Health Matters | Surfing health care on a digital waveboard

This week in health: gender gap in diabetes care, the debate around generic drugs and why AI could never replace radiologists.

Updated - August 23, 2023 10:43 am IST

Published - August 22, 2023 03:20 pm IST

Image for representational purpose only.

Image for representational purpose only. | Photo Credit: The Hindu

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Health has always surfed the waves on the wave board of technology, paddling out in an embrace, first, and then, steadied on a balance by the board beneath. No doubt, the twain co-exist in an easy symbiosis and have been for a really long while now. But in the modern age, it has become difficult to ignore the connection, as tech links become more and more obvious. While no doubt, tech is an easy glider for health care, its use is not an unalloyed blessing. Particularly now, when the flavour of the season Artificial Intelligence software expanding its presence everywhere, but more so in the health care segment. While AI bots have been busily researching and writing up articles for peer-reviewed journals, once the purview of trained scientists, Poulomi Chatterjee finds out AI may not really be all that helpful. For a while now, artificial intelligence (AI) has been touted as the replacement for radiologistsGeoffrey Hinton, the godfather of AI and a former scientist at Google Brain, said in 2016 that, “It’s completely obvious that within five years, deep learning is going to do better than radiologists.”

According to a study, radiologists even performed worse when assisted by AI, and they were second-best while performing alone compared to an AI-alone diagnosis. A joint report authored by researchers from MIT and Harvard Medical School revealed that doctors actually did worse at diagnosis when working with AI. When the AI system predicted a certain diagnosis, doctors became more certain about the opposite prediction, which was the wrong one. That’s practically the surfer in the water, and worse still, the patient in hot water.

Lav Agarwal, Additional Secretary, Ministry of Health and Family Welfare addresses the media ahead of G-20 Health Ministers meeting, in Gandhinagar on August 16, 2023.

Lav Agarwal, Additional Secretary, Ministry of Health and Family Welfare addresses the media ahead of G-20 Health Ministers meeting, in Gandhinagar on August 16, 2023. | Photo Credit: ANI

It is no coincidence that the Global Initiative on Digital Health is to be launched under India’s G-20 presidency, given India’s proven capabilities in both technology and medicine. The first-of-its-kind global initiative is aimed at data convergence, interface of health platforms and investments in the digital health space around the globe. The summit which was held mid-August in Gujarat, also worked on bringing in the crucial interim Medical Countermeasure (MCM) — “which is a ‘network of networks approach’ before the next health emergency hits us and India in collaboration with WHO is leading the advocacy,” reports Bindu Shajan Perappadan.

As part of the Ayushman Bharat Digital Mission, Karnataka will set up two microsites to accelerate digital health adoption, reports Afshan Yasmeen. A microsite is a cluster of all small and mid-sized clinics, nursing homes, hospitals, labs, pharmacies, and other healthcare facilities that are ABDM-enabled and offer digital health services to patients. The path ahead clearly includes travelling on the digital highway as well. Prime Minister Modi recently emphasised that digital innovations in healthcare must be for public good, adding a note of caution and providing direction.

More on optimising digital for reaching those left out of the system: Evidence-based digital investments can help governments save up to 15% of health system costs, reach the underserved, a World Bank report found.

Interestingly, in a move that brings a sigh of relief to the professional band of doctors, health and financial influencers now need to disclose qualifications under new Advertising Standards Council of India (ASCI) guidelines. It said medical practitioners, health and fitness, and finance experts holding certifications from recognised institutions are required to “disclose” that they are certified experts and practitioners while sharing information or promoting products or services or making any health-related claims. All advertisements published by social media influencers “must carry a disclosure label that clearly identifies it as an advertisement”, the ASCI said as it issued fresh guidelines on August 17. With the damage wreaked by hordes of influencers during the pandemic, dissuading people against vaccinations and recommending all manner of random ‘health strategies’ still fresh in the collective consciousness, ASCI needs to be congratulated for its move.

Meanwhile, video giant YouTube said recently that it will remove content that promotes cancer treatments proven to be harmful or ineffective, or content that discourages viewers from seeking professional medical treatment. It will remove content that contradicts health authority guidance on the prevention and transmission of specific health conditions, and on the safety and efficacy of approved vaccines. The Google-owned company announced that it was going to define existing medical misinformation guidelines under three categories: prevention, treatment, and denial. About time, one would think, given the vast reach of this social media platform. 

That may not be an easy task though, given the range of treatments and systems of medicine on offer. While earlier there was a clear strike, from people of science in India at least, for medicine otherwise known as allopathy, prioritising scientific rigour in terms of properly regulated trials and studies to validate the methodologies, it is not so simple to pick a side now, what with the WHO asking countries to work towards unlocking the power of traditional medicine. Scientifically validating the power of these so-called alternate systems of medicine (though popular with a large section of the population) through tried and tested methods down to science, might be a good place to start, though. 

Staying on the theme, with a small inflection, Australia’s Therapeutic Goods Administration (TGA), the country’s regulator of medicines, medical devices and biologicals, issued a medical advisory last week warning Australians of the risk of liver injury from using medicines and herbal supplements containing turmeric or its active ingredient, curcumin, writes Jacob Koshy. Notably, for years, turmeric has received “worldwide attention for its anti-inflammatory and anti-oxidant mechanisms.” The TGA warning says that the risk of liver injury did not appear to relate to curcuma longa consumed in “typical” dietary amounts as a food. As a staple ingredient in South and South East Asian cuisine, turmeric is also used in Ayurvedic and Chinese-medicine concoctions. 

An issue that is likely to grow further in the near future arises out of the National Medical Commission (NMC)’s recent rule requiring all Registered Medical Practitioners (RMPs) must prescribe medications using generic names in a legible and clear manner. Siddharth Kumar Singh notes the first objections arising from physicians and pharmacists to this move. Watch this space for more content on this, as the issue evolves. 

Following the publication of the first part on the burden that women living with diabetes have to shoulder, here are the two subsequent parts, by Saumya Kalia“Who cares for women living with diabetes?” looks at how women are natural caregivers, but often when it comes to them, there’s not enough attention. The third part, looks at possible solutions: “Can community support, social welfare policies bridge the gender gap in diabetes care?”

Yet another series that you might find worth your while is the Vital Signs podcast which examines the medical education system in the country, in particular NEET conundrum as it exists in Tamil Nadu. While the first episode examines whether NEET favours wealthy, urban and CBSE Board students, in the second episode, Vignesh Radhakrishnan and Sonikka Loganathan wonder if medical education is tailored to fill the shortage of specialists in rural India.

We are keeping our eyes peeled for developments on this front. Last month, a wave of excitement swept through the world of Alzheimer’s research after Eli Lilly published the results of a trial of their drug, donanemab. They found that the drug slowed cognitive decline in 47% of those who took the drug, vis-à-vis 29% who got a placebo. ‘Slowed’ here meant staving off the disease for six months to a year, when judged by multiple factors.

For a quirky tailpiece, do read this story from Puducherry where 23 foreign objects were removed from a young man’s stomach at a private hospital. Yep, these things keep happening.

From the Health pages

If you have a few extra minutes to spare, do read:

Continue COVID-19 testing to check emergence of new virus variants: WHO chief.

AIDWA demands free food grains, health care, and cash transfers for strife-torn Manipur.

Heat stress poses health risks for salt pan workers, study finds: Serena Josephine M. reports.

India pharma ally, but must meet U.S. standards: U.S. Health Secretary.

Maui water is unsafe even with filters, one of the lessons learned from fires in California.

For our regional stories, stay on to read:

Andhra Pradesh

T. Appala Naidu writes on the woes of wombs in Andhra Pradesh’s tribal village.

Konda Reddi tribal pregnant woman is due to give birth to her fourth child in September.

Konda Reddi tribal pregnant woman is due to give birth to her fourth child in September. | Photo Credit: T. Appala Naidu

Allay apprehensions of people on fortified rice, Visakhapatnam Joint Collector tells officials.

Assam

Cutting the flab, Assam police start fitness survey.

Telangana

Hyderabad-based NGO aims to offer affordable healthcare in Telangana’s rural, semi-urban areas reports Siddharth Kumar Singh.

Marri Ramu writes on the High Court order to government to provide medical facilities at district, taluq, village levels. 

Karnataka

Egg, banana for government and aided school students from class 1 to 10 from August 18 in Karnataka.

How safe is drinking water in Karnataka?

Antara Rai Chowdhury, Divya Ravindranath talk about Karnataka’s ‘Koosina Mane’ creches | Redefining childcare.

Kerala

SOP developed for block-level antimicrobial resistance committees in Kerala.

Good response to Indradhanush 5.0 vaccination drive in Kerala.

Rajasthan

Rajasthan to become first State with digitisation of child health services.

Tamil Nadu

Remote areas in Coimbatore see very few medical camps as Mobile Medical Unit vehicles allegedly used for other purposes, says Wilson Thomas.

Chennai residents protest at Ripon Buildings demanding a probe into deaths of pregnant woman, sanitary worker, reports Aloysius Xavier Lopez.

As always, do put us on your radar, as we bring more health content your way. Get more of The Hindu’s health coverage here.

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