Medicine and Science from The BMJ

This week we’re focusing on how healthcare is using AI systems. The NHS is firmly set on a course of AI integration, with NHS England committing £10 billion of taxpayer funds to the cause over the next three years. The pressure to implement AI in our hospitals is intense. But, how can healthcare leaders know what makes for a good AI adoption strategy? Victor Montori and Jon Tilburt are physicians from the US’ Mayo Clinic. They join us to lay out what they are calling the ‘five red flags’ that any organisation needs to consider in its AI rollout.

 

The UK is already having this conversation. The National Commission into the Regulation of AI in Healthcare released its initial report in June of this year. Among its findings was a call for a ‘lifecycle-based approach’ to regulation. To explain what this means, as well as how doctors can be equipped to ‘surveil’ AI systems as conditions evolve, we’re joined by the co-authors of a new BMJ editorial - Mark Ball from the University of Derby, and Elvira Perez Vallejos from the University of Nottingham.

 

And lastly, we talk about a research paper from last week that sparked off some concern. Researchers at Stanford University in California have used generative AI to design novel bacteriophage viruses. But, what have these scientists actually accomplished, and how can we put the right safeguards around the technology? Simon Clarke, associate professor in cellular microbiology at the University of Reading, explains the breakthrough and lays out its real implications.

 

References:

We can, but should we? Red flags for hasty, low integrity AI integration into healthcare

Regulating AI in healthcare: a moving target

Developments in AI designed viruses demonstrate why such research must be done in the open

Bipolar disorder affects almost 40 million people worldwide, but finding the right treatment is complex, and nearly half of patients struggle to follow their prescribed treatment plans.

 

In the first part of this episode, we discuss new research which aims to help patients and their doctors identify the right treatment. Michele De Prisco, psychiatrist and researcher at the Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques, joins us to discuss his team's comprehensive umbrella analysis of bipolar disorder treatment options.

 

Also this week, with the malaria vaccines RTS,S and R21 passing regulatory hurdles, and becoming available for populations around the world, the fight against malaria is shifting. Gillian Turner, Principal Research Associate at the Liverpool School of Tropical Medicine, explains the logistical challenges of the malaria vaccine rollout and what steps are needed next to control the disease.

Reading list:

 

Evidence based interventions for bipolar disorder across phases and age groups

 

Scaling up Malaria Vaccines in Africa

This week we focus on the external forces that shape medicine and healthcare. 

Global health is changing, after the reduction in financing from wealthy nations, the global community are beginning to implement reforms to improve the situation. However, any change will be unsuccessful until we tackle the fundamental structures that govern outcomes, argue Daniel Bernal-Serrano and Omar Gabriel Torres Valencia from the London School of Hygiene and Tropical Medicine. They join us to explain how economic forces, wealth distribution, and market dynamics undermine health outcomes.

We also learn about the rapid rise in private equity financing of healthcare in the UK, and the dangers that poses to healthcare quality. Bernd Rechel is a researcher at the European Observatory on Health Systems and Policies, and explains how different countries are handling this drive for healthcare profit extraction.

 

Reading list:

Private equity involvement in UK healthcare

Reforming global health architecture requires confronting its political economy

In this week's podcast - the Sensitivity of Patient Questionnaires: If you've ever asked a patient to fill out a Patient Health Questionnaire (like the PHQ-9) to assess their mental health and wondered exactly how much of a change it can actually detect, new research just published on bmj.com sets out to answer that question. We're joined by Brett Thombs, Professor in the department of Psychiatry at McGill University

Also this week, Are Doctors Scared of Death? BMJ Careers Editor Abi Rimmer sits down in the studio with Richard Coker, Emeritus Professor of Public Health at LSHTM. Drawing from his early days as an HIV doctor during the onset of the AIDS epidemic, and later with infectious disease outbreaks in South East Asia. Professor Coker discusses the profound experiences of the end of his patients lives that shaped his new book, Timor Mortis: How We Live with Death.

Reading list:

Minimal detectable change of the Patient Health Questionnaire-9, Patient Health Questionnaire-8, and Patient Health Questionnaire-2`

Known for his use of devolved powers, during his tenure as Mayor of Greater Manchester, Andy Burnham now has the opportunity to bring his local blueprint to the national stage. But what does this mean for the future of health and social care?

Our panel explore the deeply rooted health inequalities tied to the social determinants of health, the disconnect between local decision-making and national infrastructure, and the urgent need to extend the ability to access social care to more of England's population.

We're joined by

Michael Marmot: Professor of Epidemiology and Public Health at University College London (UCL) and author of the landmark Marmot Review.

Sarah Woolnough: Chief Executive of the health think tank, The King's Fund.

Matt Sutton: Professor of Health Economics at the University of Manchester.

Reading List

Devolution can create new opportunities for better health

Will devolving powers to mayors close England’s health gap?

Andy Burnham’s goal of good growth could be a health-creating mission that supports environmental action

The King's Fund responds to Andy Burnham’s comments on social care