Coffee Break: End-of-the-Week Thoughts on Science and Other Matters Arising

Good afternoon and welcome to my first rough draft of Coffee Break, which will be an ongoing part of our week here. This will be a project with an unknown evolutionary trajectory, depending on feedback from the community. Comments, criticism, and reader input are most welcome. Details are still in the making, so patience is requested. –KLG

Part the First: AI Kills Your Critical Thinking Skills. Medical students are very enthusiastic about AI – Algorithmic Intelligence (yes, that is what I call it, because I can). I remember very well the moment two years ago when ChatGPT popped its head up and students in my tutorial group were fairly thrilled at the bright, shiny new shortcut to knowledge right there in their phones. They have gone from books and paper to laptops to tablets to a phone that can be carried in one hand, all the time. The shadow medical curriculum now is the large thing casting shadows. Is this a good thing? Or a bad thing? Or just a thing? I tend to believe (OK, hope for) the latter. However, I do know from first-hand experience with students that the further they are away from their data (in this case the knowledge required to become a wise and effective physician) the more likely they are to miss the point entirely. This is not something we want in a physician, scientist, historian, psychologist, or philosopher.

Recently while I was thinking about how to improve our curriculum for preclinical medical students, up pops a link from Gizmodo, Microsoft Study Finds Relying on AI Kills Your Critical Thinking Skills. Key Point: “Over the course of the study, a pattern revealed itself: the more confident the worker was in the AI’s capability to complete the task, the more often they could feel themselves letting their hands off the wheel.” That is exactly what Elon Musk and others want us to do, isn’t it! So, whatever could be the problem?

The underlying study by a group of scientists at Carnegie-Mellon University (nice pair of American Oligarchs, those two, but they did leave a tangible legacy – especially the first) and at Microsoft in Cambridge (not the one across the river from Boston) is here: The Impact of Generative AI on Critical Thinking: Self-Reported Reductions in Cognitive Effort and Confidence Effects From a Survey of Knowledge Workers. The results are “self-reported,” which is probably the only kind of data available for this project. The “user’s task-specific self-confidence and confidence in GenAI are predictive of whether critical thinking is enacted…” I thought the purpose of GenAI is to vitiate the need for critical thinking, but on the other hand, this study does “reveal new design challenges and opportunities for developing GenAI tools for knowledge work.” The words “knowledge” and “work” are doing a lot of work here but we shall see. The scientists at Microsoft might be on to something. If it doesn’t kill us first.

In the meantime, we would do well to remember T.S. Eliot from The Rock:

Where is the Life we have lost in living?
Where is the wisdom we have lost in knowledge?
Where is the knowledge we have lost in information?
The cycles of Heaven in twenty centuries
Bring us farther from God and nearer to the Dust.

Part the Second: Progress on COVID-19? in Differential protection against SARS-CoV-2 reinfection pre- and post-Omicron. This open access paper is very technical but somewhat promising. From the Abstract:

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly evolved over short timescales, leading to the emergence of more transmissible variants such as Alpha and Delta…the Omicron variant marked a major shift (and) raised concerns regarding (the) potential impact on immune evasion, disease severity and the effectiveness of vaccines and treatments…Before Omicron, natural infection provided strong and durable protection against reinfection…(but)…during the Omicron era, protection was robust only for those recently infected, declining rapidly over time and diminishing within a year. These results demonstrate that SARS-CoV-2 immune protection is shaped by a dynamic interaction between host immunity and viral evolution, leading to contrasting reinfection patterns before and after Omicron’s first wave. This shift in patterns suggests a change in evolutionary pressures, with intrinsic transmissibility driving adaptation pre-Omicron and immune escape becoming dominant post-Omicron, underscoring the need for periodic vaccine updates to sustain immunity. (emphasis added)

Yes, we know that. We also know that durable immunity to coronaviruses has been a chimera, so far, in birds, cats, and people. One thing about this work, though. The first thing to do when reading a biomedical research paper, even before reading the abstract, is to check the acknowledgments. The authors seem to have had access to a good database and they were not required to grub for grants to get the work done. One might also note that Al-Jazeera is also funded by the government of Qatar, whose leader seems after all these years to allow the reporters and editors to do their jobs. But of course, YMMV, especially around these parts.

Part the Third: The New and Improved Department of Health and Human Services. I looked, the Secretary of Health and Human Services has generally been a politician of one sort or another, going back the when it was the Department of Health, Education, and Welfare (two out of three are bad words today; no wonder the name was changed). But few of them have been quite the lightning rod that is the current incumbent. He has quite a following among citizens of various stripes, and he is on a mission. The physicians at Science-Based Medicine are not favorably impressed, however. Based on my priors, they are correct.

The Chinese proverb, “May you live in interesting times.” is probably neither Chinese nor a proverb. Its most likely origin lies in something said by Sir Austen Chamberlain, half-brother to the much more famous Neville. But I am getting a bit tired of this, in a working life that has been coextensive with the rise of the Neoliberal Dispensation. Nevertheless, “You are not obligated to complete the work, but neither are you free to desist from it.” (Pirkei Avot: Ethics of Our Fathers, 2:21). We have work to do!