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As a fourth-year ophthalmology resident at Emory University School of Medicine, Riley Lyons biggest responsibilities include triage: When a patient comes in with an eye-related complaint, Lyons must make an immediate assessment of its urgency. Use Our Content

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He often finds patients have already turned to Dr. Google. Online, Lyons said, they are likely to find that any number of terrible things could be going on based on the symptoms that they’re experiencing.

So, when two of Lyons fellow ophthalmologists at Emory came to him and suggested evaluating the accuracy of the AI chatbot ChatGPT in diagnosing eye-related complaints, he jumped at the chance.

In June, Lyons and his colleagues reported in medRxiv, an online publisher of health science preprints, that ChatGPT compared quite well to human doctors who reviewed the same symptoms and performed vastly better than the symptom checker on the popular health website WebMD. And despite the much-publicized hallucination problem known to afflict ChatGPT its habit of occasionally making outright false statements the Emory study reported that the most recent version of ChatGPT made zero grossly inaccurate statements when presented with a standard set of eye complaints.

The relative proficiency of ChatGPT, which debuted in November 2022, was a surprise to Lyons and his co-authors. The artificial intelligence engine is definitely an improvement over just putting something into a Google search bar and seeing what you find, said co-author Nieraj Jain, an assistant professor at the Emory Eye Center who specializes in vitreoretinal surgery and disease.

But the findings underscore a challenge facing the health care industry as it assesses the promise and pitfalls of generative AI, the type of artificial intelligence used by ChatGPT: The accuracy of chatbot-delivered medical information may represent an improvement over Dr. Google, but there are still many questions about how to integrate this new technology into health care systems with the same safeguards historically applied to the introduction of new drugs or medical devices.

The smooth syntax, authoritative tone, and dexterity of generative AI have drawn extraordinary attention from all sectors of society, with some comparing its future impact to that of the internet itself. In health care, companies are working feverishly to implement generative AI in areas such as radiology and medical records. Email Sign-Up

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When it comes to consumer chatbots, though, there is still caution, even though the technology is already widely available and better than many alternatives. Many doctors believe AI-based medical tools should undergo an approval process similar to the FDAs regime for drugs, but that would be years away. Its unclear how such a regime might apply to general-purpose AIs like ChatGPT.

There’s no question we have issues with access to care, and whether or not it is a good idea to deploy ChatGPT to cover the holes or fill the gaps in access, it’s going to happen and it’s happening already, said Jain. People have already discovered its utility. So, we need to understand the potential advantages and the pitfalls.

The Emory study is not alone in ratifying the relative accuracy of the new generation of AI chatbots. A report published in Nature in early July by a group led by Google computer scientists said answers generated by Med-PaLM, an AI chatbot the company built specifically for medical use, compare favorably with answers given by clinicians.

AI may also have better bedside manner. Another study, published in April by researchers from the University of California-San Diego and other institutions, even noted that health care professionals rated ChatGPT answers as more empathetic than responses from human doctors.

Indeed, a number of companies are exploring how chatbots could be used for mental health therapy, and some investors in the companies are betting that healthy people might also enjoy chatting and even bonding with an AI friend. The company behind Replika, one of the most advanced of that genre, markets its chatbot as, The AI companion who cares. Always here to listen and talk. Always on your side.

We need physicians to start realizing that these new tools are here to stay and they’re offering new capabilities both to physicians and patients, said James Benoit, an AI consultant. While a postdoctoral fellow in nursing at the University of Alberta in Canada, he published a study in February reporting that ChatGPT significantly outperformed online symptom checkers in evaluating a set of medical scenarios. They are accurate enough at this point to start meriting some consideration, he said.

Still, even the researchers who have demonstrated ChatGPTs relative reliability are cautious about recommending that patients put their full trust in the current state of AI. For many medical professionals, AI chatbots are an invitation to trouble: They cite a host of issues relating to privacy, safety, bias, liability, transparency, and the current absence of regulatory oversight.

The proposition that AI should be embraced because it represents a marginal improvement over Dr. Google is unconvincing, these critics say.

That’s a little bit of a disappointing bar to set, isn’t it? said Mason Marks, a professor and MD who specializes in health law at Florida State University. He recently wrote an opinion piece on AI chatbots and privacy in the Journal of the American Medical Association. I don’t know how helpful it is to say, Well, let’s just throw this conversational AI on as a band-aid to make up for these deeper systemic issues, he said to KFF Health News.

The biggest danger, in his view, is the likelihood that market incentives will result in AI interfaces designed to steer patients to particular drugs or medical services. Companies might want to push a particular product over another, said Marks. The potential for exploitation of people and the commercialization of data is unprecedented.

OpenAI, the company that developed ChatGPT, also urged caution.

OpenAIs models are not fine-tuned to provide medical information, a company spokesperson said. You should never use our models to provide diagnostic or treatment services for serious medical conditions.

John Ayers, a computational epidemiologist who was the lead author of the UCSD study, said that as with other medical interventions, the focus should be on patient outcomes.

If regulators came out and said that if you want to provide patient services using a chatbot, you have to demonstrate that chatbots improve patient outcomes, then randomized controlled trials would be registered tomorrow for a host of outcomes, Ayers said.

He would like to see a more urgent stance from regulators.

One hundred million people have ChatGPT on their phone, said Ayers, and are asking questions right now. People are going to use chatbots with or without us.

At present, though, there are few signs that rigorous testing of AIs for safety and effectiveness is imminent. In May, Robert Califf, the commissioner of the FDA, described the regulation of large language models as critical to our future, but aside from recommending that regulators be nimble in their approach, he offered few details.

In the meantime, the race is on. In July, The Wall Street Journal reported that the Mayo Clinic was partnering with Google to integrate the Med-PaLM 2 chatbot into its system. In June, WebMD announced it was partnering with a Pasadena, California-based startup, HIA Technologies Inc., to provide interactive diital health assistants. And the ongoing integration of AI into both Microsofts Bing and Google Search suggests that Dr. Google is already well on its way to being replaced by Dr. Chatbot.

This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation. Related Topics California Health Industry States Georgia Contact Us Submit a Story Tip

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Budget 2025 income tax U-turn: What the hell just happened?

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Budget 2025 income tax U-turn: What the hell just happened?

What the hell’s just happened? 

On Thursday night I was told that Chancellor Rachel Reeves and Prime Minister Sir Keir Starmer were now not going to raise income tax, having had anonymous briefings for weeks that a manifesto-breaking tax rise was coming, culminating in the speech in Downing Street by the chancellor last week alluding to that.

Politics live: U-turn on budget income tax rise triggers ‘not normal’ market volatility

I had also heard the prime minister was going to make a speech next week to the same effect.

The U-turn – first broken in the Financial Times – was not something the government wanted to leak, and there is anger in Downing Street.

I was told late last night by a source that the decision had been taken to back off income tax rises.

There is obviously some consternation, to say the least, that ministers, the party, the public have been marched up the hill, only to be marched back down again. It all adds to a sense of chaos and a government out of control. So what on earth is going on?

Read more: How No 10 plunged itself into crisis

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‘Bombshell’ over income tax

Let’s first do the economics of it. I was told this morning by Treasury sources that the fiscal forecasts from the Office of Budget Responsibility are stronger than expected.

There had been expectations of a £30bn-£40bn black hole in the public finances.

But I’m told today that black hole is actually closer to £20bn: the chancellor also wants headroom of perhaps up to £15bn, but I’m told the change in forecasts has changed the calculation. I’m told wage growth has been stronger which has helped tax receipts and improved forecasts.

So, where does that leave the government? Treasury figures tell me that the change in forecasts mean the manifesto-busting income tax hike is now not necessary.

I don’t need to spell out the jeopardy for such a move: Rachel Reeves was poised to be the first chancellor in 50 years to raise the basic rate of income tax and break the core manifesto pledge that Labour made to voters last year.

It doesn’t mean taxes are not going up. The government is set to freeze tax thresholds for another two years from 2028. That will raise around £8bn as millions of workers are dragged into higher tax bands and end up paying more tax.

There will also be tax raising around pensions and salary sacrifice schemes and on electric vehicles, as well as other measures, as the chancellor casts around for £20bn.

But what about the politics? Well, one government figure today insists that the decision to drop the income tax plan is nothing to do with the self-inflicted leadership crisis at No 10 after anonymous briefings designed to see off any potential post-budget coup against the prime minister spectacularly backfired. The changed forecasts, I’m told, came in last week.

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But of course there’s tonnes of politics in this. The talk of higher wage growth perhaps offsetting some of the productivity downgrades was being flagged a couple of weeks back, before the chancellor made her speech.

It’s extremely unusual for a chancellor to pitch-roll their budget. But Reeves did it for a reason.

That was laying the ground for a massive budget that would bring manifesto-breaking tax rises.

She told us of the difficult environment, ruled out more borrowing or spending cuts before telling us “everyone must play their part”. She repeatedly refused to stick to manifesto promises on tax. It doesn’t get much more stark than that.

That the government has U-turned on that decision is about far more than just the fiscal framework.

Read more: What taxes could go up now?

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Wes Streeting: Faithful or traitor? Beth Rigby’s take

With trust so low in the government, there were serious worries – and warnings – from the party that such a big manifesto break might be something from which the PM and the chancellor wouldn’t recover.

One senior party figure that thinks there could be a leadership challenge after the May elections told me this week that manifesto-breaking tax rises would only make that more likely because Labour would “need a clean skin” to try and rebuild with the public if Starmer broke his promises in that way.

Read more: Is Starmer ‘in office but not in power’?

Lucy Powell, the deputy Labour leader, fired a warning shot last week when she said the party should stick to the manifesto and not raise tax: “We should be following through on our manifesto, of course. There’s no question about that,” she told Matt Chorley on BBC Radio 5 Live.

“Trust in politics is a key part of that because if we’re to take the country with us then they’ve got to trust us and that’s really important too.”

The party will no doubt feel relief today that the chancellor is not going to break the manifesto.

It would have only made things a whole lot worse for a government that is in real trouble.

But the shambles of this week is staggering. From the self-inflicted leadership crisis to leaks over a massive budget U-turn, it all lends to the sense that this is a No 10 out of control, lurching from one mess to another. Strap in.

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Banksy painting theft lands burglar with 13-month prison sentence

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Banksy painting theft lands burglar with 13-month prison sentence

A man has been given a 13-month prison sentence for stealing Banksy’s famous Girl With Balloon painting from a London gallery.

Larry Fraser, 49, of Beckton, east London, was sentenced on Friday after pleading guilty to one count of non-residential burglary at Kingston Crown Court on 9 October.

The painting, one of the street artist‘s most famous, was stolen from a gallery in New Cavendish Street in London at around 11pm on 8 September last year.

The recovered painting back in the gallery. Pic: Metropolitan Police
Image:
The recovered painting back in the gallery. Pic: Metropolitan Police

Fraser used a hammer to smash his way through a glass entrance door at the Grove Gallery before stealing the artwork, which was valued at £270,000.

He concealed his identity with a mask, hooded jacket and gloves, but the Metropolitan Police’s Flying Squad was able to identify him and track him to a location streets away.

He was also caught on CCTV loading the artwork into a van before fleeing the scene.

A second man, 54-year-old James Love, was accused of being the getaway driver in the burglary, but cleared of stealing the print.

Larry Fraser. Pic: Metropolitan Police
Image:
Larry Fraser. Pic: Metropolitan Police

Damage to the Grove Gallery after the theft. Pic: Metropolitan Police
Image:
Damage to the Grove Gallery after the theft. Pic: Metropolitan Police

Fraser was arrested at his home address on 10 September, within 48 hours of the burglary, and charged the next day.

Officers were able to recover the artwork after executing a warrant on the Isle of Dogs. It has now been returned to the gallery.

Fraser pleaded to the court that he was struggling with a historic drug debt and agreed to steal the work “under a degree of pressure and fear”.

He said he did not know what he would be stealing, nor its value, until the day of the offence.

Fraser was caught on CCTV taking the painting away from the gallery. Pic: Metropolitan Police
Image:
Fraser was caught on CCTV taking the painting away from the gallery. Pic: Metropolitan Police

Jeffrey Israel, defending, said Fraser lived with his mother as her principal carer, and had only managed to “break his cycle of drug addiction” after his last prison sentence.

He added that it “would take a bold advocate” to suggest that the value of the print had increased by the burglary, but insisted “that is probably the reality”.

Read more:
Banksy artwork ‘worth millions’ scrubbed off wall outside court
Blink-182 star to auction rare Banksy worth millions

Judge Anne Brown was unmoved, however, and said the offence was “simply too serious” for a suspended sentence.

“This is a brazen and serious non-domestic burglary,” she said.

“Whilst you did not know the precise value of the print, you obviously understood it to be very valuable.”

She added: “Whilst I am sure there was a high degree of planning, this was not your plan.”

However, Fraser may be eligible for immediate release due to time spent on electronic curfew.

Detective Chief Inspector Scott Mather, who led the Met’s investigation, said: “Banksy’s Girl With Balloon is known across the world – and we reacted immediately to not just bring Fraser to justice but also reunite the artwork with the gallery.

“The speed at which this took place is a testament to the tireless work of the flying squad officers – in total it took just four days for normality to be restored.”

The 2004 artwork was part of a £1.5m collection of 13 Banksy pieces at the gallery.

Gallery manager, Lindor Mehmetaj, said it was “remarkable” for the piece to have been recovered after the theft.

The 29-year-old said: “I was completely, completely shocked, but in a very, very positive way when the Flying Squad showed me the actual artwork.

“It’s very hard to put into words, the weight that comes off your shoulders.”

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Summer camp leader pleads guilty to drugging and sexually assaulting two boys

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Summer camp leader pleads guilty to drugging and sexually assaulting two boys

A former vet has admitted drugging and sexually assaulting two boys at a summer camp and child cruelty towards six other victims.

Jon Ruben, 76, of Nottinghamshire, admitted sexual assault of a child under 13, assault of a child under 13 by penetration, eight counts of child cruelty, three counts of making indecent images of children and four drugs charges.

Leicester Crown Court was told Ruben, who prosecutors said had run a holiday camp for at least 27 years, laced sweets with tranquilising drugs and attacked two children after asking youngsters to play “a sweet game”.

Ruben denied a charge of assault by penetration which prosecutors have been given two weeks to consider if they will proceed with.

Prosecutor Mary Prior KC said the charges related to a summer camp held at rented premises near a village in Leicestershire last summer.

The prosecutor told the court: “The defendant, for at least 27 years, has run a holiday camp.

“There is a long history of children feeling sick at the camp over many years.”

The rented premises, Stathern Lodge, were not connected to the camp itself, the court heard, and Ruben was in charge of youngsters there, Ms Prior said.

“He made the rules,” she added. “For many years he has played what he calls a sweet game with the children in which he goes into the bedrooms.

“The game is that each has to eat really sticky sweets as quickly as they can but they must chew them.

“Children have always felt ill the next day but he explained it as they were overwrought.”

Ruben was remanded in custody until a further hearing at the same court on 28 November.

Temporary Detective Chief Inspector Neil Holden said: “This has been a horrific, complex and emotional investigation involving multiple young, innocent, vulnerable victims and a man who committed the vilest crimes.

“Our focus today must of course remain on the young victims and with the support of partners and dedicated family liaison officers, we have and continue to support their welfare and to ensure their safeguarding going forward.”

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