Breaking News

Fetal gene editing, generative AI has reached hospitals, and advances in chronic fatigue research

February 21, 2024
Annalisa-Merelli-avatar-teal
General Assignment Reporter

Buongiorno readers! Imagine being able to treat a genetic condition in utero, before it even has time to develop. This is the mind-boggling, futuristic promise of fetal genome surgery, which uses CRISPR gene editing to modify fetal DNA. It's a field that is being pioneered by Tippi MacKenzie, whose fascinating profile you'll find today in STAT. Plus, check out our tracker for generative AI adoption in hospitals.

artificial intelligence

Generative AI has already come to a medical provider near you

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Adobe

AI isn't the future of medical care — it's the present, write my colleagues Katie Palmer and Casey Ross in their review of generative AI adoptions in health care. STAT developed a tracker that found more than 80 health systems around the country are already using generative AI to transcribe visits, write emails, and summarize hospital progress. Epic Systems, the world's largest digital medical record vendor, has five applications already available and nine more coming down the pipeline. AI will soon figure out if a patient's father had cancer, find out whether a medication is covered by insurance, and write a claim denial appeal. 

Health systems are developing and testing their own tools — and trying to limit the potential for mistakes. The tools still require a lot of policing, and despite their great potential, especially in reducing administrative burden, the dangers are real. "Harm is not just likely. It is for sure going to happen," said Rohit Chandra, chief digital officer of the Cleveland Clinic. More here.


FIRST OPINION

Puerto Ricans pay Medicare taxes, but they're missing out on the full benefits

People living in Puerto Rico pay federal taxes just like other U.S. citizens, including Medicare payroll contributions. Yet they are left behind when it comes to taking advantage of the services their taxes help maintain. For instance, they lack access to Medicare Part D low-income subsidies, which are essential to help cover out-of-pocket costs for chronic condition medications. 

But Puerto Ricans have a harder time even accessing the programs that are available to them, writes Mariela Torres Cintrón in a STAT First Opinion. For instance, Medicare Part B, which has automatic enrollment in the continental U.S., requires proactive signup in Puerto Rico, leaving out many who don't know about it. What's more, Medicare reimbursement rates are about 40% lower in Puerto Rico than in the rest of the U.S. (though that isn't proportional to the cost of care), which can even affect the benefits offered by Medicare Advantage plans. Cintrón argues that Congress must make it a priority to reform Medicare funding for Puerto Rico if it wants to ensure equitable access to health care in the territory. Read more.


academia

Harvard graduate students and postdocs are struggling with food insecurity

A concerning percentage of graduate students and postdoctoral researchers suffer from food insecurity, according to an investigation published yesterday in JAMA Network Open. Researchers surveyed nearly 1,750 people across Harvard's medical, dental, and public health schools and found that 17% of graduate students and 13% of postdocs reported food insecurity, defined in the study "as the lack of access to enough food to attain a healthy, active life."

Among the factors associated with food insecurity were receiving financial aid, having housing instability, and, for graduate students, belonging to a racial or ethnic minority. The overall prevalence of food insecurity identified by the study is higher than averages for both the U.S. (12.8%) and Massachusetts (8.5%), pointing to the need for national and institutional interventions. 



closer look

Meet the fetal surgeon pioneering CRISPR's next frontier: the womb

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Laura Morton / for STAT 

In August 1996, Tippi MacKenzie, a medical student, watched as Michael Harrison — known as the father of fetal surgery — removed a tumor from a 23-week-old fetus the size of a mango. A former aspiring pianist turned scientist, she decided to follow Harrison's footsteps of surgical virtuosity. "I thought she would be a star," he said. "But no one else did."

But 30 years later, she is working on something that could take fetal surgery into the future: fetal genome surgery. In the next five years, she plans to draw a blueprint for how CRISPR gene editing could be used on fetuses in a safe and ethical way, modifying fetal DNA to stop genetic diseases before they even have the time to manifest. 

In her profile of MacKenzie, my colleague Megan Molteni tells the fascinating story of a gifted surgeon and scientist who just might end up changing the future of medicine. More here.


research

NIH study sheds new light on chronic fatigue syndrome, a long-dismissed condition

Myalgic encephalomyelitis/chronic fatigue syndrome, or ME/CFS, is a chronic condition often occurring after an infection that leaves its sufferers crushed by a fatigue that can often be debilitating. Science doesn't understand much about the condition, which affects 4.3 million Americans, and there are no treatments. 

Now, the most detailed study to date offers some clarity, including by identifying specific biological markers associated with the condition. Researchers found that patients have a protracted immune response that exhausts T cells, which causes a state of perpetual inflammation in the body, making people feel as if they were constantly fighting a flu. Outside experts caution that the study is important but extremely small (only 17 participants with ME/CFS). It also does not explain what causes the condition or point to new potential treatments, reports Isabella Cueto. However, its publication may help accelerate long-overdue research on a condition that affects millions of patients. More here


health CARE

Health care costs are U.S. voters' biggest worry, but they like the ACA

Medical affordability is a major financial concern for U.S. voters, second only to inflation, according to a health tracking poll released today by KFF, a health policy research nonprofit. Among the respondents, 74% said they were worried about unexpected medical bills and 73% about the broader cost of health care. The survey, focused on health care affordability and the Affordable Care Act (ACA), found that medical costs are a major factor behind the public's negative perception of the economy. 

But the ACA remains very popular, and nearly 60% of voters (including a minority of Republicans), have a positive view of the law. And while only one in four voters is aware of the ACA provision mandating coverage of preexisting conditions, a majority of those who do know the provision want to keep it in place. Asked what Congress should do with the law, about half of respondents say they would like it expanded, much more than the 32% who would like to see it scaled back or repealed.


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What we're reading

  • Alabama Supreme Court rules frozen embryos are 'children' under state law, Associated Press

  • FDA warns medical device makers about rise in fabricated data, STAT

  • Mind-reading devices are revealing the brain's secrets, Nature

  • A lawsuit over a controversial Sanofi drug shortage is unexpectedly revived, STAT

  • An essential medical device fails people of color. A clinic is suing to fix that, Los Angeles Times

  • AbbVie CEO Gonzalez to step down after a decade fiercely defending its top seller, Humira, STAT


Thanks for reading! More tomorrow — Nalis


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