Doctor - Consultant / Attending Geriatrician on a career break 🇭🇰🇬🇧🇺🇸 Thinking about ageing / future of healthcare. What’s next? 🌞🌊

London & San Francisco
Joined November 2007
how it started how it’s going
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Katherine Law retweeted
The cancer-Alzheimer's paradox, an inverse correlation, with an unexplained mechanism "The risk of Alzheimer’s disease in patients with cancer is significantly reduced, and the risk of cancer in patients with Alzheimer’s disease is halved." nature.com/articles/s41514-0…
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Katherine Law retweeted
For medical information, general AI frontier models (Google, OpenAI, Anthropic) outperformed specialized @openevidence and @UpToDate as assessed by 12 US clinicians, randomized and blinded to which model and extensive testing/benchmarks. This was not anticipated. @NatureMedicine nature.com/articles/s41591-0…
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I recently took @tszzl and @RichardHanania (true story lolz-and both advisors to my new venture in full disclosure) to one of the countries largest academic medical centers. @tszzl has since wrote a viral X thread thats worth reading again xitter.cf/tszzl/status/195869377… It speaks for itself. I'll just add if he's surprised by the missing data .....he'd be further surprised by the data we do capture: fragmented, delayed, and built for billing, not clinical insight. It tells us very little about human disease and how to truly treat it. Epic Systems is at the center of this monumental failure. Simply put: AI cannot reach its full potential in medicine while Epic Systems controls the underlying data architecture. The ideas are fundamentally oppositional at their core. I explain why Epic's culture, regulatory inertia, and the staggering $1B sunk costs of its clients do not guarantee its dominance but if anything bring a slow march into irrelevance.
companies like Facebook record every imaginable interaction their users have with the platform. they log each of your clicks and taps. they keep track of how long your gaze lingered on a post, whether you were on the same WiFi as that woman who might be your friend, which instagram reel you watched three times. for a single user this is quaint, but these practices are done on a planetary scale across all technology giants. they create petabytes of data per day and keep it for as long as the European regulators will let them. then they can have machine intelligence instrument it into useful knowledge for their cybernetic control systems that build newsfeeds, serve ads, decide how much compute to spend on you, which SKUs should be in which warehouses right before you want them. the Hive metastore bills run into the billions hospitals throw most of their data and telemetry out after each case, every single day. they record videos of vascular surgeries, endoscopies, discovering interesting physiologies. sometimes they're not recorded at all and most of them the time they delete them as soon as they’re done it's even worse for physiologic waveforms (ECG, EEG, arterial lines) which are essentially never recorded anywhere at all. milisecond scale views of patient's brains, vasculatures, hearts are generated and instantly destroyed. all of these time series of course predict people's hearts stopping, brains exploding, etc ahead of time. surgeons teleoperate robots, none of the micro-movements are recorded, policies never learned, never correlated into which outcomes were successful or not this would be unthinkable to most software people whose instinct is to record everything everywhere never mind the cloud costs, because we are sure there will be some use for it later and some model to be trained later. i don't have a prescription here per se my point is just that our civilization routinely hoards and treasures some of the silliest data in the world "i pressed like on the john pork reel" & destroys much of all the most important data it generates and limits what machines can learn
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Katherine Law retweeted
Dave Ricks has been at @EliLillyandCo for 20% of its 150-year history. He came to the pub, poured his own Guinness, and gave us a 2-hour state of the pharma union: drug prices, clinical trials, patent clocks, the rise of generics, Chinese peptides, compounding pharmacies, the US healthcare system, and how the broad success of GLP-1s have transformed Lilly's business. If you've never heard Dave speak before, you're in for a treat. Timestamps: 00:00 Intro 05:08 Making R&D decisions 10:11 Clinical trials 24:59 Drug pricing 32:43 Stimulating more R&D 45:16 Pros and cons of US healthcare 58:20 New pharma business models 01:05:53 Stripe + enterprises 01:07:00 China 01:16:31 Generics 01:22:37 GLP-1s 1:37:43 r/Peptides 01:41:25 LillyDirect 01:46:35 Why do investors love LLY?
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A few months ago, we were both excited and nervous to stage a public face-off at @Harvard between “Dr. CaBot,” our AI system that simulates an @NEJM expert discussant, and a real @NEJM discussant & expert diagnostician. Today, @DhruvKhullar tells the story in The New Yorker.
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Katherine Law retweeted
Most people haven’t heard of this test, which is available in the US. It accurately predicts Alzheimer’s (not just if there’s a risk, but when). It is favorably affected by exercise and likely many other lifestyle factors. Here’s (almost) everything we know about it. In Ground Truths (link in my profile d/t X-suppression)
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Moved to SF for over a month and just realise I haven’t seen a single smoker / cigarettes??
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What an incredible week!
Top 5 advances in medicine this week (🧵) 1. Gene therapy provided sight to children born blind The 4 children had a rare form of blindness, caused by mutations in the retina gene, AIPL1 A functional copy of this gene was introduced, in one eye per patient, using the other eye as a control All of the children started to see (though imperfectly): they started to draw and write, moved around on their own, and played with others This is not the first time gene therapy has been used to treat blindness (there is even an approved therapy for inherited RPE65 mutations) This approach is now being rolled out more widely to children affected by AIPL1 deficiency Study: thelancet.com/journals/lance…
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Some of you might know that I am moving to the US and will be based in SF! Thinking about next steps and interested to meet people in medicine / health and O3 spouses wanting to hang out:)
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I am interested in health (obv) but also in other wellness pursuits - yoga, running, outdoors, vino.
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Food for thought re anticoagulation for the frailest
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Glad they made it to the horse-pital 🏥
A further update on the wellbeing of our horses following the incident on Wednesday, where some of them were spooked in central London. Every one of the horses involved continue to be cared for and closely observed. (1/3)
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"Without rehabilitation older people being discharged from hospital experience further deterioration of their health. On average 15% of older people being discharged from hospital are readmitted within 28 days." Supporting #RightToRehab via #BGSblueprint bgs.org.uk/Blueprint
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Katherine Law retweeted
IMG doctors struggle to express their achievements & sell themselves both on application forms & in the interviews due to not having a command of the English language. Here is a list of action verbs that can be used in personal statements & also during interviews while describing your achievements & CV. · Managed · Led · Coordinated · Assisted · Collaborated · Conducted · Facilitated · Developed · Implemented · Contributed · Supported · Guided · Executed · Established · Evaluated · Enhanced · Achieved · Presented · Advocated Best wishes.
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Given that older people are the main users of the NHS, and that those living with frailty have a higher risk of admission, unintended harm and delayed discharge I would say the "push" is appropriate. Agree it's disappointing this study is negative -
Given how heavily Frailty has been pushed by NHSE, a critically important study. Best practice Frailty services NOT demonstrated to improve outcomes at national level.
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NEW: we need to talk about NHS staff retention. At a time when Britain’s healthcare system is acutely short of workers, *1 in 7* UK-trained doctors are practising overseas. No other developed country is like this, which immediately tells you there’s a problem. Let’s dig deeper:
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