Blog

First Opinion is STAT’s platform for interesting, insightful, and perhaps even provocative articles about the life sciences in general, written by biotechnology insiders, health care professionals, researchers, and others.

To encourage deep, serious discussion of the issues raised in the First Opinion essays, STAT publishes selected letters to the editor received in response. You can submit a letter to the editor here or find the submission form at the end of each First Opinion essay.

“Long Covid feels like a gun to my head” by Rachel Hall-Clifford

As someone living with a chronic illness, I would like to a) express my gratitude to the author and everyone else out there who continues to survive and fight for answers about Long Covid and other post-viral syndromes and b) make a sort of public service announcement:

It is now common knowledge in the community of people living with postural orthostatic tachycardia syndrome (POTS) that long covid is largely trauma/virus-induced autonomic nervous system dysfunction (also called dysautonomia), specifically POTS. Many of us have been living with the symptoms of “long covid” long before covid. In people with genetic predisposition to autoimmunity and other precursors to POTS, the disease was most likely triggered by the coronavirus. It pains me that this is still not common knowledge among sufferers. Please seek help from a POTS specialist and continue to investigate your underlying condition if you have the energy to do so, so you can eventually return to living a more fulfilling life. It is not easy and requires an enormous amount of time and will. But it will be worth it. Do it as best you can!

— Sandra Ivanov

“FDA: Don’t rush to publish your diversity guide. Take your time and do it right.” by Tamei Elliott and Maria Vassileva

“Equity” in clinical trial participation does not mean that the trials “look like America,” but rather that they “look like the therapeutic population.” But it must be more than just clinical trial participants. Equally important, we must also increase diversity among clinical trial designers, recruiters, principal investigators, FDA review teams, and advisory committee members—not just patient representatives. This is not the end, but just the beginning, and the goal must not be diversity for diversity’s sake, but enabling better trials that lead to better data, better regulatory reviews, better and more accurate labeling, which in turn lead to better options and outcomes for patients.

— Peter Pitts, Centre for Medicine in the Public Interest

“AI and Rural Healthcare: A Paradigm Shift in the Heart of America”, by Bill Gassen

I found some of AI’s potential cures misleading. While the article says AI won’t save the clinician time by reducing cognitive load, it won’t reduce the burden of answering patients’ questions through text prompts. And those fully transcribed clinical encounters need to be fully reviewed. Without knowing why late-stage cancer rates are higher, risk calculators and reminders may fail to deliver on their supposed promise. Much of what AI promises is to fix the unintended consequences of the last big idea, electronic health records.

Can AI help reduce healthcare inequalities for our rural populations? Maybe. But like many other articles, this is more about vested interests looking at the latest shiny object that promises to “move fast, break things, and apologize later.”

— Charles Dinerstein, American Council on Science and Health