Wave revealed a striking misstep in the USA health care system - widespread dissatisfaction among older adults with care delivery. The researchers combined information from a Harris Poll, focus group analysis, and recent research reports. The report deserves your attention and I would recommend downloading a copy of the report entitled Meeting the Growing Demand for Age-Friendly Care: Health Care at the Crossroads. For all of us who are leaders in health care and/or deliverers of care…an important read.
Oh No – Don’t Tell Me It’s True! – Sorry, but it does seem to be true. According to a recent article in the journal Nature, the Large Language Models (LLMs) used in AI products are beginning to get the drift of how to lie. Yes, lie!! There is logic to everything from structured information that gives answers to complete questions to how best to lie about some issue or topic. As a result – according to the article – the LLMs are becoming less reliable because they are increasingly recognizing that it is more important to “make things up” rather than to not provide an answer. “Millions of people are using general-purpose artificial intelligence (AI) systems based on large language models (LLMs), which have become commonplace in areas such as education6, medicine7, science8,9 and administration10,11” [NOTE: citations copied directly from the article]. Although the LLMs are increasing their reliability, they are also getting better at lying!
At the same time – as a proponent of learning how to effectively integrate AI/ML learning derived from LLMs into medical and healthcare delivery – there is reason to be positive. In a recent post, Azeem Azhar argued that humanity needs to embrace AI as a source for accelerating our knowledge development capabilities. I agree! Rather than rejecting AI/ML or putting it in a box, we need to determine how best to use it, what policies are required to assure its value to society, how to prevent misuse of the technology, and a host of other thoughts. It’s very clear that the path of Generative AI/ML development is on a much more accelerated pathway of development than either the use of personal computers or the Internet. I remember introducing the use of computers to office work in the early 1980s. Then, I was on the horn in the early 1990s learning about this new resource called “the web”. And, where we’ve come from those early days is incredible! And, the acceleration is even accelerating with the advent of OpenAI – the beginning tool of down-the-road tools that we will need to integrate into the medical and health system. AND, we are not educating or training our young health and medical graduates across the board in the effective use of AI/ML – let alone those who are in practice today.
Alzheimer’s Disease, Dementia, And Falls – In a new report from JAMA Network Open researchers found that when controlled study parameters were put in place death and falling were associated with a 21% increased risk of a subsequent dementia diagnosis. The metanalysis examined almost 2.5 million Medicare claims to derive the assessment. The claims were for older adults who had a traumatic injury leading to an emergency room visit as a result of a fall. The researchers found that within one year of the incident “new dementia diagnoses were more common in people with falls than other injuries.” They didn’t say anything about falling out of your office chair when you swivel around quickly – like I did yesterday. However, I was able to jump up right away and luckily no one was around to see the incident. Now about those stairs, I walk up and down from the kitchen at least 10x per day…hmmm…
Step It Up A Notch – Of late, I’ve become a lot more interested in the use of physical exercise as a mode for sustaining health. I guess that getting older has something to do with my enhanced interest. Nonetheless, the data shows very clearly that physical exercise is a proven modality of not only managing but also preventing chronic disease. This is especially apropos for any adults 65 and older such as an increased number of independent living years, reduced risk of falling – one of the major contributors to decline among the elderly – and improved brain health in the form of reduced dementia, including Alzheimer’s disease. If you’re looking for more immediate results consider the value of sleep quality, reduction in blood pressure, weight loss (a good thing unless you’re ill), bone health derived from exercise, and less anxiety. You should start early and go often. It makes a difference. I’m finding that it’s made life a lot better for me and increased my sense of well-being. So, step it up a notch to better in the end…
Ubiquitous Microplastics Found In Brain Tissue – In another study from JAMA Network Open by Brazilian researchers, they found that microplastics were prevalent in brain tissue derived from human cadavers. The sampling was small where the olfactory bulb was sampled in 15 patients between the ages of 15 and 100. Samples from eight of the cadavers contained microplastics — tiny bits of plastic that ranged from 5.5 micrometers to 26.4 micrometers in size consisting of plastic fibers and particles. The composition of the plastics were polyethylene vinyl acetate, polypropylene, and polyamide – all common materials used in coverings for commercial products. Yikes!! It’s unclear what the presence of plastics means but foreign bodies inside the body for any reason are cause for concern. And, it’s clear that microplastics are a ubiquitous problem for the world. It’s another “world health” problem we need to be thinking about – and, more importantly – doing something about…
The Vaccination Dilemma – It was very disturbing to read an Associated Press release noting that: “…U.S. kindergarten vaccination rates dipped last year and the proportion of children with exemptions rose to an all-time high, according to federal data...where the percent “of kids exempted from vaccine requirements rose to 3.3%, up from 3% the year before.” Although a large percentage of kindergartners got their shots (=92.7%), the fact that we’re seeing a gradual increase in non-vaccinated kids over the last several years is a disturbing trend. In fact, vaccine exemptions increased in 40 of the states according to CDC data. And, it’s occurring across the board for measles, mumps, rubella, diphtheria, tetanus, and pertussis – diseases that we’ve been working to wipe out BUT that will no doubt recur without attention to effective vaccination programs. As a result of the vaccination decline, there were 13 measles outbreaks this past year compared to four in 2023. And, more generally the states with the greatest number of outbreaks have been in California, Florida, Illinois, Minnesota, New York, and Oregon. I’m of the age where I remember having playmates with sequelae from a number of these diseases. Let’s not let them come back. Once again, it seems that we need to counter the misinformation.
