Another Government Recommendation

 How many people die as a result of a Government mandate. Take breast cancer. The USPSTF issued an update recommendation in JAMA. They note:

The USPSTF recommends biennial screening mammography for women aged 40 to 74 years. (B recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening mammography in women 75 years or older. (I statement) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of supplemental screening for breast cancer using breast ultrasonography or MRI in women identified to have dense breasts on an otherwise negative screening mammogram. (I statement)

 In my clinical experience women over 75 still have a high incidence of BCa and it is essential to take measures to mitigate the costs, pain, suffering and demands on health care. The USPSTF has a chronic reputation of making grossly inappropriate recommendations in my opinion.

How MIT Has Changed ... Better or Worse

 During WW II MIT managed the Rad Labs, designing and implementing radar systems to protect US forces across the globe. Following that the technology developed led to the explosion of technology that became silicon valley as we know it.

Now MIT has entered the new world.  They note:

Part of ... postdoctoral research involves complementing her computational abilities by acquiring and improving her skills in biochemistry and cell biology, and tissue mechanics and engineering. Her current work on how clitoral anatomy relates to sexual function, especially after gynecological surgery, explores a topic that has seen little research, ... says, adding that her work could improve postoperative sexual function outcomes.

Yes, you read it right. No linger information theory, systems design, genetic structure, cancer research, but, well you can read it. Forty years ago a few MIT coeds published a Sex Survey, in "Thursday", a campus wide news sheet. It exploded with the Administration. Women rating male performance. But the above is now a fully funded research program. 

I wonder where MIT is going next. After its President being a Barbie aficionado, and doing nothing about the rampant antisemitism on campus, well one can just wonder.

AI Redux

 As usual, some one else is opining on AI, this time an MIT economist. As noted in the NY times:

David Autor seems an unlikely A.I. optimist. The labor economist at the Massachusetts Institute of Technology is best known for his in-depth studies showing how much technology and trade have eroded the incomes of millions of American workers over the years. But Mr. Autor is now making the case that the new wave of technology — generative artificial intelligence, which can produce hyper-realistic images and video and convincingly imitate humans’ voices and writing — could reverse that trend. “A.I., if used well, can assist with restoring the middle-skill, middle-class heart of the U.S. labor market that has been hollowed out by automation and globalization,” Mr. Autor wrote in a paper that Noema Magazine published in February. Mr. Autor’s stance on A.I. looks like a stunning conversion for a longtime expert on technology’s work force casualties. But he said the facts had changed and so had his thinking. Modern A.I., Mr. Autor said, is a fundamentally different technology, opening the door to new possibilities. It can, he continued, change the economics of high-stakes decision-making so more people can take on some of the work that is now the province of elite, and expensive, experts like doctors, lawyers, software engineers and college professors. And if more people, including those without college degrees, can do more valuable work, they should be paid more, lifting more workers into the middle class.

 The advantage of being over eighty is that I have a memory of times distant. I am now more productive than I was sixty years ago. Why? Simply:

1. Word processing and spreadsheets. I can now create documents the way I think. Layer after layer, assembling like a puzzle, looking for the missing pieces and putting them together. I do not need a typist, no secretary. Wish I had an editor, but I do not rely upon AI ever doing that. Editors must not change the intent. I once had an editor who wanted co-authorship, for doing nothing, just inserting his thoughts. As for spreadsheets, in the old days they were massive sheets of numbers and calculators. Hours wasted, rigid thinking.

2. Search engines let me get what I want. I get to choose and seek out the best that reflects my intent. They are primary pieces of work. Perhaps with AI they will all be reflective of GIGO stuff! But now at least I can get some original work short of fraud.

3. Smart phones. I hate Apps, like to text and make calls if necessary. Real time access globally. Apps are what I see the walkers staring at when I cycle by.

4. Zoom, the initial attempt at multimedia. Kind of works, but still like human contact. Not easy any longer in NYC, likely to get assaulted of killed, retro to the Dinkins Days. Not easy at MIT since the gated the campus. Lots of equity but no access. That was then end of my donations.

5. Online books. I now buy the hardcover to get the online version. Rarely use the hardcover, easy to search the online. Hardcovers are great backdrops for Zoom calls.

Now I fear that AI will not add to this. 

As to doctors and lawyers, not really. Osler was famous for "if all else fails listen to the patient". AI is not really a good human listener, especially for symptoms and things that need understanding. As for lawyers, this is really game playing. One step to beat out a previous step. Lawyers often make a lot up on the fly.

On the convergence of law and medicine, I asked a few Docs who were praising AI in medicine, who do I sue when a patient is harmed. The response was "I guess I get sued" In fact liability for AI use is negligible. Lawyers will have a field day. Now consider AI and FDA approval. FDA may approve an AI engine as a medical device. But minutes after the approval the "device" just gathered more information, does it then make the device unapproved? This will be a field day for litigators. There is no law, no precedence.