Health Rounds: AI can improve the diagnosis of skin diseases, but prejudice linked to skin color remains – 02/08/2024 at 8:19 pm

((Automatic translation by Reuters, see disclaimer by Nancy Lapid

Hello Health Rounds readers! Today we bring another example of a potential benefit of artificial intelligence: it can help doctors improve the diagnosis of skin diseases, but it does not necessarily reduce racial bias in diagnoses. We also highlight a potentially important discovery about the mechanism behind allergic reactions. Finally, we report the finding that more frequent intercourse improves erections in rats, which could help understand erectile dysfunction in humans.

AI can improve skin diagnosis, but it cannot compensate for bias

Artificial intelligence (AI) could increase doctors’ chances of correctly diagnosing skin problems, but that doesn’t automatically mean it will offset racial bias in medicine, according to a new report.

The researchers recruited about 850 dermatologists and general practitioners and asked them to analyze photographs of various skin diseases, including atopic dermatitis, Lyme disease and skin cancer, in patients with different skin colors.

Overall, dermatologists were able to accurately diagnose diseases in 38% of skin images, while general practitioners achieved a 19% accuracy rate, researchers reported Monday in Nature Medicine.

But images of darker skin were diagnosed with 10% less accuracy than images of light skin by dermatologists and with 22% less accuracy by general practitioners.

Using an AI algorithm developed by the research team, the accuracy rate increased to 60% among dermatologists and 47% among general practitioners, but the improvements were greatest for diagnosing patients with lighter skin.

The researchers also found bias in identifying patients who needed a biopsy.

For example, based on photographs showing signs of potentially fatal skin cancer, both groups of doctors would send light-skinned patients for biopsy much more frequently than darker-skinned patients.

Dark-skinned people are more likely to be referred by dermatologists for biopsies for common, non-dangerous skin conditions like atopic dermatitis, according to the photos.

Researchers note that it is much more difficult to make a diagnosis based on photos than to examine a patient in person.

“These results demonstrate that well-designed doctor-machine partnerships can improve doctors’ diagnostic accuracy…(but) success in improving overall diagnostic accuracy does not necessarily eliminate bias,” they said.

Researchers find source of antibodies for allergic reactions

Researchers have discovered which immune system cells are responsible for producing antibodies that trigger allergic reactions, according to two reports published Wednesday in Science Translational Medicine.

These 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, researchers found.

“Finding the cells that retain IgE memory is a fundamental step and a watershed in our understanding of the causes of allergy and how treatment, such as immunotherapy, can modify the disease,” said Peter Sejer Andersen of Danish pharmaceutical company ALK -Abello.

ALKb.CO, which co-led one of the studies, in a statement.

His team found large quantities of these B cells in adults who suffer from allergies to birch, dust mites or peanuts, but not in volunteers without these allergies.

Another team found large amounts of these B cells in children with peanut allergies, but not in similar non-allergic children.

“This discovery highlights two potential therapeutic approaches we could take,” said Kelly Bruton of Stanford University, who collaborated on the study with Andersen.

“One is to target these MBC2s and eliminate them in an allergic person,” Bruton said. “The other option may be to modify their function and force them to do something that will not be harmful when the person is exposed to the allergen.

More sex promotes erections in rats and perhaps humans

Research in rats has shown that regular erections help maintain erectile function and that cells that help form connective tissue, called fibroblasts, play an important role in maintaining healthy erections.

Fibroblasts absorb the neurotransmitter norepinephrine, which causes blood vessels in the penis to widen. Dilated blood vessels allow more blood to flow into the cylinder-shaped erectile cavities called corpora cavernosa, allowing the penis to become erect.

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 discovered. The more frequent the rats had erections, the more fibroblasts there were in the penis.

This is likely to be true in humans as well, researchers speculated in a report published Thursday in the journal Science.

The older mice had fewer fibroblasts in the penis and therefore less blood flow. The ability to have an erection also declines with age in men, which may be in part due to fewer fibroblasts in the penis, researchers say.

The researchers said they hope their findings could lead to new treatments for erectile dysfunction.

It is known that physical exercise in general increases the production of fibroblasts, as previous research in humans has shown.

“If sedentary behavior and low sexual activity lead to a decrease in these fibroblasts… then regular exercise, sexual activity and other lifestyle changes should be helpful in cases of sexual dysfunction,” suggests a comment posted on the site of the study.

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