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Josh Briscoe @jbriscoe.bsky.social · 15h

a man in a suit and tie is being touched by a woman .

ALT: a man in a suit and tie is being touched by a woman .

media.tenor.com

Reposted by Josh Briscoe

Emily Moin @emilymoin.com · 16h

I have expertise in both the technical and ethical aspects of clinical AI, so one of my most frequent refrains is that we need to separately address questions of "can we?" and "should we?"

Anyway, absolutely not.

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Reposted by Josh Briscoe

NEJM AI @ai.nejm.org · 1d

Although ML has been shown to outperform surrogate decision-makers in predicting patient preferences for CPR, the authors of a new editorial argue that ML cannot replace surrogates in making decisions for incapacitated patients. nejm.ai/3Vysymr

#AI #MedSky #MLSky

Our greatest concern as clinicians is that the data presented in this article will be interpreted by the media and other readers as evidence that ML can replace surrogates in end-of-life decision-making.

“Machine Learning Cannot Replace Surrogate Decision-Makers in Resuscitation Decisions for Incapacitated Patients” by Robert D. Truog, M.D., M.A., and R. Sean Morrison, M.D.

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Josh Briscoe @jbriscoe.bsky.social · 4d

The sad thing about this is clinicians are so beleaguered by the burdens of the EMR, they'll take any port in a storm without fully appreciating the hidden costs. It looks very official to study things like data privacy but overlook the surveillance risks. #ai #medsky

Josh Briscoe @jbriscoe.bsky.social · 5d

The ambient AI scribe revolution - how it's going: jamanetwork.com/journals/jam... #medsky #ai and...

Ambient AI Scribe Early Gains and Open Questions

Ambient artificial intelligence (AI) scribes are the fastest adopted and most widely implemented generative AI health care solution to date. Currently, these tools listen to an ambulatory encounter an...

jamanetwork.com

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Josh Briscoe @jbriscoe.bsky.social · 5d

The evidence I've seen suggests patients do not like their clinicians typing away looking at a computer screen as they attempt to share sensitive details about their health. Presumably ambient AI scribing might fix this, but I have my doubts because clinicians have many reasons not to listen well.

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Josh Briscoe @jbriscoe.bsky.social · 5d

I’m amazed anyone could believe that once an AI scribe saves a clinician time, administrators will leave the reclaimed time untouched. If a clinician could see 14-16 patients in a day without an AI scribe (already a number too high for primary care and most sub-specialties), surely they could see 20-25 patients with an AI scribe. The encounters become shorter because what is expected isn’t human connection but a technical service rendered ever more efficiently by other tools in the AI suite. That reclaimed, unbillable time shouldn’t be given back to those 14-16 patients because presumably those encounters are already optimized. It should be given to 6-9 other patients who can be seen today instead of next week. This isn’t good for the clinicians but the encounter isn’t about them. They are parts in the machine, and may soon be expunged by AI anyway. Ironically, neither is it good for the patient who finds themselves treated as a bureaucratic client, a machine, or an animal, depending on the flavor of dehumanization their condition warrants.

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Josh Briscoe @jbriscoe.bsky.social · 5d

...where I worry it's headed: familymeetingnotes.substack.com/p/where-the-... #medsky #ai

Dr. Paisley’s brow furrowed. “I will say, it looks like you’re spending about an average of three minutes per encounter on non-clinical chatter. Hmm. The weather, patient vacations. Of course, of course we want our patients to feel welcome, but…” A pie chart grew on the wall. “If you reduce that to just one minute, you’ll be able to see seven more patients in a day! Goodness, look at that. Three minutes of non-clinical puts you in the bottom 10th percentile. Friendly, but inefficient!” An item popped up on Winston’s to do list at the bottom right hand corner of the wall: Complete efficiency module #151.

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Josh Briscoe @jbriscoe.bsky.social · 5d

The ambient AI scribe revolution - how it's going: jamanetwork.com/journals/jam... #medsky #ai and...

Ambient AI Scribe Early Gains and Open Questions

Ambient artificial intelligence (AI) scribes are the fastest adopted and most widely implemented generative AI health care solution to date. Currently, these tools listen to an ambulatory encounter an...

jamanetwork.com

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Reposted by Josh Briscoe

josh farkas 💊 @pulmcrit.bsky.social · 6d

be kind and give your patients a REGULAR DIET

caffeine-free diets ➡️ caffeine withdrawal

sodium-restricted diets aren't evidence-based (use diuretics to balance volume)

treat hyperglycemia with insulin (not by artificially restricting carbs)

(renal diet for hyperkalemic renal failure = exception)

a man in scrubs is eating a piece of food while sitting in a hospital bed .

ALT: a man in scrubs is eating a piece of food while sitting in a hospital bed .

media.tenor.com

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Reposted by Josh Briscoe

Shannon Vallor @shannonvallor.bsky.social · 6d

Since it resonated with the audience, I’ll recap my main argument against AGI here. ‘General intelligence’ is like phlogiston, or the aether. It’s an outmoded scientific concept that does not refer to anything real. Any explanatory work it did can be done better by a richer scientific frame. 1/3

Shannon Vallor @shannonvallor.bsky.social · 6d

This was a truly heartening day, with deeply thoughtful challenges to the dominant narrative framed around AGI, coming from across disciplines and perspectives. Felt like the tide might finally be turning a bit, at least among the scientific community. Thanks @royalsociety.org!

Anil Seth @anilseth.bsky.social · 7d

1/2 I'm looking forward to taking part in a panel on AGI and the Turing Test, tomorrow afternoon (Thurs 2nd Oct) at the @royalsociety.org, w/ Dame Wendy Hall, Shannon Vallor, William Isaac, & Sir Nigel Shadbolt. royalsociety.org/science-even...

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Reposted by Josh Briscoe

Boze the Library Owl @sketchesbyboze.bsky.social · 7d

The part of Orwell's 1984 that everyone forgets is how human music has been replaced by soulless, machine-generated pop songs. The AI attempt to take over the film and music industries is an attack on the human spirit. Boycott AI actors. Boycott AI bands. Support human artists.

“There was a whole chain of separate departments dealing with proletarian literature, music, drama, and entertainment generally. Here were produced rubbishy newspapers containing almost nothing except sport, crime, and astrology, sensational five-cent novelettes, films oozing with sex, and sentimental songs which were composed entirely by mechanical means on a special kind of kaleidoscope known as a versificator.”

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Reposted by Josh Briscoe

Christianity Today @christianitytoday.com · 7d

“We are created not to be whole alone but to become whole together,” writes John Swinton.

“Any account of the imago Dei that cannot make theological sense of the person in decline, distress, or dependency is not merely incomplete; it is false.”

It Was ‘Good,’ Not Perfect - Christianity Today

The language of creation can reframe the way we view people with disabilities in the church.

www.christianitytoday.com

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Josh Briscoe @jbriscoe.bsky.social · 10d

My own reflections on using a machine to act as a surrogate decision-maker. When machine's set the standard, humans won't keep up, but will fall over ourselves trying: familymeetingnotes.substack.com/p/a-machine-...

A Machine Better Than Family

Artificial Surrogate Decision-Makers (i.e., the Patient Preference Predictor)

familymeetingnotes.substack.com

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Josh Briscoe @jbriscoe.bsky.social · 10d

The accompanying editorial by Truog and Morrison shines light on some obvious problems: ai.nejm.org/doi/full/10....

Machine Learning Cannot Replace Surrogate Decision-Makers in Resuscitation Decisions for Incapacitated Patients

Although machine learning has been shown to outperform surrogate decision-makers in predicting patient preferences for cardiopulmonary resuscitation, the authors argue that ML cannot replace surrog...

ai.nejm.org

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Josh Briscoe @jbriscoe.bsky.social · 10d

Hope springs eternal: ai.nejm.org/doi/full/10.... #hapc #medsky #ai

Machine Learning–Based Patient Preference Prediction: A Proof of Concept

Respecting patient autonomy and delivering goal-concordant care require an understanding of individual preferences. However, the preferences of incapacitated patients are often unknown and substitu...

ai.nejm.org

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Reposted by Josh Briscoe

Jack Iwashyna @iwashyna.bsky.social · 12d

Raiffa’s footnotes are great:

“One of the most popular paradigms in the theory of mathematics describes the case in which a researcher has either to accept or reject a so-called null hypothesis…

Cover of Howard Raiffa Decision Analysis

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Josh Briscoe @jbriscoe.bsky.social · 18d

And the episode of @geripal.bsky.social ! geripal.org/what-makes-a...

What Makes a Good Death? Karen Steinhauser, Rasa Mikelyte, Edison Vidal

In today’s podcast we discuss what makes a good death for patients close to end of life and those with dementia with guests Karen Steinhauser, Rasa Mikelyte, and Edison Vidal.

geripal.org

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Josh Briscoe @jbriscoe.bsky.social · 18d

A response to a thought-provoking conversation on @geripal.bsky.social familymeetingnotes.substack.com/p/whats-a-go... #medsky #hapc

What's a Good Death...

...apart from a good life?

familymeetingnotes.substack.com

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Josh Briscoe @jbriscoe.bsky.social · 20d

youtube.com/shorts/-gAys...

The cost of a CPR attempt

YouTube video by How To Train Your Doctor

youtube.com

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Reposted by Josh Briscoe

Brent Toderian @brenttoderian.bsky.social · Aug 29

“Over the past 20 years, Paris has undergone a major physical transformation, trading automotive arteries for bike lanes, adding green spaces and eliminating 50,000 parking spaces.

Part of the payoff has been invisible — in the air itself.”

Leadership, strategy, real action, common sense. #Paris

Paris said au revoir to cars. Air pollution maps reveal a dramatic change.

Air pollution fell substantially as the city restricted car traffic and made way for parks and bike lanes.

www.washingtonpost.com

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Reposted by Josh Briscoe

Dr Rachel Clarke @drrachelclarke.com · Aug 30

Most doctors, most of the time, draw on their years (decades, in my case) of medical training & expertise to do the best we can for you.

What distinguishes us from snake oil salesmen - persuasive grifters who prey on human fears to line their pockets - is our expertise & our integrity.

Trust… 1/n

Republicans Against Trumpism @rpsagainsttrump.bsky.social · Aug 29

RFK Jr: We need to stop trusting the experts... Trusting the experts is not a feature of science or democracy, it's a feature of religion and totalitarianism.

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Josh Briscoe @jbriscoe.bsky.social · Aug 30

The work of rebuilding trust is going to take patience, listening, and grace.

Josh Briscoe @jbriscoe.bsky.social · Aug 30

Earning back trust is going to take more, a lot more, than stomping our feet, pointing at our diplomas and certifications, and making fun of the populists. If we just attack those we think are grifters, we'll distance ourselves from our patients who are buying their snake oil.

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Josh Briscoe @jbriscoe.bsky.social · Aug 30

Edmund Pellegrino once observed that the therapeutic relationship is "a peculiar constellation of urgency, intimacy, unavoidability, unpredictability, and extraordinary vulnerability." That means it's sensitive to distrust: why submit to that role if I can do something else? #medsky

Republicans Against Trumpism @rpsagainsttrump.bsky.social · Aug 29

RFK Jr: We need to stop trusting the experts... Trusting the experts is not a feature of science or democracy, it's a feature of religion and totalitarianism.

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Reposted by Josh Briscoe

The New York Times @nytimes.com · Aug 28

Physicians are using A.I. for diagnoses and more. But a new study found evidence that relying on A.I. tools might erode a doctor’s ability to perform fundamental skills without the technology, a phenomenon known as “deskilling.”

Are A.I. Tools Making Doctors Worse at Their Jobs?

Physicians are using the technology for diagnoses and more — but may be losing skills in the process.

nyti.ms

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