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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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Heathrow warns of delays as cyber attack disrupts European airports

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Heathrow warns of delays as cyber attack disrupts European airports

European airports – including London’s Heathrow – are warning of delays after a “technical issue” affected check-in and boarding systems.

Brussels Airport said a cyber attack was causing the disruption, as it confirmed 10 flights had been cancelled and 17 flights were experiencing delays of more than one hour.

“It is still too early to say when the problem will be resolved,” it said.

Berlin Airport is also among those experiencing delays.

The attack targeted a business providing check-in and boarding systems for several airlines around the world.

With automated systems down, staff are having to conduct manual check-in and boarding procedures, according to Brussels Airport.

“This has a large impact on the flight schedule and will unfortunately cause delays and cancellations of flights,” it said in a statement on its website.

Heathrow warned of delays caused by “a technical issue” at a third-party supplier and told passengers to check the status of their flight before travelling to the airport.

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Less camp, more conservative – welcome to Russia’s alternative Eurovision

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Less camp, more conservative - welcome to Russia's alternative Eurovision

Banned from Eurovision after its invasion of Ukraine, Russia will hold a rival international song contest on Saturday, with an emphasis on “traditional values”.

Instead of camp, think conservative – patriotic pop with a PG-rating.

“Intervision” was launched under the order of Vladimir Putin, with the hope it would serve as an expression of Moscow’s international pulling power.

Intervision decorations in  Red Square, Moscow, ahead of the contest
Image:
Intervision decorations in Red Square, Moscow, ahead of the contest

There are contestants from 23 countries, which are a mixture of Russia’s allies old and new, including Belarus, Cuba and Tajikistan as well as China, India and Saudi Arabia.

The odd one out is the United States, who’ll be represented by an artist called “Vassy”. She’s not part of an official delegation, but an American voice is still a coup for the Kremlin, which will seek to use this contest as proof of the West’s failure to isolate Russia on the global stage.

‘War whitewash’

Intervision is not entirely new. It was originally launched in the 1960s as an instrument of Soviet soft power, before largely fading from view in the 1980s.

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According to Moscow, its revival has nothing to do with politics. But Ukraine has condemned it as propaganda, and an attempt to whitewash Russia’s war.

It was a point I put to some contestants after their final press conferences, but it didn’t go down well.

“We don’t think like that, we are here to spread peace,” India’s Rauhan Malik told me, when I asked if his participation was a show of support for Russia’s invasion.

Malik, one of the contestants
Image:
Malik, one of the contestants

“Are you not turning a blind eye to Russia’s aggression?” I countered.

“I have no idea about it,” he said. “I have no idea about the current situation that’s happening. I don’t want to speak about that as well.”

Eurovision legends Abba would almost certainly not make the Russian contest guest list. Pic: AP
Image:
Eurovision legends Abba would almost certainly not make the Russian contest guest list. Pic: AP

Really? He had no idea? But before I could go on, I felt a forceful hand on my shoulder and a minder stepped in.

The intervention was even quicker when it came to speaking to Brazil’s act. As soon as I mentioned the word Ukraine, I was drowned out by shouts of “no, no, no, no” and the duo were ushered away.

Brazilian contestants, duo Luciano Calazans and Thais Nader
Image:
Brazilian contestants, duo Luciano Calazans and Thais Nader

Where’s the glitter?

Intervision is not just a reaction to Russia’s recent exclusion from Eurosivion, however, it’s also a reaction to the contest’s values and what it’s come to represent.

Its celebration of sexual diversity and LGBTQ+ rights are seen as a symbol of what the Kremlin calls the West’s moral decline. In contrast, Intervision organisers say their contest will promote “traditional, family values.”

Judging by the costumes on show ahead of last week’s draw, that translates to less glitter, more embroidery, with a thematic emphasis on national heritage.

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So what do Russians think of Intervision’s resurrection? Can it replace Eurovision?

“We don’t miss Eurovision,” Galina and Tatiana say, underneath a collection of purple and pink ‘Intervision’ flags near Red Square.

“It was so horrible, especially lately. We didn’t like watching it at all.”

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Why are countries boycotting Eurovision?

Polina agrees, believing Russia’s version will be “more interesting”.

“Many countries that participated in Eurovision want to boycott it, so it’s interesting to see a more peaceful event now,” she says.

Igor is more circumspect. “I’d like to believe that this isn’t a political event,” he says, “but rather an event that unites nations and people.”

Intervision will succeed in uniting some nations. But at the same time, it may only deepen divisions with others – further evidence that Russia and the West are singing very different tunes.

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She smiled and his eyes filled with emotion – the moment British couple were freed by the Taliban

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She smiled and his eyes filled with emotion - the moment British couple were freed by the Taliban

At Kabul International Airport, we watched as a string of Afghan, Qatari and British officials walked into a building by the runway, alongside doctors.

On the runway a plane waited, the steps ready for what appeared to be an imminent departure. We had heard from our sources about the possible release of Peter and Barbie Reynolds, the elderly British couple detained in February, but we had no official confirmation yet.

Then, from behind a double door, I caught the eye of Barbie. The 76-year old smiled at me – her face seemingly bright with relief. Her husband, Peter, 80, then stepped into frame. A tall gentle looking man, his eyes looked filled with emotion.

Their relief and gratitude was immediately apparent. It was of course impossible to know what state their health was in, but they appeared alert and composed, despite nearly eight months in detention.

The couple’s son, Jonathan, had previously said his father had been suffering serious convulsions and his mother was “numb” from anaemia and malnutrition. The UN had also described their conditions as “degrading”. But today, as he prepared to leave the country, Peter wouldn’t be drawn on the conditions he faced. “We’re just very thankful, very thankful,” he told me.

Peter Reynolds arrives in Doha with his daughter Sarah Entwistle following his release. (Picture: Reuters)
Image:
Peter Reynolds arrives in Doha with his daughter Sarah Entwistle following his release. (Picture: Reuters)

Barbie, who spent part of her detention in a separate facility, looked strikingly calm – a graceful and understated demeanour. “We’ve been treated very well,” she said as she made her way to the plane. Taliban officials maintained they received adequate medical care in prison and their human rights were respected.

The couple’s four children campaigned carefully but consistently for their release. “We’re looking forward to seeing our children,” Barbie told me with a wide beam. I asked if she had a message for family and friends. “God is good as they say here in Afghanistan,” she declared.

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And despite their surprise detention, she hoped they would be back. “Will you return to Afghanistan?” I asked. “Oh yes, if we can,” she said. “We are Afghan citizens.”

What happened

The couple have been together since the 1960s and married in the Afghan capital, Kabul, in 1970. They have lived in the country for 18 years and ran an organisation called Rebuild, which provides educational and leadership programmes, including training for mothers and children.

They have been described by family as having a lifelong love of Afghanistan. After the Taliban seized control in August 2021 and many other Westerners left, they decided to stay. They were arrested on their way home to Bamiyan. The Taliban has said the couple broke Afghanistan law. But after the couple faced four court proceedings, no charges were ever brought.

In a statement today, Hamdullah Fitrat, Deputy Spokesman of the Islamic Emirate of Afghanistan, said: “Two British nationals named Peter and Barbara Reynolds, who had violated the laws of Afghanistan, were released from custody today following the judicial process. The Islamic Emirate of Afghanistan does not view the issues of its nationals from a political or bargaining perspective.”

Peter and Barbie Reynolds  walk after disembarking from a plane, in Doha, Qatar.
Pic: Reuters
Image:
Peter and Barbie Reynolds walk after disembarking from a plane, in Doha, Qatar.
Pic: Reuters

Both the UK and Qatari officials were keen to express their deep gratitude to Afghanistan’s leadership for releasing the Reynolds. Richard Lindsay, Special Envoy to Afghanistan said it was a “very great humanitarian day”. But he acknowledged he did not know on what grounds the couple were held.

The Qataris appeared to play a critical role in negotiating with the Afghan authorities. They said they were able to ensure medical assistance was provided and enable the couple to communicate with their families. “The release of Barbie and Peter Reynolds shows that when two parties are committed to reaching an agreement, Qatar’s mediators will find a way to achieve it,” one Qatari official told Sky News.

In 2022, the Taliban banned Afghan women from working for NGOs. What led up to the arrest of the Reynolds, who dedicated so much of their lives to running an NGO is still unclear. But for their family, today is a day they had longed for.

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