Hello Health Rounds readers! Today we bring you another example of a potential benefit of artificial intelligence – it may help doctors improve their diagnoses of skin conditions. But there’s a caveat: it doesn’t necessarily yield an equivalent benefit in reducing racial biases in diagnoses. We also highlight a potentially important discovery in the mechanism behind allergic reactions. And we report on a finding that more frequent sex improved erections in mice, which might help understanding of erectile dysfunction in humans.
Doctors are less likely to correctly diagnose skin diseases on non-white skin even with assistance from artificial intelligence algorithms, a new study suggests. REUTERS/Alishia Abodunde
AI may improve skin diagnoses, may not compensate for bias
Artificial intelligence (AI) can improve the odds that doctors will correctly diagnose skin disease, but that does not automatically mean it will compensate for racial bias in medicine, a new report shows.
Researchers recruited nearly 850 dermatologists and general practitioners and had them look at photographs of various skin diseases, including atopic dermatitis, Lyme disease, and skin cancer in patients with different skin tones.
Overall, the dermatologists could accurately diagnose the conditions in 38% of the skin images, while general practitioners had an accuracy rate of 19%, researchers reported on Monday in Nature Medicine.
But darker-skin images were diagnosed 10% less accurately than images of light skin by dermatologists and 22% less accurately by primary care providers.
Using an AI algorithm developed by the research team, the accuracy rate rose to 60% among dermatologists and 47% among general practitioners, but the improvements were greater when diagnosing patients with lighter skin.
The researchers also found bias in identifying patients who needed a biopsy.
For example, based on pictures showing evidence of a life-threatening skin cancer, both groups of doctors would send light-skinned patients for biopsy significantly more often than darker-skinned patients.
People with dark skin would more often be sent by dermatologists for biopsies of common non-dangerous skin conditions such as atopic dermatitis, based on the photos.
The researchers note that making a diagnosis based only on photos is much harder than when examining a patient in person.
“These results demonstrate that well-designed physician–machine partnerships can enhance the diagnostic accuracy of physicians… (but) success in improving overall diagnostic accuracy does not necessarily address bias,” they said.
Read more about racial bias in medicine on Reuters.com
Researchers find source of allergic reaction antibodies
Researchers have discovered which immune system cells initiate production of antibodies that trigger allergic reactions, according to two reports published on Wednesday in Science Translational Medicine.
These so-called type-2 memory B cells (MBC2) respond to allergens by rapidly transforming into plasma cells that produce the immunoglobulin E (IgE) antibodies that trigger the allergic reaction, the researchers found.
“Finding the cells that hold IgE memory is a key step forward and a game changer in our understanding of what causes allergy and how treatment, such as allergy immunotherapy, can modify the disease,” Peter Sejer Andersen of Danish drugmaker ALK-Abello, who co-led one of the studies, said in a statement.
His team found large amounts of these B cells in adults with birch allergy, house dust mite allergy, or peanut allergy, but not in volunteers without the allergies.
A separate team found large amounts of these B cells in children with peanut allergy but not in similar children without allergy.
“The discovery really pinpoints two potential therapeutic approaches we might be able to take,” Kelly Bruton of Stanford University, who worked on the study with Andersen, said in a statement.
“The first is targeting those MBC2s and eliminating them from an allergic person,” Bruton said. “The other option could involve changing their function and have them do something that’s not going to be ultimately harmful when the individual is exposed to the allergen.”
More sex helps erections in mice and maybe humans
Research in mice has found that regular erections help maintain erectile function and that cells that contribute to the formation of connective tissue called fibroblasts play an important role in supporting healthy erections.
The fibroblasts take up the neurotransmitter noradrenaline, which leads to the widening of blood vessels in the penis. The widened blood vessels allow more blood to flow into cylinder-shaped erectile chambers known as corpora cavernosa, which straightens the penis.
The effectiveness of this process depends on the number of fibroblasts, which in turn is affected by the frequency of erections, among other factors, the researchers also found. The more frequently the mice had erections, the more fibroblasts in the penis.
This would likely be true in humans, too, the researchers surmised in a report on Thursday in the journal Science.
Older mice had fewer fibroblasts in the penis, and consequently lower blood flow. The ability to get an erection decreases with age also in humans, which could be partly due to fewer fibroblasts in the penis, the researchers said.
The researchers said they hope their findings may lead to new treatments for erectile dysfunction.
Exercise in general is known to increase fibroblast production, previous research on humans has shown.
“If sedentary behavior and low sexual activity leads to fewer of these fibroblasts… then regular exercise, sexual activity and other lifestyle changes should be helpful for sexual dysfunction,” a commentary published with the study suggests.
This newsletter was edited by Bill Berkrot; additional reporting by Shawana Alleyne-Morris.