AI’s data dilemma: How subtle shifts send hospital algorithms into a tailspin

(Mike Reddy for STAT)

Subtle shifts in data fed into popular health care algorithms — used to warn caregivers of impending medical crises – can cause their accuracy to plummet over time, raising the prospect that AI could do more harm than good in many hospitals, an investigation by STAT and MIT has found. Instead of transforming care, the algorithms withered in the face of fast-moving clinical conditions, unable to keep up with the pace of change. Their frailty exposes gaping holes in the governance of products whose quiet deterioration in hospitals around the country threatens to mislead doctors and undermine patient safety. “You have to wait until [an algorithm] is broken enough for them to notice,” Sharon Davis of Vanderbilt told STAT’s Casey Ross. Read more in STAT+ about what the monthslong experiment found.

CDC's new mask guide shifts to community risk

CDC’s new Covid strategy to minimize severe disease and make sure hospitals can function means that roughly 70% of the U.S. population can now contemplate removing their masks. The long-awaited guidance, issued Friday, designates individual counties as at low, medium, or high risk of Covid transmission. The 71.7% of Americans who live in counties at low and medium risk are not being urged to wear masks; people at high risk from Covid who live in counties at medium risk should talk with their health care providers about wearing a mask. The 28% of Americans who live in counties where the risk of transmission is now high should wear masks in indoor public settings, including schools, the guidance states. “If you are more comfortable wearing a mask, feel free to do so,” CDC Director Rochelle Walensky said. STAT’s Helen Branswell has more.

Transplant system must change to be more fair, advisory panel urges

The U.S. transplant system needs to stop wasting organs and start improving fairness for patients, the National Academies of Sciences, Engineering and Medicine said in a new report. While a record 41,000 transplants were performed last year, more than 106,000 patients remain on the waiting list and others don’t even make the list, especially people of color. The transplant system "is demonstrably inequitable and doesn’t work for enough people,” Kenneth Kizer, who chaired the panel, told the Associated Press. Two of the panel's recommendations:

Hospitals must reduce organ waste and be candid about the option of a less-than-perfect offer.
Black Americans are three times more likely to suffer from kidney failure than white people but far less likely to be referred for transplant evaluation. So the federal government should start regulatory oversight once patients are diagnosed with organ failure — rather than on the transplant waiting list.

Closer look: Treating sleepless children, remembering restless nights

When Christopher Hartnick was about 7 years old, he lost the ability to place his head on his pillow, close his eyes, and trust that he would soon slide away into that mysterious state of sleep. His childhood of sleepless nights prepared him well for going into medicine, he notes in a STAT First Opinion, with the profession's sleep-disrupting 80-hour work weeks and overnight shifts. Now an otolaryngologist at Massachusetts Eye and Ear Infirmary and still an insomniac, he was drawn to children with sleep disorders. He tells the story of one family whose daytime life also improved when their child could finally sleep. “Our nights and days are not disconnected but are really one, and each of us struggles to find the path that weaves our nights into the fabric of our days,” he writes. Read more.

Adolescents' mental health improved in the year after starting gender-affirming care

Amid a wave of state legislation to limit access to gender-affirming care, new research shows that within one year of transgender or nonbinary adolescents' receiving puberty blockers or gender-affirming hormones, rates of depression and suicidal thoughts dropped significantly. It’s well-known that transgender and nonbinary young people have high levels of depression, anxiety, and suicidality, linked to social rejection and sometimes violence. Medical treatments are known to help over the long term, but researchers who conducted this JAMA Network Open study were concerned about the short term. Among 104 people from age 13 through 20, their odds of depressive symptoms fell 60% and their odds of self-harm or suicidal thoughts fell 73%. Anxiety did not change. Also in the same journal issue: A brief video showing a transgender person describing coping with depression reduced transphobia in 1,098 adolescent viewers, the study says.

Indoor disinfectants rival vehicle exhaust when it comes to pollutants, study says

We might not be spraying down our groceries anymore, but pandemic-inspired cleaning has upped our disinfecting behaviors at home and at work. A new study in Science Advances tells us people who clean buildings for a living face potential harm from the products whose aerosols they breathe in. The researchers tested commercial disinfectants by mopping the floor of a mechanically ventilated office room, simulating what a janitor might do. When they measured concentrations of particles in the air, they found levels similar to outdoor traffic, suggesting custodial staff and people who clean frequently could be exposed to harmful pollutants during brief indoor cleaning. “Workplace and residential exposures resulting in adverse health effects are likely to be influenced by increased chemical disinfection of indoor surfaces during the coronavirus disease 2019 pandemic,” they write.

What to read around the web today

Medical oxygen running out in Ukraine as war rages, WHO warns. Reuters
A Kennedy’s crusade against Covid vaccines anguishes family and friends. New York Times
Opinion: What biotech can learn from past stock market downturns. STAT+
How to protect the first ‘CRISPR babies’ prompts ethical debate. Nature
Johnson & Johnson, three pharma wholesalers finalize $26 billion opioid crisis settlement. STAT+