Journals rebuff AI peer review

Presented by PBM Accountability Project: The ideas and innovators shaping health care
Dec 09, 2024 View in browser
 
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By Gregory Svirnovskiy, Ruth Reader and Daniel Payne

Presented by PBM Accountability Project

TECH MAZE

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Top medical journals are not turning to AI to help with peer review. | Carl Court/Getty Images

Despite an overwhelming number of submissions and a shortage of reviewers, many top medical journals oppose using artificial intelligence for peer review.

Their main concern: confidentiality.

According to new research published last week in JAMA Network Open, 46 of 78 top medical journals that offer guidance on AI-assisted peer review prohibit its use. The 32 journals that allow AI in peer review do so only under strict conditions.

TD;LR: While AI could speed up the peer-review process, journals worry about introducing bias or compromising privacy or security.

Ninety-six percent of journals that prohibit AI review do so because of confidentiality concerns. While traditional reviewers keep manuscripts and author identities secure to protect researchers' ideas and intellectual property, AI may not uphold those standards.

What they’re saying: “Used safely and ethically, AI can increase productivity and innovation,” the researchers, based in China and Norway, write. “Thus, continuous monitoring and regular assessment of AI’s impact are essential for updating guidance, thereby maintaining high-quality peer review.”

The status quo: Researchers and academics have called the peer-review process "slow, opaque and cliquey" and reliant on overworked volunteers. Reviewers spent upward of 100 million hours evaluating their peers’ work in 2020. It’s hard, sluggish and often thankless work.

But AI isn’t the answer. Not yet.

 

REGISTER NOW: As the 118th Congress ends, major decisions loom, including healthcare appropriations. Key focus: site neutrality. Can aligning hospital and clinic costs cut federal spending, reflect physician costs, and lower patient expenses? Join policymakers and providers to discuss.

 
 
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A message from PBM Accountability Project:

Pharmacy benefit managers (PBMs) are taking advantage of Medicare and America’s seniors. It's time for Congress to act. Rein in PBMs by requiring them to increase transparency, share discounts with seniors, and delink PBM profits from the cost of medicines in Medicare. Congress must pass S. 2973 and S. 3430 this year. Learn more.

 
EXAM ROOM

FILE - A patient prepares to take the first of two combination pills, mifepristone, for a medication abortion during a visit to a clinic in Kansas City, Kan., Oct. 12, 2022. (AP Photo/Charlie Riedel, File)

Researchers are working to better understand how many pregnancy crisis centers exist. | AP

A group of researchers harnessed big data to count pregnancy crisis centers, which position themselves as medical centers to hawk unproven “abortion-reversal” treatments. Their findings were recently published in a research letter in JAMA Internal Medicine.

There isn’t good data on pregnancy crisis centers, which try to steer pregnant women away from abortion, and their impact on public health. The American Medical Association calls them unethical because they purport to offer medical advice but peddle medical misinformation. Yet there’s a partisan divide on whether these centers are helpful or harmful.

The report found at least 1,825 pregnancy crisis centers across the country. The vast majority, a whopping 91 percent, advertise medical services, including sexually transmitted infection testing. Just shy of a third offer abortion pill-reversal services, an unproven treatment that involves a high dose of progesterone.

Pregnancy crisis centers aren’t medical centers, often don’t have doctors or nurses on staff and aren’t bound by health care laws. Yet, about 40 percent say they’re compliant with privacy laws meant for health systems, insurers and doctors, according to study data.

“We want to create transparency,” John Ayers, a behavioral scientist at the University of California, San Diego, and a study author, told Ruth. “Identify how many, where they operate and what services they offer.”

The data is posted on a website by the researchers, who are affiliated with the University of Michigan; the University of California, San Diego; and Johns Hopkins University.

Why it matters: Despite concerns, pregnancy crisis centers are taxpayer-funded. Some 21 states have put half a billion taxpayer dollars into pregnancy crisis centers, according to reporting from The Independent. Another $400 million in federal funds flowed to pregnancy crisis centers between 2017 and 2023, according to health industry consultant Health Management Associates.

Meanwhile, Congressional Democrats tried to legally prevent these organizations from offering services and raised concerns about their deceptive marketing tactics.

What else: Fifteen states have passed laws requiring doctors to tell patients about abortion reversals, even though there’s no evidence for the treatment. By contrast, only Colorado outlaws abortion-reversal treatments and advertisements for deceptive medical practices.

 

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WASHINGTON WATCH

Robert Califf testifies before the Senate HELP Committee.

Lawmakers seem ready to take on food policy to improve health outcomes. But FDA Commissioner Robert Califf says the ball is in Congress' court. | Win McNamee/Getty Images

Lawmakers on the Hill are ready to take on food policy in the next Congress — with an eye toward improving health outcomes.

Senators from all parties, ideologies and backgrounds pledged their support for changes to the Food and Drug Administration during a Health, Education, Labor and Pensions Committee hearing this week with agency leadership on the relationship between food regulation and health.

On the spot: FDA Commissioner Robert Califf agreed at the hearing that some changes would be essential to improving Americans’ health but suggested the ball, to some extent, is in Congress’ court.

The FDA needs more funding, said Califf. It also needs its functions explicitly laid out in legislation to ensure they survive legal scrutiny after the Supreme Court overturned the Chevron deference, a precedent agencies relied on to justify their authorities.

Ranking member Bill Cassidy (R-La.), who will chair the committee next year, said he was prepared to craft policy with the Trump administration, whose chosen leaders have pledged to home in on food policy to improve health outcomes.

Democrats see an opportunity for agreement on the issue, too. The committee’s current chair, Sen. Bernie Sanders (I-Vt.), has repeatedly said in recent days that U.S. food regulations need tightening, with an emphasis on providing consumers with more thorough, easier-to-understand information.

Why it matters: Public health experts have long contended that upstream changes are key to U.S. health care’s future, with nutrition being a major health indicator across ages, ethnicities, geographies and health conditions.

Even so: A policy push is possible with the incoming administration and Republican and Democratic leaders of both parties taking interest in the issue. But many policies with wide agreement still don’t pass in Congress.

 

A message from PBM Accountability Project:

There’s consensus in Congress – real PBM reform is needed NOW.

Both sides agree we need to: improve transparency, break the link that allows PBMs to tie their profits to the price of the drug, and force PBMs to share discounts with seniors.

Congress: It is time to finish the job and pass bipartisan senate bills 2973 and 3430. America’s seniors are counting on it. Learn more.

 
 

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