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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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How to keep a support contract • The Register

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On Call Let us take a little trip back to the days before the PC, when terminals ruled supreme, to find that the more things change the more they stay the same. Welcome to On Call.

Today’s story comes from “Keith” (not his name) and concerns the rage of a user whose expensive terminal would crash once a day, pretty much at the same time.

The terminal in question was a TAB 132/15. It was an impressive bit of kit for the time and was capable of displaying 132 characters of crisp, green text on a 15-inch CRT housed in a futuristic plastic case. Luxury for sure, unless one was the financial trader trying to use the device.

Once a day, at around 13:30, the terminal would hang. The user would have to reach behind it, power it off, wait a bit, and then fire it back up again. To placate the angry customer, a replacement was dispatched, and all was well. Until the problem started again. Another replacement was made. Another week or so went by with no complaints. And again, another call: the terminal was hanging. Same time. A few times a week.

“These terminals were in the thousand-dollar range,” Keith told us, so a monthly replacement cycle was not really an option. He even used one of the faulty units himself for a while and encountered no issues, which was odd in itself and, we reckon, planted a seed of suspicion.

As for the customer, he was raging by this point. “He was threatening to cancel our contract for his entire firm,” remembered Keith, which would hit the bottom line hard. A salesperson was sent out to see what was happening, but there was no failure.

A technician went out; again no failure. Was this a case of “Technician Syndrome”, where a problem cannot be replicated in front of service personnel? Maybe. Keith’s team were at their wit’s end while the customer had hit the end of his tether and gone beyond.

The solution to the problem was accidental. Keith was back on site, diagnosing an unrelated software issue, but could see the suspect terminal on the other side of the room. As he watched, the trader using the machine sat back for lunch, flipping through the pages of a financial newspaper. A phone call came through, and the trader slung the paper on top of the monitor, took the call, and then resumed work.

Oblivious to the newspaper.

A few minutes later there was uproar. The trader had stood and was slapping the side of the terminal, yelling all manner of not-safe-for-work oaths and casting aspersions upon the good name of Keith’s firm, the software, the programmers, and the computing industry in general. The cursing continued as the trader reached behind for the power switch, knocking the paper aside.

Keith had his solution. But was smart enough to know that a bland presentation of facts would probably not help. Instead, he arranged for his office to call the trader and tell him that a tech was on the way to help. He waited until the trader was distracted and sauntered over.

“Sure enough,” said Keith, “he said he was glad to see me but launched into a tirade again about the device’s many faults.”

He let the customer vent for a while, and surreptitiously placed the newspaper back on top over the heat vents on the terminal while pretending to examine the rear of the unit.

Now patience was needed. It wouldn’t take long – the terminal had, after all, only just recovered from its last overheating episode – and Keith encouraged the trader to unload all his woes and grievances.

The bug list was building as the screen suddenly flickered and locked up. “There! You see that?” exclaimed the user. Keith nodded and reached round the side of the terminal to cycle the power. Sure enough, it came back up.

Keith made a show of thanking the user for showing him the elusive bug and was staging a call with a co-worker, supposedly to prepare a replacement, when the terminal locked up again.

Keith wrinkled his forehead at the “mystery” before offering up an explanation.

“Ah!” he exclaimed, “Did you see how that flicker started from the top and moved to the down?”

Those familiar with the technology will know it was just following the raster pattern. The customer, on the other hand, did not.

“That is often a sign it is overheating,” said Keith, playing fast and loose with the truth, “but this office is cool?”

He pretended to be mystified until the penny dropped for the trader, who unleashed yet more expletives as he realised where he’d dropped his newspaper and snatched it away from the vents.

Feeling the volcanic heat spewing from the depths of the terminal, he turned to Keith, suddenly concerned: “Will it be OK?”

Of course it would. It had only been overheating for a short time every day. The apologies from the customer, who had “discovered” the problem, were profuse and copious. Keith excused himself, but not before rubbing a bit more salt into the wound by telling the user he needed to cancel the burn-in process of yet another expensive replacement.

As it turned out, rather than the customer cancelling the support contact, it ended up being extended.

“It was a good thing I’d let him ‘discover’ the fault,” said Keith. “If I had found it, he would have been very defensive and we still might have lost that contract.”

The minor bugs the user had reported while Keith had been waiting for the overheating to happen again were swiftly dealt with and the enhancement requests logged. Keith also reported back to his boss, who spent rather a lot of time laughing.

“It was a good day.”

Ever set the stage so the customer thinks they’re the hero of the hour? Or maybe you’ve wished all manner of unpleasantness upon your suppliers before realising the blame laid with you all along? Tell us about the time you picked up the phone with an email to On Call. ®

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NUIG to spend €5m on research to help address global issues

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Several key research areas have been identified by NUI Galway to work towards for 2026.

NUI Galway’s recently launched research and innovation strategy includes a €5m investment on support for its multi-disciplinary research teams as they grapple with several global issues.

The strategy, which lays out plans for the university’s next five years of research, focuses on six areas: antimicrobial resistance, decarbonisation, democracy and its future, food security, human-centred data and ocean and coastal health.

“As a public university, we have a special responsibility to direct our research toward the most pressing questions and the most difficult issues,” said to Prof Jim Livesey, VP for research and innovation at NUI Galway.

“As we look into the future, we face uncertainty about the number and nature of challenges we will face, but we know that we will rely on our research capacity as we work together to overcome them,” Livesey added.

The plan focuses on creating the conditions to intensify the quality, scale and scope of research in the university into the future. This includes identifying areas with genuine potential to achieve international recognition for NUI Galway. It also aims to continue to cultivate a supportive and diverse environment within its research community.

NUI Galway has research collaborations with 3,267 international institutions in 114 different countries. The university also has five research institutes on its Galway city campus, including the Data Science Institute, the Whitaker Institute for social change and innovation and the Ryan Institute for marine research.

Its research centres in the medtech area include Science Foundation Ireland’s Cúram and the Corrib Research Centre for Advanced Imaging and Core Lab.

The university will also continue to involve the public with its research and innovation plans through various education and outreach initiatives. It is leading the Public Patient Involvement Ignite network, which it claims, will “bring the public into the heart of research initiatives”.

Another key area identified in the strategy report is the development of partnerships with industry stakeholders. NUI Galway has spun out many successful companies in recent years, including medtechs such as AuriGen Medical, Atrian, Vetex Medical and Neurent.

According to MedTech Europe, Ireland has the highest number of medtech employees per capita in Europe along with Switzerland.

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France hails victory as Facebook agrees to pay newspapers for content | France

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France has hailed a victory in its long-running quest for fairer action from tech companies after Facebook reached an agreement with a group of national and regional newspapers to pay for content shared by its users.

Facebook on Thursday announced a licensing agreement with the APIG alliance of French national and regional newspapers, which includes Le Parisien and Ouest-France as well as smaller titles. It said this meant “people on Facebook will be able to continue uploading and sharing news stories freely amongst their communities, whilst also ensuring that the copyright of our publishing partners is protected”.

France had been battling for two years to protect the publishing rights and revenue of its press and news agencies against what it termed the domination of powerful tech companies that share news content or show news stories in web searches.

In 2019 France became the first EU country to enact a directive on the publishing rights of media companies and news agencies, called “neighbouring rights”, which required large tech platforms to open talks with publishers seeking remuneration for use of news content. But it has taken long negotiations to reach agreements on paying publishers for content.

No detail was given of the exact amount agreed by Facebook and the APIG.

Pierre Louette, the head of the media group Les Echos-Le Parisien, led the alliance of newspapers who negotiated as a group with Facebook. He said the agreement was “the result of an outspoken and fruitful dialogue between publishers and a leading digital platform”. He said the terms agreed would allow Facebook to implement French law “while generating significant funding” for news publishers, notably the smallest ones.

Other newspapers, such as the national daily Le Monde, have negotiated their own deals in recent months. News agencies have also negotiated separately.

After the 2019 French directive to protect publishers’ rights, a copyright spat raged for more than a year in which French media groups sought to find common ground with international tech firms. Google initially refused to comply, saying media groups already benefited by receiving millions of visits to their websites. News outlets struggling with dwindling print subscriptions complained about not receiving a cut of the millions made from ads displayed alongside news stories, particularly on Google.

But this year Google announced it had reached a draft agreement with the APIG to pay publishers for a selection of content shown in its searches.

Facebook said that besides paying for French content, it would also launch a French news service, Facebook News, in January – a follow-up to similar services in the US and UK – to “give people a dedicated space to access content from trusted and reputable news sources”.

Facebook reached deals with most of Australia’s largest media companies earlier this year. Nine Entertainment, which includes the Sydney Morning Herald and the Age, said in its annual report that it was expecting “strong growth in the short-term” from its deals with Facebook and Google.

British newspapers including the Guardian signed up last year to a programme in which Facebook pays to license articles that appear on a dedicated news section on the social media site. Separately, in July Guardian Australia struck a deal with Facebook to license news content.

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