Last week I had the pleasure & privilege of spending time with REAL practitioners discussing a REAL case & being part of a REAL discussion and a REAL exchange of all our ideas & experiences. I know, how quaint! Because unlike the AI apps we’re all increasingly interacting with, we’re clinicians and we take theory from the safe confines of ‘science’ and test-run it in the real world: dealing with patients, pathology, products alike, everyday. As a result, as is so often the case, the ultimate gifts came from our interactive Q & A and chatbox, in the form of our opportunity for genuine exchange of ideas & experiences.
Comparing real world costs for pay out of pocket providers of Lp(a) labs (& a hot tip on those not charging at all!)
All the tentacle topics that extend out octopus style from one presentation or pathology marker: ‘While we’re here what should ferritin be for lowest CVD risk in women?”
Cross-referencing with other content from other education sources – putting it out there for everyone to benefit from -“Now I know why they assess Lp(a) in chronic UTI presentations!”
Genuine unfettered product suggestions, reviews & even whispers about new ones allegedly in the pipeline.
With information overload at all of our fingertips, what we need most right now is something else. Real cases rather than random facts (& factoids). Thoughtful application of ideas instead of AI slop. An opportunity for debate and discussion based on real world clinical encounters rather than just duelling between our respective LLM VAs…is this sounding familiar?
Because fountains of facts at our fingertips doesn’t actually increase our knowledge effectively…We need to go retro and get real!
Because, if you ever want to truly check you understand something correctly – AI is not the place. Not even for the theory be warned!!! Intentionally designed to ‘people-please’ to ensure you pick ‘IT’ and stay engaged, always…I mean come on…the premise that ‘the customer is always right’ is a dangerous one in this context, right?! In fact, this latest study describes how overwhelmingly sycophantic LLM are. “Sycophancy essentially means that the model trusts the user to say correct things,” says Jasper Dekoninck, a data science PhD student at the Swiss Federal Institute of Technology in Zurich. “Knowing that these models are sycophantic makes me very wary whenever I give them some problem,” he adds. “I always double-check everything that they write.” IYKYK!
“What an excellent insight and nuanced perspective!” it tells me on the regular…sheesh easy way to boost my ego and dangerously lead us all on our march towards the death of facts, science, objective knowledge…
So we are ALL apparently right. You are when you ask, but your patients are too…even when they and we are not!
Cracking the Case Series: Uncovering Cardiovascular Risk – Elevated Lipoprotein(a)
How do you conduct a comprehensive cardiovascular risk assessment? It should always include a Lipoprotein (a) result, having been declared the biomarker with the strongest indication of causality in both atherosclerosis & valvular aortic stenosis. But what use is getting this tested, if, when we identify increased risk due to elevated results, we have no means to lower it? Until now. This is a 57 year old female with a striking personal and family medical history, a peachy coronary calcium score, mildly elevated LDL-C but significantly elevated Lp(a). We describe in detail the meaningfulness of this, as one element in our understanding of her overall inter-connected health story and reveal the prescription and approach that got results. We also discuss the challenge that is inherent in both ‘uncovering risk’ in someone while remaining on the right side of hope vs despair and of the nature of CVD risk reduction which requires lifelong management.
