Thursday, September 28, 2023

Journal Club: NEJM Compares AI and Traditional Statistics

 A new paper in NEJM from London by Hunter & Holmes provides a deep dive comparison of data analysis by traditional statistics and by AI.   Find it here:  [subscription]

The article has no abstract.   Below, I provide an AI short summary and then an AI long summary.  I also ask Chat GPT to imagine what the paper is, from the citations alone.  Finally, I ask Chat GPT for weak points or missing points in the paper.


This article by Hunter & Holmes in the New England Journal explores the evolving synergy between Artificial Intelligence (AI) and traditional statistical methods in medical science. While AI offers powerful tools for data analysis and risk prediction, it can present challenges related to transparency and reproducibility. The text underscores the value of combining AI's capabilities with human expertise to ensure responsible and effective advancements in medical research and practice. It highlights the importance of robust validation and the need for a collaborative "human-in-the-loop" approach to maximize the benefits of AI while maintaining critical oversight.


Writing in the NEJM, Hunter and Holmes explores the dynamic intersection of Artificial Intelligence (AI) and traditional statistical methods within the domain of medical science. It presents a nuanced perspective on how AI is reshaping the landscape of medical research and clinical practice, while also highlighting the inherent challenges and opportunities it brings to the table.

The text begins by introducing the concept of AI in medical science and underscores its potential to revolutionize the analysis of vast and intricate datasets. It acknowledges AI's strengths in tasks such as automated feature extraction and risk prediction. However, it also emphasizes that the complexity of AI algorithms can make it challenging to audit and reproduce their conclusions, thus raising concerns about the transparency and verifiability of AI-based findings.

Moving on to the comparison between statistical methods and AI models, the text sheds light on their fundamental differences. Traditional statistical approaches are characterized by hypothesis-driven analysis, where predefined plans guide the research process, and reproducibility is a central tenet. In contrast, AI often takes an exploratory route, seeking patterns in data without a priori hypotheses. This exploratory nature can render AI models opaque, potentially leading to overfitting and false positives, highlighting the importance of clear reporting and the availability of code for external validation.

The text recognizes AI's utility in reducing the dimensionality of complex datasets, making them more amenable to traditional statistical analysis. It also draws attention to the challenge of biases in AI models, particularly when trained on biased data, and the critical issue of interpretability in AI-driven research and decision-making.

Furthermore, stability and statistical guarantees in AI analyses are addressed. The text stresses the need for robust validation, either through independent datasets or in-sample partitioning, to mitigate the risk of erroneous positive results. It emphasizes that human expertise remains indispensable in designing studies, tailoring models to specific research questions, and interpreting results, aspects that extend beyond the capabilities of data-driven AI algorithms.

In conclusion, the text advocates for a collaborative approach that combines the strengths of AI and human expertise. It suggests that AI can complement the work of statisticians and researchers, but it should not replace them. This interdisciplinary collaboration, often referred to as "human-in-the-loop" development, is seen as pivotal for advancing medical science responsibly and effectively.

Overall, the text offers a comprehensive overview of the multifaceted relationship between AI and statistics in the realm of medical science. It underscores the importance of careful consideration, validation, and transparency when integrating AI into healthcare practices, while also emphasizing the indispensable role of human expertise in guiding AI-driven research and clinical decision-making.


I ask Chat GPT what it could surmise or impute about the publication, if it had ONLY access to the reference list.

From the titles in the detailed bibliography, we can infer that the overarching paper likely discusses the intersection of medical statistics and artificial intelligence (AI) within the field of healthcare and biomedical research. It appears to provide a comprehensive exploration of how AI and machine learning techniques are being integrated into various aspects of medicine and medical research. The references cover a wide range of topics related to AI in healthcare, including its applications, challenges, and ethical considerations. Additionally, the paper seems to emphasize the importance of transparency, reporting standards, and the mitigation of bias in AI algorithms used in the medical domain. It may also touch upon the need for human expertise and domain knowledge in conjunction with AI for responsible and effective healthcare applications. Overall, the paper likely aims to provide insights into the evolving landscape where medical statistics meets AI in the context of modern healthcare.

I ask Chat GPT for any weaknesses or missing points in the paper.

In the full paper, the authors provide a comprehensive discussion of the intersection of statistics and AI in the field of healthcare and medical research. However, there are a few potential weak points or missing points that could be considered:

Lack of Specific Examples: While the paper discusses the integration of AI into healthcare and the importance of statistical thinking, it could benefit from more specific examples or case studies to illustrate how AI and statistics have been effectively combined to address real-world medical challenges. Providing concrete examples would help readers better understand the practical applications of these concepts.

Ethical and Privacy Concerns: While the paper touches on the need for transparency and addressing bias in AI algorithms, it could delve deeper into the ethical and privacy considerations associated with AI in healthcare. Issues related to patient data privacy, informed consent, and potential biases in AI models are critical aspects of AI adoption in medicine.

Interdisciplinary Collaboration: The paper emphasizes the importance of collaboration between statisticians and AI experts but does not delve deeply into how such interdisciplinary collaboration can be fostered and optimized. Exploring strategies for effective collaboration and knowledge sharing between these domains could be valuable.

Regulatory and Legal Frameworks: The discussion could include more insights into the evolving regulatory and legal frameworks governing the use of AI in healthcare. Addressing issues related to FDA approvals, liability, and compliance with healthcare regulations would be relevant, as these factors play a crucial role in the adoption of AI in the medical field.

Patient-Centeredness: While the paper mentions the potential benefits of AI in healthcare, it could emphasize the importance of patient-centered care. Discussing how AI can enhance patient outcomes, improve diagnoses, and contribute to personalized medicine would strengthen the argument for its integration into healthcare.

Challenges in Validation: The paper briefly mentions the importance of validating AI findings but could explore the specific challenges and methodologies involved in the rigorous validation of AI models in healthcare settings. Addressing issues of data quality and reproducibility is crucial.

Future Directions: While the paper discusses the current state of AI and statistics in healthcare, it could provide more insights into future directions and emerging trends in this field. Predictive analytics, causal inference, and the integration of multi-modal data sources are areas that could be explored in greater detail.

In summary, while the paper offers a solid foundation for understanding the convergence of statistics and AI in healthcare, it could be enhanced by providing more concrete examples, delving deeper into ethical and regulatory considerations, and offering insights into the evolving landscape of AI in medicine. Additionally, discussing challenges and future directions would further enrich the discussion.