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Doctors fear Google skin check app will lead to ‘tsunami of overdiagnosis’ | Health

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Google’s entry into health diagnostics has alarmed health experts who fear a new artificial intelligence tool to identify skin conditions could lead to overdiagnosis, or rare and complex skin conditions being missed.

At a technology conference in the US on Tuesday, Google revealed there are almost 10bn Google searches related to skin, nail and hair issues every year. In response, Google has developed an artificial intelligence “dermatology assist tool” for people with concerns about their skin. Users of the app can use their phone to take three images of their skin, hair or nails from different angles.

The app will then ask users questions about their skin type, how long they have had the issue, and for other symptoms that help narrow down the possibilities.

“The artificial intelligence model analyses this information and draws from its knowledge of 288 conditions to give you a list of possible matching conditions that you can then research further,” Google said in a statement.

“The tool is not intended to provide a diagnosis nor be a substitute for medical advice, as many conditions require clinician review, in-person examination or additional testing like a biopsy. Rather we hope it gives you access to authoritative information so you can make a more informed decision about your next step.”

The immediate past president of the Australasian College of Dermatologists, Dr Andrew Miller, said it was true that there is a global shortage of dermatologists worldwide, making it difficult for people with concerns to see a specialist.

“Around the world there are about 100,000 dermatologists, and considering there are almost eight billion people in the world that’s an amazing shortage,” he said. “We also have maldistribution of more in city and well-off areas and less in rural and disadvantaged areas. So I definitely understand that issues of access are front of mind.”

But Miller said government-subsidised appointments allowing GPs to collaborate with dermatologists were the answer, not artificial intelligence [AI]. He said while telehealth appointments might be subsidised, they were not an ideal way to examine skin or to take photographs, because images taken during video streaming were poor quality.

“What we want is subsidies to be able to work with GPs who will contact us with the patient’s history, and who can take good quality photographs for us and send those through. We can then take our time to analyse those and, with the patient’s consent, work with their GP to come up with a treatment plan. We already do this kind of work where we can, but there is complex back-of-house analytical work that requires more than just a telehealth appointment.

“But there is no Medicare schedule for dermatology to be performed via telehealth in the way we would like to do it, which is involving the GP and having time to analyse properly taken images.”

In this situation Miller said the GP could explain the next steps and treatments, but this level of communication would not be available for people using Google.

“The standard textbook for dermatology is four volumes thick and weighs a couple of kilos,” Miller said. “People do get rare things. One of the things doctors and specialists have is an antennae that there is something wrong even if it may not look obvious, and when talking to a patient you also read body language and get a sense of whether they understand what you are telling them and if they are taking it all in.

“I’d worry that with a computer, people might ignore advice to see a doctor, or the algorithm might miss anything complex. I’d also worry that they might misunderstand questions asked by the app.”

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There is some evidence that AI has diagnostic potential. A 2017 study published in the journal Nature found an artificial intelligence network was capable of classifying skin cancer with a level of competence comparable to dermatologists. “It is projected that 6.3bn smartphone subscriptions will exist by the year 2021, and can therefore potentially provide low-cost universal access to vital diagnostic care,” the paper says.

But assistant professor and NHMRC early career fellow with Bond University’s Institute for Evidence-Based Healthcare Dr Ray Moynihan said; “There is great concern that the entry of Big Tech into healthcare will bring a tsunami of overdiagnosis – because there is a lot of money to be made telling healthy people they are sick.”

While early detection of deadly skin cancers such as melanoma is essential to improving the success of treatment, there is growing concern that harmless lesions are being diagnosed as melanoma, with the consequences being unnecessary treatment, psychological distress and medical costs. A study published in 2020 in the Medical Journal of Australia found 58% of melanomas were overdiagnosed, or 24% of all cancer diagnoses.

“There is already compelling evidence of much overdiagnosis of skin cancer – and over-enthusiastic acceptance of new screening tools could make the problem far worse,” Moynihan said.

“There is of course the chance that careful judicious use of some of this new technology could reduce the problem of overdiagnosis, by better distinguishing between malignant and benign problems – but that would require rigorous evaluation of risks and benefits by independent researchers and regulators.

“What we have at the moment are puffed up press releases and promotional media stories that make no mention of the potential downsides of these experimental AI tools – and one of the biggest downsides is unnecessary diagnosis, and the harm, anxiety and waste that can cause.”

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Elon Musk sells Tesla shares worth $6.9bn as Twitter trial looms | Elon Musk

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Elon Musk has sold $6.9bn (£5.7bn) worth of shares in Tesla after admitting that he could need the funds if he loses a legal battle with Twitter and is forced to buy the social media platform.

The Tesla CEO walked away from a $44bn deal to buy Twitter in July but the company has launched a lawsuit demanding that he complete the deal. A trial will take place in Delaware in October.

“In the (hopefully unlikely) event that Twitter forces this deal to close *and* some equity partners don’t come through, it is important to avoid an emergency sale of Tesla stock,” Musk said in a tweet late on Tuesday.

In other comments on Twitter on Tuesday, Musk said “yes” when asked if he was finished selling Tesla stock. He also said he would buy Tesla stock again if the Twitter deal does not close.

Musk has committed more than $30bn of his own money to the financing of the deal, with more than $7bn of that total provided by a coterie of associates including tech tycoon Larry Ellison, the Qatar state investment fund and the world’s biggest cryptocurrency exchange, Binance.

Musk, the world’s richest person, sold $8.5bn worth of Tesla shares in April and had said at the time there were no further sales planned. But since then, legal experts had suggested that if Musk is forced to complete the acquisition or settle the dispute with a stiff penalty, he was likely to sell more Tesla shares.

Last week Musk launched a countersuit against Twitter, accusing the platform of deliberately miscounting the number of spam accounts on the platform. Twitter has consistently stated that the number of spam accounts on its service is less than 5% of its user base, which currently stands at just under 238 million. Legal experts have said that Musk will find it hard to convince a judge that Twitter’s spam issue represents a “company material adverse effect” that substantially alters the company’s value – and therefore voids the deal.

Musk sold about 7.92m Tesla shares between 5 August and 9 August, according to multiple filings. He now owns 155m Tesla shares or just under 15% of the electric carmaker.

The latest sales bring total Tesla stock sales by Musk to about $32bn in less than one year. However, Musk remains comfortably ahead of Jeff Bezos as the world’s richest man with an estimated $250bn fortune, according to the Bloomberg billionaires index.

Tesla shares have risen nearly 15% since the automaker reported better-than-expected earnings on 20 July, also helped by the Biden administration’s climate bill that, if passed, would lift the cap on tax credits for electric vehicles.

Musk also teased on Tuesday that he could start his own social media platform. When asked by a Twitter user if he had thought about creating his own platform if the deal didn’t close, he replied: “X.com”.

With Reuters



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Iran reveals use of cryptocurrency to pay for imports • The Register

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Iran has announced it used cryptocurrency to pay for imports, raising the prospect that the nation is using digital assets to evade sanctions.

Trade minister Alireza Peyman Pak revealed the transaction with the tweet below, which translates as “This week, the first official import order was successfully placed with cryptocurrency worth ten million dollars. By the end of September, the use of cryptocurrencies and smart contracts will be widespread in foreign trade with target countries.”

It is unclear what Peman Pak referred to with his mention of widespread use of crypto for foreign trade, and the identity of the foreign countries he mentioned is also obscure.

But the intent of the announcement appears clear: Iran will use cryptocurrency to settle cross-border trades.

That’s very significant because Iran is subject to extensive sanctions aimed at preventing its ability to acquire nuclear weapons and reduce its ability to sponsor terrorism. Sanctions prevent the sale of many commodities and technologies to Iran, and financial institutions aren’t allowed to deal with their Iranian counterparts, who are mostly shunned around the world.

As explained in this advisory [PDF] issued by the US Treasury, Iran has developed numerous practices to evade sanctions, including payment offsetting schemes that let it sell oil in contravention of sanctions. Proceeds of such sales are alleged to have been funnelled to terrorist groups.

While cryptocurrency’s anonymity has been largely disproved, trades in digital assets aren’t regulated so sanctions enforcement will be more complex if Iran and its trading partners use crypto instead of fiat currencies.

Which perhaps adds more weight to the argument that cryptocurrency has few proven uses beyond speculative trading, making the ransomware industry possible, and helping authoritarian states like Iran and North Korea to acquire materiel for weapons.

Peyman Pak’s mention of “widespread” cross-border crypto deals, facilitated by automated smart contracts, therefore represents a challenge to those who monitor and enforce sanctions – and something new to worry about for the rest of us. ®



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Edwards Lifesciences is hiring at its ‘key’ Shannon and Limerick facilities

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The medtech company is hiring for a variety of roles at both its Limerick and Shannon sites, the latter of which is being transformed into a specialised manufacturing facility.

Medical devices giant Edwards Lifesciences began renovations to convert its existing Shannon facility into a specialised manufacturing centre at the end of July.

The expansion will allow the company to produce components that are an integral part of its transcatheter heart valves. The conversion is part of Edwards Lifesciences’ expansion plan that will see it hire for hundreds of new roles in the coming years.

“The expanded capability at our Shannon facility demonstrates that our operations in Ireland are a key enabler for Edwards to continue helping patients across the globe,” said Andrew Walls, general manager for the company’s manufacturing facilities in Ireland.

According to Walls, hiring is currently underway at the company’s Shannon and Limerick facilities for a variety of functions such as assembly and inspection roles, manufacturing and quality engineering, supply chain, warehouse operations and project management.

Why Ireland?

Headquartered in Irvine, California, Edwards Lifesciences established its operations in Shannon in 2018 and announced 600 new jobs for the mid-west region. This number was then doubled a year later when it revealed increased investment in Limerick.

When the Limerick plant was officially opened in October 2021, the medtech company added another 250 roles onto the previously announced 600, promising 850 new jobs by 2025.

“As the company grows and serves even more patients around the world, Edwards conducted a thorough review of its global valve manufacturing network to ensure we have the right facilities and talent to address our future needs,” Walls told SiliconRepublic.com

“We consider multiple factors when determining where we decide to manufacture – for example, a location that will allow us to produce close to where products are utilised, a location that offers advantages for our supply chain, excellent local talent pool for an engaged workforce, an interest in education and good academic infrastructure, and other characteristics that will be good for business and, ultimately, good for patients.

“Both our Shannon and Limerick sites are key enablers for Edwards Lifesciences to continue helping patients across the globe.”

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