AI applied to cardiometabolic prevention & multimodality cardiovascular imaging; Posts may be my opinions & are not medical advice; RT≠endorse

Ann Arbor, MI
My tweets are not a news outlet (i.e. "All the News That's Fit to Print"). I tweet what I find interesting. I don't tweet things that are stated frequently or better by others. My goal is not to please all readers but simply to amuse myself.
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Venk Murthy MD PhD retweeted
Interesting study with obvious flaws. Some plaque regression is possible with very intensive lipid lowering 1. LDLc 69.5 v/s 42.5 mg/dL explains this regression? 2. Or is it the Statin chosen (Atorva v/s Rosuva), the dose (Rosuva 40 = Atorva 80) 3. Or is it the Ezetimibe add that mattered. Surrogates addressed here. What about clinical benefit? I always suspect resurgence of statin-lipid lowering is a backdoor for injectables for primary prevention @anish_koka @venkmurthy @VPrasadMDMPH
🫀 Can coronary atherosclerosis actually regress? Our new randomized FLOWPROMOTE trial analysis, published TODAY in JAMA Cardiology, shows remarkable coronary plaque regression with intensive LDL-C lowering! Atherosclerosis is not necessarily a one-way process. 📄 JAMA Cardiology: doi.org/10.1001/jamacardio.2… #Atherosclerosis #LDL #Cardiology #CCTA
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Well stated critique of deep issue with academic research and how AI may help
People who have been in research fields develop a felt sense that most "research" (in almost any field that isn't exactingly technical) is research theater, and many superstar careers enjoy star status not because of a unique connection to the truth but because of a unique connection with an audience. No one really has the time or stature to, from a position of objectivity and trust, bring popular researchers to heel. But it will get increasingly hard to hide from serious critique. The machines can do critique now, at the level of depth and rigor previously only possible for the academically deranged. We're going to have to revise a lot of what we "know" about the world that isn't really knowledge but is actually just received popular consensus - like floating voltages without grounding wires. The grounding wires are coming.
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Venk Murthy MD PhD retweeted
I’ll never forget how sad I was the week of May 23, 1994 when this aired. I’ll never forget how sad I am today.
tvshowclips
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Like many, I went from using books (mostly O'Reilly menagerie but some preceding them too) to Stack Overflow and related sites to LLMs Each step was a one way rachet upward in productivity but also left some sadness for the loss of what came before
New record for Stack Overflow: <1000 questions posted last month
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Reviewer quality is an issue but ultimately the decision is one the editors make at most journals Are we ready for AI to take on the editor role?
I believe firmly that AI manuscript review will make science better. Often, low-quality papers slip through and get published, even in high impact journals, because they somehow escaped review by a high-quality human. It's the variance of review quality, not the median, that remains the largest problem with human manuscript review.
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Many academic stories are about to be overturned The question is whether academics will take this to heart or if they will largely shrug as they have done before? H/t @zakkohane
Tyler Cowen: 'I am not even sure what to say at this point. We need a radical revaluation of this work, and of the associated policy arguments. More generally, this is only a single step in the story of how AI is going to revise economic science, and indeed past research more generally. As I stress in many of my recent talks, there will be significant gains and losses in status, with the losses often outweighing the gains. I see this as one of those cases.'
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Heros have scars
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Replying to @venkmurthy
The use of AI and healthcare extenders should be a platform for considering an entire revamping of medical education and how our healthcare is delivered. The critical issue is to learn how to learn, not just the facts, which has been a major emphasis of the pre-medical pathway as well as medical education. This ancient approach will need to change very rapidly.
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Unexpected consequences are common and often problematic
Replying to @JoelDeTeves
Anthropic/OpenAI (and all other Frontier AI companies for that matter) are causing a paradox. They're trying so desperately hard to avoid agents doing "bad things" but in the act of being so cautious and restrictive, are causing the rise in abliterated/uncensored models.
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Some medical societies bring in retired politicians to talk about the past for their keynotes, others bring in Nobel scientists to talk about the future!
Craig Mello kicking off the nephrology meeting ! @ASNKidney RNA medicines and oligo therapies will be the next generation cures for the kidney patients
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Venk Murthy MD PhD retweeted
We can't brute force compute all possible moves in Go, a static game with a simple 19 x 19 grid, yet somehow people think we're going to simulate a dynamic system of trillions of cells each containing trillions of molecules.
If you had an exponential amount of compute you could solve simulate biology exactly and wouldn't need to run any experiments. Some of you will think "of course, but that's an unrealistic assumption" and others will think "no, you need experiments even with that much compute. That's just How It's Done". You would of course need evaluations once you have a solution, but you don't in principle need experiments to find it: Experiments are a way to save compute, dating from a time when it was much more expensive. And I think the presentation is exponential but real systems aren't irreducibly exponential. AlphaFold worked, after all.
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Venk Murthy MD PhD retweeted
Updated intro2echo.com with sections on structural heart echo. Walks through the steps for TAVR, mTEER, and tTEER. This includes 3D models as well as simulated 2D ultrasound images. Would appreciate feedback and suggestions for improvement! intro2echo.com/#mteer
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This cycle is broken. Important results should be released when they are ready, not because of hype cycles around major meetings!
The leaked Merck vaccine data @myESMO underscore the challenges of the orchestrated theater of Act 1, company press release -> Act 2 hold data -> Act 3 public report at major meetings. Act 2, the hold phase, builds excitement for the company & discussion but inevitably there are data shared with KOLs and other stakeholders. $MRNA rose 276% (🔼mkt cap $40+B) on press release and fell 18% (🔽$12B) on leak. Seems unclear how this orchestration helps patients or actual research. To the extent there is peer review, it is done by the journals and not the meeting organizers themselves. @adamfeuerstein @matthewherper wsj.com/health/pharma/modern…
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Venk Murthy MD PhD retweeted
So the media and KOLs failed miserably in carrying their water based on press release without any data. What.A.Shocker What do you call failing over and over?
The leaked Merck vaccine data @myESMO underscore the challenges of the orchestrated theater of Act 1, company press release -> Act 2 hold data -> Act 3 public report at major meetings. Act 2, the hold phase, builds excitement for the company & discussion but inevitably there are data shared with KOLs and other stakeholders. $MRNA rose 276% (🔼mkt cap $40+B) on press release and fell 18% (🔽$12B) on leak. Seems unclear how this orchestration helps patients or actual research. To the extent there is peer review, it is done by the journals and not the meeting organizers themselves. @adamfeuerstein @matthewherper wsj.com/health/pharma/modern…
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Yep. And because of caps on some overall buckets of Medicare spend, one day this could manifest in further cuts to physician payments!
Medicine will be the only field in which AI increases cost. Why are doctors allowing AI companies to feed off of the Physician Fee Schedule?
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Same thing is happening for ECGs and about to happen for echocardiograms
Medicare paying hospitals an extra $137.53 for a chest CT they run thru AIDoc Multi-Triage CT Body software, meanwhile rad actually reading the study only makes about $49. Makes sense. radiologybusiness.com/topics…
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Venk Murthy MD PhD retweeted
Medicare paying hospitals an extra $137.53 for a chest CT they run thru AIDoc Multi-Triage CT Body software, meanwhile rad actually reading the study only makes about $49. Makes sense. radiologybusiness.com/topics…
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