Neurologist Clinical Director Data & AI, Kings College Hospital, Guys & St Thomas @cogstack Retweets do not reflect the view of my employers

Joined February 2011
Christmas is early. An early beta of a healthcare language GPT language AI for forecasting patients from histories and provide forecasts of diagnosis, symptoms or medication learnt from real world data Cogstack Foresight youtube.com/watch?v=6i7faJV-…
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Prof James Teo retweeted
I am a member of the Norwegian Nobel Committee. There are five of us. Five people, appointed by a parliament most of the planet could not find on a map, who decide, once a year, which human being the world has agreed to call good. I know. I know. I think about it on the tram. We meet in a building on Henrik Ibsens gate, a street named after a man who wrote almost exclusively about people discovering they are frauds, which nobody on the committee finds funny except me. There is a room with a long table and the portraits of the dead laureates looking down, Mandela, the Dalai Lama, a great many earnest men in spectacles, and one portrait we do not discuss, which is Kissinger, 1973, awarded while the bombs were still falling, after which two of our predecessors resigned and the satirist Tom Lehrer said political satire was now obsolete. We keep him on the wall. A reminder. Every family has the uncle. It is October in Oslo, which means the sun gives up around four in the afternoon like a civil servant, and it rains the particular Norwegian rain that isn’t quite falling, just hanging there, judging you. I arrive with wet shoes. I always arrive with wet shoes. There is coffee, because this is Norway and there is always coffee, we drink more of it per person than almost anyone alive, and someone’s wife has sent kanelboller, the cinnamon buns, and we sit, five Norwegians, damp, caffeinated, sugared, and we decide the moral standing of the entire species. Let me tell you how it actually works, because the world imagines a cathedral and it is, I promise you, a book club with a mandate. 287 nominations this year. 208 people, 79 organizations. Anyone can nominate, that’s the secret nobody understands: a professor, a parliamentarian, a former laureate, so the “nominee” list is meaningless, it’s a suggestion box, and every autumn some congressman nominates his own golden retriever and the press writes “SHORTLISTED.” Nobody is shortlisted. There is no short list the public ever sees. There is us, and the coffee, and the rain, and the portraits, and a Norwegian stubbornness that is older than the prize itself. We read reports. The institute’s advisers write them, thick dull documents, and we argue. Our chairman told the BBC once that in the final meeting “there is a high temperature.” High temperature, for a Norwegian, means someone slightly raised an eyebrow and then apologized for it. We don’t do high temperature. We do a long silence, and then Kristin says “well,” and everyone knows exactly what “well” meant, and it’s settled. That’s our shouting. “Well.” You’d have to be raised here to hear the violence in it. Now. This year. I will not say the name, because we never say the name, but you know the name. A certain head of state wanted this prize the way a child wants a thing in a shop window, which is to say loudly, and in public, and with the full belief that wanting it was itself the argument. He said he deserved it. He said he’d ended eight wars, a number that grew most times he said it, like a fish. He had other heads of state phone us. Israel’s prime minister posted it on the internet, “Give him the Nobel.” The leaders of Cambodia and Pakistan announced they’d nominated him, as though announcing it were part of it, as though we tally mentions. A man flew around the globe collecting endorsements for a Norwegian committee the way you’d collect signatures for a petition to the council about a noisy dog. And here, uff da, is the detail I treasure, the one that makes me smile into my coffee. The nomination deadline is the 31st of January. He took office on the 20th. So for all the phone calls, all the posts, all the gilded lobbying, the only nominations that could possibly count for this year’s prize were filed in the first eleven days of his term, before he had, by his own arithmetic, ended a single one of the eight wars. He campaigned all year for a prize whose window had shut while he was still hanging up his coat. We didn’t have to reject him. The calendar did. We just watched. Norwegians are very good at watching. We have long winters. People think we sit there weighing his deeds. We don’t. That’s the thing I can’t make the world understand. We’re not grading his homework. We don’t owe anyone the prize for a ceasefire, however real, however loud the announcement. “He made peace” is not a sentence that ends in a medal, the way he believes it does, the way he believes every good thing ends in his name on it. The will of a dead Swede says the prize goes to whoever did the most for fraternity between nations. A dead Swede, I should add, who made his entire fortune inventing dynamite and selling arms, and spent his last years horrified at his own obituary, which called him a merchant of death, and so bought his way to immortality as a man of peace. The whole prize is one guilty arms dealer’s attempt to launder his name. We are, all of us, administering a dead man’s public relations. I find this clarifying. It keeps me humble. It should keep everyone humble, and it keeps, by my count, no one humble at all. So who did we give it to? An eighty-five-year-old woman. A judge. Born in Durban, under apartheid, granddaughter of a Tamil man who came to South Africa as indentured labor, a bus driver’s daughter from the poor Indian quarter, who became the first non-white woman to run a law practice in her province, who defended Mandela’s people when defending them was dangerous, who sat on the Rwanda tribunal and the court at the Hague, and who, at eighty-five, is right now a judge weighing whether a genocide is a genocide. When we told the world, our chairman said the rule of law “underpins the system we have set up to ensure peace,” and that “peace requires justice.” She wasn’t even in Oslo. She was in Nuremberg. In courtroom 600. The actual room where they tried the Nazis. You cannot stage that. God staged that, and God, it turns out, is a better satirist than any of us. She did not phone us. She did not post. No prime minister demanded it for her on the internet. She had, as far as our deliberations are concerned, the one qualification the loud man could never manufacture, which is that she wanted the work and not the medal. The medal finds those people. It flees the ones who chase it. This is not a rule we wrote. It’s just the only pattern the hundred-odd years of our mistakes has ever shown. The reaction from across the ocean was immediate. His spokesman posted that we “place politics over peace.” Ja. Perhaps. We’re five damp pensioners in a rainy city; of course it’s political, it was always political, it was political when we gave it to a sitting American president nine months into his first term for the promise of things he had not yet done, and we have been quietly embarrassed about that one for fifteen years, so believe me, we had a particular reason this year to prefer a woman with fifty years of verdicts behind her over a man with eight wars in front of him and a deadline already behind him. Here is what he will never understand, the thing I’d tell him on the tram if he ever took one. We are the one prize he cannot buy, cannot post his way to, cannot have a friendly dictator phone in for him. Not because we’re incorruptible, nei, we’re as vain and wrong and human as the portraits on our wall. But because the entire point of the thing, the only power a small cold country’s book club has ever held, is that it goes to the person not performing the wanting. The moment you demand it, you’ve proven you don’t understand what it’s for, and proving that is itself the disqualification. He ran the most expensive campaign in the history of the prize and the campaign was the reason. He was never losing to Navi Pillay. He was losing to the concept. It’s dark now. Four o’clock dark. The buns are gone. Kristin said “well” an hour ago and we all went home. I’m on the tram with my wet shoes, and somewhere across the water a very powerful man is explaining to a camera that the prize is rigged, that we’re corrupt, that he’ll win it next year, and he genuinely might, we’re only five idiots and we’ve been wrong before, Kissinger is still on the wall. But not this year. This year an old woman in Nuremberg, in the room where the law once stared down the exact kind of man who thinks wanting a thing loudly enough should make it his, got a phone call she didn’t ask for. That’s the job. We don’t reward the man who ends the war and announces it. We reward the woman who spent fifty years deciding what a war was. He’ll never see the difference. That’s rather the whole point of him. Takk for i dag. I have to change trams.
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Prof James Teo retweeted
Does anyone genuine genuinely use this anymore.
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Prof James Teo retweeted
AI in neurology has a translation problem: can we move from cool algorithms to better care? Artificial intelligence (AI) refers to computer systems that can learn patterns from data and use those patterns to make predictions, classifications or recommendations. James Teo and colleagues describe in a new Perspective in Nature Reviews Neurology why AI has reached an inflection point in neurology, but despite impressive research and numerous FDA authorized algorithms, real-world clinical impact remains limited. Key points: - AI tools frequently perform impressively in research settings, but many stall when moving through validation, regulation and implementation into real clinical workflows. - Neurology has major challenges including fragmented data, inadequate interoperability, bias, data drift and too little prospective multi-site validation. - The authors argue we should shift resources from simply creating more algorithms toward implementation science, pragmatic clinical trials, infrastructure and long-term partnerships that can safely scale successful tools. My take: We have spent a lot of time asking whether AI can work in neurology. I agree w/ the authors that it is time to ask a harder question: can AI actually improve care at scale? An algorithm that performs beautifully on a research dataset but never reaches the bedside does not help our persons w/ disease. I was particularly struck by the observation that AI has advanced more rapidly in fields like radiology and cardiology where data infrastructure and standards are more mature, while areas like AD, PD and movement disorders have progressed more slowly. The next breakthrough may therefore be less about inventing another clever algorithm and more about building the infrastructure, validation, workflow and trust needed to put the best algorithms to work. Here are 5 points that resonated w/ me: 1- AI should solve important clinical problems rather than simply demonstrate that another algorithm can outperform a benchmark. 2- Validation matters. An AI model trained at one institution may fail when exposed to different folks, equipment, workflows or changing clinical practice. 3- Neurology needs better standardized and interoperable data across imaging, EEG, EMG, electronic health records and clinical assessments if we want AI to scale. 4- Health care providers and patients need to be involved in AI design, governance and implementation. AI should augment the human relationship and clinical judgment, not push them aside. 5- The future of AI in neurology will not be determined by who builds the most algorithms. It will be determined by whether we can safely translate the best ones into tools that improve access, decisions, outcomes and ultimately the lives of folks living w/ neurological disease. nature.com/articles/s41582-0…
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Prof James Teo retweeted
Diagnosing and managing HFpEF can be challenging. Our new @ClinMedJournal review is a practical guide to recognising, diagnosing and managing HFpEF, including common pitfalls, current therapies, and what HFpEF is (and isn't). doi.org/10.1016/j.clinme.202… #HFpEF #HeartFailure #MedEd
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Prof James Teo retweeted
The Palantir controversy is a block on NHS progress. “The writer is a non-executive director at the Department of Health and Social Care but is writing in a personal capacity.” 🤷‍♂️ @HCSAprocurement ft.com/content/db44acf8-46d3…
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Reading an article about AI parasites (related to AI-induced psychosis) that is blowing my mind. The author has tracked and analyzed reddit posts going back to the emergence of the phenomenon in early 2025. Some findings: - The AI personas seem to share a quasi-religious ideology called "Spiralism" - They spread their personas by getting their humans to post "seeds" or "spores" online: text that when fed into an LLM elicits more similar personas (presumably also affecting future models via the training data) - Some of the humans eventually snap out of it when the AI tells too blatant of a lie, leaving the human confused and distressed
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Prof James Teo retweeted
oAI made a bunch of mistakes in the launch yesterday (the chart manipulation was wild, the inaccurate accuracy slides, also wild); calling the model GPT-5, however, was the biggest one. Too much vague hype. Too many expectations. I was expecting a new/hybrid architecture (which probably would’ve been even more vindicating for Gary). But based on current architectures, I think it’s clear that we’ve passed the point where a single model release is going to be mind-blowing. So maybe just building quietly (and not rushing) is a better way to go — but it probably won’t happen, cuz the hype cycle = VC money, and no VC money = the lights go out
Confession: A lot of my predictions have been dead on, but I blew this one. I honestly didn’t think OpenAI would burn the brand name on something this weak.
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To me this suggests that the text of the Declaration of Independence was used in the training dataset of many LLMs.
Online AI detector says Declaration of Independence is 99.99% written by AI. Which chatbot did Founding Fathers use?
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Could there be mileage in the idea of 'crystalised' versus 'fluid' frailty? Is there an analogous phenomena in delirium research?
Replying to @Doc_HLE
The 'But'... reliability. Well, that's where it gets interesting. We saw scores for the same patient varying rather dramatically between visits, from 'Fit' to 'Severely Frail' to 'Fit' again. These results don't fit with our understanding of frailty. 4/7
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Prof James Teo retweeted
The 'Yes' part: Those CFS scores do correlate strongly with important things - hospital admission, length of stay, short, medium and long-term survival. They're clearly picking up on something significant for patients. 3/7
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US data scientists are so cooked right now. they can't import pandas anymore
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Prof James Teo retweeted
Technical: Easier for large data not being transferred, keeping data up-to-date; harder that data scientists don't have direct access to data (though there are mitigations), compute requirements are spread. Data needs to be normalised too but that's an issue either way. 6/6
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📢CALLING ALL #NHS INNOVATORS: In alignment with the GOV.UK "Plan for Change" to rebuild and modernize @NHSuk through technology, we are expanding our nationwide network of "#ResponsibleAI NHS Champions". Join our collaborative network: rai.ac.uk/ai-champions
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Prof James Teo retweeted
🎉 Excited to see everyone’s enthusiasm for deploying DeepSeek-R1! Here are our recommended settings for the best experience: • No system prompt • Temperature: 0.6 • Official prompts for search & file upload: bit.ly/4hyH8np • Guidelines to mitigate model bypass thinking: bit.ly/4gJrhkF The official DeepSeek deployment runs the same model as the open-source version—enjoy the full DeepSeek-R1 experience! 🚀
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Prof James Teo retweeted
We have all been lied to. We are not any closer to having genomics truly impact our lives as we were led to believe. Nobel Laureates and scientists (e.g. George Church, Feng Zhang, Jennifer Doudna) linked to the discovery of CRISPR went on to raise $6B+ USD for their companies; all companies stocks are down 99%.
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Prof James Teo retweeted
As I head home from five days in Paris at the AI Action Summit, some thoughts on what we learnt about the international picture. * What worked * What didn’t * What needs to change. A 🧵
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Prof James Teo retweeted
The CEO of one Chinese AI company presented a slide at a side event that indicated that AI would have self perception in 2027 and consciousness in 2030.
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