Health Care on Scott Gilmore, MD

Explainable Explainability for Clinical LLMs

Mon, 15 Jul 2024 00:00:00 +0000

Discussions of explainability for large language models (LLMs) tend to focus on methods that identify what parts of a neural network encode certain concepts or words, with the hope that by illuminating the meaning of parts of the LLM “black box” we can be certain of how it is making a decision. These methods resemble those used in convolutional neural network architectures processing imaging data from, say, a CT scan, where parts of the source image important to the label are highlighted to help humans understand how the categorization was performed.

Optimal Deployment of Automation in Healthcare

Sun, 07 Jul 2024 00:00:00 +0000

When we talk about implementing AI in healthcare, a lot of people envision using computers to offload part of the cognitive work related to direct patient care. Countless startups promise to reduce cost by automating, say, writing doctors notes in a more efficient way, or automatic physician messages to patients.

But a very large proportion of the cognitive work in health systems is not performed by providers, but the vast administrative staff who support them. But since clinicians are paid more for their time, that must be the highest value target for automation, right?

Exercise in a Bottle? The Promise of α-Klotho Biologics for Age-Related Cognitive Decline

Thu, 27 Jun 2024 00:00:00 +0000

I came across a recent podcast by Peter Attia M.D. where he interviews Dena Dubal M.D. Ph.D. on a potential “breakthrough in Alzheimer’s disease” in the form of α-klotho supplementation. α-klotho, often referred to as just “klotho,” is a transmembrane protein expressed in the brain, liver, and kidney. Klotho seems to have several mechanisms of control over different metabolic pathways, including insulin sensitivity, maintaining calcium homeostasis, mitigating oxidative stress and endothelial dysfunction, facilitating oligodendrocyte maturation, myelin integrity, and a host of other functions. ¹