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Finding social determinants of health with AI, zeroing in on cancer genomes, & teens trying 'budget Ozempic'

January 11, 2024
Reporter, Morning Rounds Writer
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health tech

AI outperformed clinicians in identifying social determinants on health from medical records

Here's some hope about what AI might do for health: A new study in npj Digital Medicine has found that large language models like ChatGPT did a better job than health care providers at mining patients' medical records to find their social needs among all the notes recorded there. Collectively known as the social determinants of health, those factors include housing, transportation, financial stability, and community support. Because screening for such factors in clinical notes is so challenging, researchers tested AI tools to see how they compared. 

Among 770 cancer patients who received radiation therapy, 48 had an adverse social determinant hidden in their clinical notes. The best-performing model identified 45 of those patients. STAT's Katie Palmer has more, including concerns about bias and cautions that this is not ready for prime time.


biopharma

JPM roundup: Verve's plan for heart attacks, a lawsuit heats up, and Morgan Health says hello

We have more news and views from JPM24:

  • Verve CEO Sek Kathiresan sat down with STAT's Damian Garde to explain his company's single-minded mission: "Five years ago, when we proposed this, it was pretty much like science fiction. You're going to go in and make a single spelling change and turn off a gene in the liver in a living human being? And now we've demonstrated that actually works; we were able to turn the gene off. There's a series of other challenges that we'll have to go through, but the clinical development vision remains." Read the full interview to see what that means.
  • A lawsuit between nonprofit hospital giant AdventHealth and MultiPlan, a dominant vendor that works for health insurance companies, is getting a lot more heated just as MultiPlan and more than a dozen of the largest tax-exempt, nonprofit hospital systems are wooing investors at the J.P. Morgan Healthcare Conference. (AdventHealth did not attend this year's conference, but did last year.) STAT's Bob Herman has the details
  • Meanwhile, another health care player has been almost silent for almost three years. That's when the country's biggest bank, JP Morgan Chase, unveiled a lofty plan to fix the health care industry's entrenched problems with its new business unit, Morgan Health. Now CEO Dan Mendelson is reaching out to reporters at JPM. "For the uninitiated, it's usually the other way around," STAT's Tara Bannow notes.

obesity revolution

Nearly 1 in 10 adolescents opted for 'budget Ozempic' or other risky ways to lose weight 

Surely you've heard of the new weight loss drugs Ozempic and Wegovy. But did you know about "nature's Ozempic" or "budget Ozempic?" The one from "nature" is the supplement berberine, and the one for the budget-conscious is a laxative. Teens on TikTok already know this, and some are drawn not just to their price but to their OTC availability. Nearly 1 in 10 adolescents (girls more than boys) around the world have used these non-prescription weight loss products, a new study in JAMA Network Open estimates. 

That's worrying because using such products can be harmful in both the short and long term, putting young people at a higher risk of cardiac issues, eating disorders, and other mental illnesses. "I worry that kids are being missed within the actual medical system," Treah Haggerty of WVU Medicine Children's Hospital in West Virginia, who was not involved with the study, told STAT's Theresa Gaffney. Read more on the push to regulate these products.



in the lab

U.K.'s 100,000 genome project zeroes in on cancerabstract dna

Adobe

When the U.K.'s 100,000 Genomes Project launched 10 years ago, its mission wasn't just to sequence that many people's genomes to see how they influenced health. It also set out to understand the genomes of some volunteers' tumors. The fruits of that research appear today in Nature Medicine, based on work analyzing 13,800 solid tumors in adults. Some tumors were more likely to carry mutations, a discovery that is already helping direct treatment choices for the patient and in some cases indicating potential risks for the patient's family.

It's now standard practice for patients in the National Health Service with those tumors — including certain brain cancers, sarcomas, and ovarian cancers — to have their tumors sequenced. "Mostly they got into clinical trials, some of them got medicines they wouldn't have got, others avoided medicines because their genetic makeup suggested that if they were exposed to the medicines, they would be at risk of harm," study co-author Mark Caulfield of Queen Mary University of London said. STAT's Andrew Joseph has more.


mental health

Doctors who revised the latest psychiatric bible pocketed $14 million from drug makers

It's officially known as the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, but in shorthand, it's the bible of psychiatry. A new BMJ study calls into question, not for the first time, the editorial independence of the physicians charged with the DSM's 2022 revision. Combing through the U.S. government's OpenPayments database, where drug and device makers must report payments made to doctors, the study's authors found that 60% of the 92 U.S. physicians who served as panel and task force members received industry payments totaling more than $14 million. 

Previous research has linked financial conflicts of interest to pro-industry habits of thought, study co-author Lisa Cosgrove of the University of Massachusetts in Boston told STAT's Ed Silverman. "In the case of the DSM, this leads to the medicalization of emotional distress, over-diagnosis and over treatment, and the search for magic bullets." The APA's response:  "No content was found in the submitted text that related to a specific treatment for which industry funding may have been provided for related research." Read more.


 

health

Transportation as a health indicator 

Reliable access to transportation can make a difference in getting health care, especially for people who are older, have lower income, and don't have insurance, a new CDC report points out. In 2022, 5.7% of U.S. adults didn't have reliable transportation for daily living, with women (6.1%) more likely than men (5.3%) to lack it. There were differences by race and ethnicity:Screen Shot 2024-01-10 at 4.42.51 PM

CDC

And by geography:Screen Shot 2024-01-10 at 4.34.18 PM

CDC

This is the first time a question about transportation to be included in the National Health Interview Survey, so the agency plans to monitor how it affects health outcomes and health care use.


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What we're reading

  • As the U.S. struggles with a stillbirth crisis, Australia offers a model for how to do better, ProPublica

  • Why are American drivers so deadly? New York Times

  • Courts will decide the future of Medicare's power to negotiate drug prices within months, STAT
  • Air pollution is ruining your skin, Wired

  • After grilling Fauci on Covid origin, House Republicans want to consider new rules for foreign research, STAT

Thanks for reading! More tomorrow,


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