American Journal of Medicine, internal medicine, medicine, health, healthy lifestyles, cancer, heart disease, drugs
What Happens When an Unstoppable Force Meets an Immovable Object?
This paradox plays out in many high-stakes global arenas—geopolitics, climate change, and financial markets, to name a few. Artificial intelligence thrives on massive disparate data sets, so it is not surprising that these data-dense megatrends are being shaped by artificial intelligence1 Although most humans do not face election, live near receding glaciers, or trade in cryptocurrencies, we are all learning that when manmade forces and intelligent machines collide, the costs and consequences can be real.

So it is with human health data.

Humans share 1 inherent right and bear 1 attendant risk—good health. In an inexorably older and progressively sicker world,2 another potential cataclysm confronts patients and physicians—the silent explosion of health data. The uses and fates of these health data, which will have grown from an estimated 153 exabytes in 2013 to 2314 exabytes by 2020 in the United States alone, are already being influenced by artificial intelligence.3 Medical students and trainees learn humanistic principles based on the Hippocratic precept, Primum non nocere (‘First do no harm’). Will humans use intelligent machines wisely, using big data responsibly for health care and medical training? Or will their power and immensity paradoxically produce unintended harms?

The expanding digital health data universe is the unstoppable force saturating the Cloud with big data droplets.

Individual personal health information resides in and fluxes through 2 types of data repositories. Administrative health care databases are operated by entities responsible for resourcing care and managing costs in socialized and quasi-market health insurance systems. Administrative health care databases are massive multigenerational payloads of demographic and utilization data (ie, pharmacy, physician, ambulatory, and hospital services)4 linked to multiple electronic medical records (EMRs) and increasingly homed in Cloud platforms compliant with the Health Insurance Portability and Accountability Act. Despite informatician and analyst expertise, their complexity and the density of their data defy standard statistical methods, limiting their applications to health care process and utilization management.

 CLEF = Cross Language Evaluation Forum; CNN = convolutional neural network; LSTM = long short-term memory unit; METEOR = Metric for Evaluation of Translation with Explicit Ordering; MS COCO = Microsoft Coco framework; RNN = recurrent neural network.

The Big Health Data–Intelligent Machine Paradox

What Happens When an Unstoppable Force Meets an Immovable Object? This paradox plays out in many high-stakes global arenas—geopolitics, climate change, and financial markets, to name a few. Artificial intelligence thrives on massive disparate data sets, so it is not surprising that these data-dense megatrends are being shaped by artificial intelligence1 Although most humans do not […]

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Tramadol: Understanding the Risk of Serotonin Syndrome and Seizures

Tramadol is commonly prescribed for pain control because it presents a lower risk for addiction and respiratory depression compared to other opioids. However, tramadol’s serotonin and norepinephrine reuptake inhibitory effects result in a unique adverse effect profile. Two such adverse events are serotonin syndrome and seizures. The prevalence of tramadol-induced serotonin syndrome and seizures is […]

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doctor in uniform using futuristic looking digital screens and keyboard

Sherlock Holmes and the Case of the Vanishing Examination

We live in a world steeped in technology where we all spend increasing amounts of time on our cell phones and computers and less time observing the world around us. These changes have also affected how we practice medicine. Many physicians today spend more time reviewing imaging studies and laboratory tests and less time taking […]

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Colon Adenocarcinoma Presenting as Plummer-Vinson Syndrome

  Colon cancer is a leading cause of cancer mortality. It could be asymptomatic but usually presents with bowel movement changes and anemia. We present a case of colonic adenocarcinoma that presented with Plummer-Vinson syndrome. A 66-year-old woman presented with a 3-month history of dysphagia. She had progressive dysphagia to solid foods that led to […]

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Possible pathophysiology of thyrotoxicosis-induced vomiting.

A Grave Case of Vomiting

A 60-year-old woman presented with intractable nausea and vomiting, which had progressively intensified over the past 2 weeks. Her past medical history was remarkable for mild thrombocytopenia and mildly elevated liver enzymes. Her vomiting was triggered by oral intake, nonbloody and nonbilious, and associated with nonresolving epigastric pain, dysphagia, anorexia, and weight loss. She had […]

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A Case of Addison’s Disease Nearly Mistaken for Anorexia Nervosa

A 22-year-old woman presented to her primary care physician because of an unintentional weight loss of 30 pounds (Figure A) associated with nausea, vomiting, anorexia, and generalized abdominal pain. She also described symptoms of anxiety and low mood that coincided with the breakdown of a relationship. Although she did not report body image distortion or fear […]

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Time trends of acute hepatitis C incidence by age groups: 2003-2016.

Hepatitis C Infection Screening and Management in Opioid Use Epidemics in the United States

Acute hepatitis C infection is on the rise in the United States, with a more than twofold increase in incidence rate from 2003 to 2016 overall and a threefold increase among young adults1, 2 (Figure). In 2016, a total of 2967 cases were reported from 42 states, and the Centers for Disease Control and Prevention estimates the […]

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Caught on Colonoscopy: Schistosomiasis Manifesting as a Single Colonic Polyp

A screening colonoscopy identified an unexpected diagnosis in a 64-year-old male patient. He was an asymptomatic landscaper who presented for a first-time screening colonoscopy based on age. His only active medical issue was psoriasis, for which he took apremilast. At the time of colonoscopy, he denied any bright red blood per rectum, melena, changes in […]

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Risk of Recurrent Venous Thromboembolism (video)

In this study, we aimed to estimate recurrence risk after incident venous thromboembolism, stratified according to unprovoked, provoked, and cancer-related venous thromboembolism in a prospective cohort of inpatients and outpatients receiving routine care. Methods We linked nationwide Danish health registries to identify all patients with incident venous thromboembolism from January 2000 through December 2015. Rates […]

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