👋 Heyyy, Happy Friday. This is The Handover!
The first Weekly Handover. Kinda shy, kinda nervous 👉️ 👈️ . Here’s what we got:

• 🍿 Marking Scandal 2: Revenge of Oriel

• 🫣 Prostate Biopsy: Middle-Aged Male Horror Has a New Villain

• ⚔️ AI vs PA: The Superior Assistant?

• 🔮 Start-Up Synchron Develops Telekinesis

NHS NEWS

🍿 Marking Scandal 2: Revenge of Oriel

(sigh) Another Day, Another Mess-up.

Oriel (NHS recruitment organisation) has given 1000’s of doctors metaphorical blue balls.

This has come to light through redditor u/HoraceCope on March 24th. After accepting their Clinical Radiology offer—thus rejecting IMT and GP posts—Oriel basically went, “Haha, just kidding 🤗.” 

Turns out Radiology rankings were all wrong and their offer may be revoked. 

You know what? Don’t stop at Clinical Radiology. If they can’t get their posts, nobody can! So they decided to postpone everyone's results until they rectify the errors. 

They did, of course, offer a deeply sincere apology for their... what's the word... catastrophic blunder. Then began the process of undoing every single offer that had already been made. u/HoraceCope and fellow would-be Radiologists got put back in limbo, until finally, by the 26th, corrected offers were reissued across the board.

The BMA has since launched an investigation into how this was even allowed to happen in the first place.

Luckily this time, the issue was sorted within 48 hours, not 18 months. Progress guys…it’s progress.

RESEARCH UPDATE

🫣 Prostate Biopsy: Middle-Aged Male Horror Has a New Villain

If you were to make a horror movie for a middle-aged man, what’s the theme?

Psycho Killer? Nah.
Cursed Spirits? Overdone.
Prostate exam and biopsy? 
Now we’re getting somewhere.

In the urology waiting room, you can smell the trepidation. A fog of dread clings to the air, brewed from last night’s YouTube spiral—videos of probes entering places probes shouldn’t enter, replaying in their minds.

But of course, prostate biopsies are critically important to diagnosing prostate cancer—the commonest cancer for men in the UK. There is no getting around it. We need the sample.

But there is an alternative on the come up. Rather than the transrectal ultrasound(TRUS), Local anaesthetic transperineal(LATP) biopsy is now gaining popularity. 

The people at Oxford University conducted the TRANSLATE study. This was a RCT conducted across 10 hospitals in the UK, including 1,126 men who are biopsy-naive(yes, the official term) with suspected prostate cancer. 

Aims of the study were to assess detection rates of prostate cancer, defined as Gleason Grade Group(GGG) 2 or more. Additionally, detect infection rates and patient experience. 

Key Findings:

• Detection Rate: LATP in 60% compared to 54% in TRUS (1-0)

• Infection Rate: LATP <1% compared to 2% in TRUS (2-0)

• Patient Experience: LATP 38% reported pain and embarrassment compared to 27% in TRUS (2-1)

So yes, it’s clinically better—but I’m not sure we’ve cured the fear. We might’ve just swapped Saw for The Shining.

And no study is without its drawbacks. This study had a population of 93% White British… which is impressive, considering the UK’s diversity. Also prostate cancer equalling GGG2++ is a bit of a grey area. 

So all in all, the waiting room worries will continue regardless of technique. But at least we have a safer, more accurate detection technique.

RESEARCH UPDATE

⚔️ AI vs PA: The Superior Assistant?

Alright, alright–my turn. 
Would you rather… put your health in the hands of AI(GPT-4o) orr… a Physicians Associate?

It’s a difficult one really. They are both so similar. 

Both have around three years of training. 
Neither has a medical degree(although AI has passed the USMLE). 
Both are being pitched as substitutes for doctors.

So if dystopia approaches and I’m called into the GP surgery to see either Dr AI or Dr Noctor…

Who do I trust more to get me right? 

Not sure?
A new randomised controlled trial in Nature Medicine just tested AI’s potential as physicians assistant and its clinical acumen — specifically in management reasoning (think: treatment plans, risk, guidelines, patient preferences), in open-ending questions rather than multiple-choice.

They split 92 doctors into three groups:

• Doctor + GPT-4

• Doctor + Conventional tools (UpToDate, Google)

• GPT-4 alone (as a reference)

Each group tackled five real patient cases, with information revealed in stages to mimic real-life clinical visits.

The outcome?
Doctors using GPT-4 scored significantly higher than those using standard tools (+6.5%; p < 0.001) .

But here’s the kicker:
GPT-4 alone performed just as well as the Doctor + GPT-4 combo.
And there was no increase in harmful decision-making when GPT-4 was in play. 

1 - 0 to AI.

This of course doesn’t paint the full picture. 

We already know AI is more liable to confabulation than a patient with Korsakoff’s. There is also a bias in AI’s clinical expertise, due to its training data.

Take this study investigating colorectal cancer, AI was on par with the decisions of an MDT. 
But when it came to urology, it was more like a Year 13 on work experience. 

So we definitely don’t want clinicians going to consult AI instead of their seniors when tough get going.

So… AI or PA?
Neither’s perfect. One guesses, the other glitches.
But if I had to choose? Neither.
Find me a doctor with good Wi-Fi.

MEDTECH

🔮 Start-up Synchron Develop Telekinesis

Kinda.

Whilst you won't be boomeranging lightsabers like a Jedi, or flinging furniture like Matilda. You can now turn on the TV, text your partner, and feed your dog… without lifting a finger.

What’s the catch 🧐? 
Well… You’ll need Synchron to install a device in your brain, stream your thoughts through a wirelessly connected interface, and wear an 800-gram Apple Vision Pro on your face.

And also—you have to be quadriplegic. That part’s kind of important.

At the heart of the company's technology lies the Sentrode. This is a stent-like device covered in electrodes. This allows for the Brain-Computer Interface(BCI) to be implanted through the superior sagittal sinus to the motor cortex and capture neural signals. All without need for open surgery. Neat.

Now combine these signals with eye movement tracking from the Vision Pro and Nvidia's Holoscan to train AI on your thought patterns —and you’ve got a seriously innovative bit of tech.

It’s the first step in achieving their dream of a brain-based foundational model– An AI trained not on pirated ebooks, but you. And all the pirated ebooks you’ve read.

If this all sounds a bit too Black Mirror for you, relax. You see, in a study published in JAMA neurology, although they successfully demonstrated safety and efficacy. Their sample size was just four patients. And the follow up period was also only 12 months. So we won’t know if the implant will remain stable or get rejected like the F6 trying into cardiology training.

So all in all? Good try, Synchron. Your not their just quite yet, 
But hey–you’re ahead of Elon and Neurolink!

And that counts for something ✊

So… yeah. That was the first Weekly Handover.
Kinda like your first cannula—bit shaky, bit messy, but it went in.

If you liked it, tell your mates.
If you hated it, tell your enemies.

See you on Sunday, where i’m gunna explain WTF is going on with American Healthcare.

Also, I am looking for a junior writer/researcher. If you’re interested, or know someone who would be, reply to this email!