A cogent argument for a more humane—and human—medicine, assisted by technology but not driven by it.

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DEEP MEDICINE

HOW ARTIFICIAL INTELLIGENCE CAN MAKE HEALTHCARE HUMAN AGAIN

A gimlet-eyed look at the role of computers in medicine.

Building on earlier fly-on-the-wall looks at modern healing (The Patient Will See You Now: The Future of Medicine Is in Your Hands, 2015, etc.), cardiologist Topol examines the pros and cons of putting artificial intelligence, database crunching, and the like into the service of doctors who may or may not appreciate the new powers gained and limits reached. In this, the question is one of building a body of testable data and using it wisely. As the author writes, “shallow evidence…leads to shallow medical practice, with plenty of misdiagnosis and unnecessary procedures.” The data is more abundant than the meaning derived from it—by most estimates, Topol writes, doctors have collectively absorbed perhaps 5 percent of the whole literature. AI is useful for plowing through that huge body of material and weeding out the inapplicable and unlikely. AI is not, however, yet up to the “outlandish expectations,” as he puts it, that some administrators—and, more to the point, cost-cutting insurers—are placing on it, from curing cancer to eliminating possible harm to patients to lessening workloads. To be sure, he notes, there are many places where an algorithm’s ability to “eat data” is most welcome, as with correlating a patient’s intake of fluids with his or her output of urine. Given that most Americans have their medical records scattered over many providers and insurers, it’s important that data be consolidated and put in the hands of consumers. Perhaps paradoxically, notes the author, “the only way it can be made secure is to be decentralized.” Another issue is the possible overreliance of doctors on data in place of good practice, and Topol closes with the warning: "Machine medicine need not be our future.”

A cogent argument for a more humane—and human—medicine, assisted by technology but not driven by it.

Pub Date: March 12, 2019

ISBN: 978-1-5416-4463-2

Page Count: 400

Publisher: Basic

Review Posted Online: Jan. 13, 2019

Kirkus Reviews Issue: Feb. 1, 2019

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Striking research showing the immense complexity of ordinary thought and revealing the identities of the gatekeepers in our...

THINKING, FAST AND SLOW

A psychologist and Nobel Prize winner summarizes and synthesizes the recent decades of research on intuition and systematic thinking.

The author of several scholarly texts, Kahneman (Emeritus Psychology and Public Affairs/Princeton Univ.) now offers general readers not just the findings of psychological research but also a better understanding of how research questions arise and how scholars systematically frame and answer them. He begins with the distinction between System 1 and System 2 mental operations, the former referring to quick, automatic thought, the latter to more effortful, overt thinking. We rely heavily, writes, on System 1, resorting to the higher-energy System 2 only when we need or want to. Kahneman continually refers to System 2 as “lazy”: We don’t want to think rigorously about something. The author then explores the nuances of our two-system minds, showing how they perform in various situations. Psychological experiments have repeatedly revealed that our intuitions are generally wrong, that our assessments are based on biases and that our System 1 hates doubt and despises ambiguity. Kahneman largely avoids jargon; when he does use some (“heuristics,” for example), he argues that such terms really ought to join our everyday vocabulary. He reviews many fundamental concepts in psychology and statistics (regression to the mean, the narrative fallacy, the optimistic bias), showing how they relate to his overall concerns about how we think and why we make the decisions that we do. Some of the later chapters (dealing with risk-taking and statistics and probabilities) are denser than others (some readers may resent such demands on System 2!), but the passages that deal with the economic and political implications of the research are gripping.

Striking research showing the immense complexity of ordinary thought and revealing the identities of the gatekeepers in our minds.

Pub Date: Nov. 1, 2011

ISBN: 978-0-374-27563-1

Page Count: 512

Publisher: Farrar, Straus and Giroux

Review Posted Online: Sept. 4, 2011

Kirkus Reviews Issue: Sept. 15, 2011

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A deftly argued case for a new kind of socialism that, while sure to inspire controversy, bears widespread discussion.

CAPITAL AND IDEOLOGY

A massive investigation of economic history in the service of proposing a political order to overcome inequality.

Readers who like their political manifestoes in manageable sizes, à la Common Sense or The Communist Manifesto, may be overwhelmed by the latest from famed French economist Piketty (Top Incomes in France in the Twentieth Century: Inequality and Redistribution, 1901-1998, 2014, etc.), but it’s a significant work. The author interrogates the principal forms of economic organization over time, from slavery to “non-European trifunctional societies,” Chinese-style communism, and “hypercapitalist” orders, in order to examine relative levels of inequality and its evolution. Each system is founded on an ideology, and “every ideology, no matter how extreme it may seem in its defense of inequality, expresses a certain idea of social justice.” In the present era, at least in the U.S., that idea of social justice would seem to be only that the big ones eat the little ones, the principal justification being that the wealthiest people became rich because they are “the most enterprising, deserving, and useful.” In fact, as Piketty demonstrates, there’s more to inequality than the mere “size of the income gap.” Contrary to hypercapitalist ideology and its defenders, the playing field is not level, the market is not self-regulating, and access is not evenly distributed. Against this, Piketty arrives at a proposed system that, among other things, would redistribute wealth across societies by heavy taxation, especially of inheritances, to create a “participatory socialism” in which power is widely shared and trade across nations is truly free. The word “socialism,” he allows, is a kind of Pandora’s box that can scare people off—and, he further acknowledges, “the Russian and Czech oligarchs who buy athletic teams and newspapers may not be the most savory characters, but the Soviet system was a nightmare and had to go.” Yet so, too, writes the author, is a capitalism that rewards so few at the expense of so many.

A deftly argued case for a new kind of socialism that, while sure to inspire controversy, bears widespread discussion.

Pub Date: March 10, 2020

ISBN: 978-0-674-98082-2

Page Count: 976

Publisher: Belknap/Harvard Univ.

Review Posted Online: Dec. 22, 2019

Kirkus Reviews Issue: Jan. 15, 2020

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