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Would You Eat A Centipede to Prevent a Heart Attack?

A randomized trial shows the efficacy of Tongxinluo, a traditional Chinese medicine. But you may not want to know what is in it.

F. Perry Wilson, MD MSCE
6 min readOct 24, 2023

As some of you may know, I do a fair amount of clinical research developing and evaluating artificial intelligence models — particularly machine learning algorithms that predict certain outcomes.

And there’s this thorny issue that comes up as algorithms have gotten more complicated — it’s called “explainability”. The problem is that AI can be a black box. Even if you have a model that is very accurate at predicting death, clinicians don’t trust it unless you can explain how it makes its predictions — how it works. “It just works” is not good enough to build trust.

It’s easier to build trust when you’re talking about a medication instead of a computer program. A new blood pressure drug comes out, it lowers blood pressure, and, importantly, we know why it lowers blood pressure — every drug has a mechanism of action and — for most of the drugs in our arsenal — we know what that mechanism is.

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F. Perry Wilson, MD MSCE
F. Perry Wilson, MD MSCE

Written by F. Perry Wilson, MD MSCE

Medicine, science, statistics. Associate Professor of Medicine and Public Health at Yale. Host of "Impact Factor" on Medscape.com.

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