Closer Look
Predicting an emergency C-section in advance sounds promising, but there may be pitfalls
Adobe
The name says it all: emergency C-section. Of the 30% of C-section deliveries in the U.S., 10% come urgently, after hours of labor and carrying compounded risks when exhausted doctors and patients decide at the last minute. Researchers who believe there must be a better way have developed an answer: a new machine learning model that predicts who is at risk of an emergency C-section — before it's time to give birth — so parents can consider a planned C-section instead.
But like other AI solutions, there could be pitfalls, STAT contributor Ida Emilie Steinmark reports. One is possibly encouraging unnecessary C-sections. And another: The model uses race-based risk factors, which some experts say could unfairly bias care. Black and Asian people are more likely to get an emergency C-section, and for Black patients, the reason is more likely to be the potentially subjective interpretation of the baby's heart rate. Read more.
drug development
FDA chief asks insurers to chip in on drug research
FDA Commissioner Robert Califf got feisty yesterday, as STAT's John Wilkerson puts it. He lobbed a new idea into the mix at an America's Health Insurance Plans conference, suggesting private insurers step up on post-approval clinical trials on drugs that reach the market on an accelerated pathway. "I looked at the profits, by the way, on the internet before coming over, and there's a lot of money being made in this business," he said. "And it would seem like we ought to all be working together to develop the evidence so we spend the money on the things that work and we don't spend the money on the things that don't work."
And in an apparent reference to a STAT investigation on how Medicare Advantage plans use algorithms to deny care, Califf said, "I am very concerned that there is data sharing, information sharing, going on with companies, totally outside of sunshine." Read more.
health
Elite soccer players face higher risk for dementia, Swedish study says
If you follow sports like football, boxing, ice hockey, or rugby, you know repeated hits to the head have been linked to later brain damage and disease. A new Lancet study from Sweden finds the same connection for male soccer players, suggesting they're 1.5 times more likely than similar men to develop dementia. That held true for outfielders, who were 1.4 times more likely than goalkeepers to be diagnosed with Alzheimer's and other dementias, but among all the players, there was no link to ALS or Parkinson's.
Because the players shared generally good health, the researchers say their work strengthens the hypothesis blaming repeated mild head impacts that the fielders but not the goalies sustained over their playing days. There are caveats: The results, gleaned from players from 1924 through 2019, might not hold up among more contemporary players and they may not be the same for elite female players.
Correction: While the FDA declined Helen Branswell's request to interview Peter Marks, director of its Center for Biologics Evaluation and Research, for her story about spring Covid bivalent boosters, it did eventually reply — so I was incorrect to say this morning the agency had not responded. It sidestepped her questions, saying only, "We continue to closely monitor the emerging data in the United States and globally, and we will base any decision on additional updated boosters upon those data."
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