Good morning. Andrew here. It was quite a stressful week of news in the markets, so we decided to focus this a.m. on your health — and the big business of preventative health measures and data. I happen to be an enthusiast of health tests, gizmos and measurements. I wear two different fitness trackers, sleep on a mattress cover that automatically adjusts to my body and have undergone a preventative full body M.R.I. scan. I tend to find this stuff helpful (or at least I tell myself that); other people think it is quackery. DealBook contributor Brent Crane does a deep dive into this world, both the business of it all — and the debate about its efficacy. We’ve also got a great Q&A by DealBook’s Sarah Kessler with a researcher who built a corporate board with artificial intelligence agents. Was the A.I. board smarter than human ones? Keep reading for the answer. (Was this newsletter forwarded to you? Sign up here.)
No doctor’s order required
Last year, Thomas Hogan, a Texas software C.E.O., began to experience gastrointestinal issues. During an M.R.I. scan clinicians discovered what they said was a benign cyst in his spleen; nothing to worry about. Still his discomfort continued. A concerned friend booked Hogan, 66, an appointment with the personalized health start-up Prenuvo, which charged Hogan $2,500 for an additional 60-minute M.R.I. scan. Three days later, he was on the phone with a Prenuvo clinician. “They said, ‘You need to get in to see an oncologist,’” Hogan recalled. “‘It would appear that you’ve got a tumor on your spleen.’” It was stage IV cancer. Medical tests have become the next frontier of a growing obsession with personal wellness data. Just as wearable devices like the Oura Ring and Apple Watch have made it easy to track once esoteric stats like heart rate variability and blood oxygen levels, a new batch of companies allow customers to access tests like cholesterol levels, inflammation markers, gut-microbiome readouts and even full body M.R.I.s whenever they want them. Occasionally, as in Hogan’s case, these tests can lead to a critical medical diagnosis. But some physicians warn that over-testing might lead to unnecessary medical interventions. Regardless of whether or not it’s wise to sidestep your doctor, there’s a lot of money betting that demand for personalized medical testing will continue to grow. The concept has attracted venture capital backing from the likes of Andreessen Horowitz. Famous entrepreneurs including Daniel Ek, who recently announced that he would step down as C.E.O. of Spotify, and John Mackey, the co-founder and former C.E.O. of Whole Foods, have founded personalized wellness companies. And some employers, including John Hancock Financial, the National Basketball Players Association and the city of Tempe, Ariz., now offer such testing services as a perk. Offerings and price tags vary widely. Function Health, for example, sells $499 annual memberships for 100-plus “biomarker” tests, promising clients a digital dashboard of their own biology. (QuestDiagnostics actually conducts the tests for Function.) Prenuvo charges $2,500 for full-body M.R.I.s that aim to detect undiagnosed cancers, aneurysms and other silent killers. And Love.Life, a Los Angeles “holistic health and wellness club” backed by Mackey, goes even further, with memberships that can reach $25,000 a year and include blood tests, wellness coaching, yoga, pickleball, acupuncture, reiki and other offerings. Typically, in-house clinicians analyze test results and suggest next steps (which may include reporting back to your doctor). “It’s about shifting from a sick care model to a prevention and wellness model,” said Betsy Foster, the co-founder of Love.Life. “Right now, the model is broken and we’re doing it very differently so we can truly transform people’s lives.” Companies that offer concierge medical testing often explicitly lean into frustration with the traditional health care system in their marketing. But the industry is also the product of what Jonathan Swerdlin, the founder of Function Health, deems “a cultural shift” toward wellness that began nearly two decades ago — Pilates, yoga, saunas, ice baths, ayahuasca retreats, MAHA. The Covid-19 pandemic accelerated this trend. “Health has left the four walls of the doctor’s office,” Swerdlin said. “But wellness got to a place where it lacked scientific and medical rigor. We’re finally applying science to what people are trying to achieve, which is living a longer, healthier life.” Critics of turning medical testing into a “choose your own adventure” service argue that too much wellness tracking could actually make you unwell. Even the data from an Oura Ring, a wearable that monitors sleep time and heart rate variability, can send users into anxiety spirals, according to some experts. “‘Healthy’ people are not infrequently turned into ‘patients’ because of the detection of abnormalities that eventually prove to be false positives,” cautioned Dr. Thomas Kwee, a radiologist at the University Medical Center Groningen in the Netherlands, over email. (In that country, people cannot order diagnostic tests without a doctor’s visit, he added.) If you look closely enough, almost everyone has something in their bodies that might appear off but is ultimately insignificant — a patch of scarring, a strange growth. Once you become aware of it, how do you proceed? “Incidental findings of unclear significance often require other, sometimes risky tests like biopsies to resolve,” said Dr. Mike Pignone, a Duke University medical professor and former member of the U.S. Preventive Services Task Force. “Or they can’t be fully resolved and thus increase a patient’s anxiety and spending without health benefits.” “We believe the bigger problem is false negatives rather than false positives,” countered Andrew Lacy, the founder and C.E.O. of Prenuvo. In May, his company presented the results of a clinical study that followed 1,011 patients who underwent pre-emptive full body M.R.I. scans. (Not all experts took it seriously: “It is a retrospective and nonrandomized study,” said Kwee.) Of the patients, who were mostly asymptomatic, the screenings flagged potential signs of cancer in about 45 people. About half of those patients were later confirmed by biopsies to have cancer. The other half, of course, received biopsies they didn't need. In the case of Mr. Hogan, the Austin software C.E.O., the cancer which Prenuvo discovered had metastasized into his lungs, spleen, lower abdomen and bones. It was large B-cell lymphoma, an aggressive form. At the MD Anderson Cancer Center in Houston, Mr. Hogan began a regiment of chemotherapy and other treatments. Now in remission, he is “much more dialed in” to his health, he said: infrared saunas, cold plunge pools, red light therapy. “But the moral of the story is that if I hadn’t gotten this scan, it would probably have been game over for me.”
It was a volatile week for stocks. On Thursday, tech stocks briefly surged following Nvidia’s better-than-expected earnings report the night before. But global stocks dropped again on Friday. Among the factors weighing on markets: concerns over lavish A.I. spending, jitters over the Fed’s next interest rate decision and a Bitcoin losing streak that may have forced some investors to sell other assets to cover crypto margin calls. A new law orders the release of the Epstein files. But it has significant loopholes that could mean many files remain confidential. Larry Summers, the former Treasury secretary, said he would step back from public commitments after the release of emails between him and Jeffrey Epstein. He resigned from the board of OpenAI and stepped back from his teaching duties at Harvard. Trump gave Ukraine a Thanksgiving deadline to accept his peace plan. The White House’s 28-point proposal to end its war against Russia includes the surrender of Ukrainian territory and sharp limits on Ukraine’s military. Kyiv has said it was drafted without its involvement. Saudi Arabia’s de facto ruler visited the White House. It was the crown prince’s first visit since the 2018 killing of the Washington Post columnist Jamal Khashoggi, which U.S. intelligence determined the prince had approved. A roster of prominent C.E.O.s attended a dinner following the talks, many hoping to strike a deal. More big deals: Netflix, Paramount and Comcast submitted first-round takeover bids for Warner Bros. Discovery. A judge ruled that Meta’s acquisitions of Instagram and WhatsApp did not violate antitrust law. Jeff Bezos is a C.E.O. again. And Jamie Dimon threw King Charles a birthday party. Do A.I.s make the best board members?In training programs for corporate directors, participants often simulate board meetings about big problems at fictional companies. Researchers at INSEAD, the French business school, and Wharton recently asked a panel of A.I. agents to do the same. The A.I. agents, they found, were much better deliberators. Three large language models and three independent (human) experts rated the transcripts of each meeting on eight criteria, without knowing which transcript had been generated by A.I. agents. In every domain, including “decision quality” and “fair and inclusive process,” both the A.I. and the expert evaluators ranked the A.I. board better than the human boards. DealBook’s Sarah Kessler talked with Valery Yakubovich, the executive director of the Mack Institute for Innovation Management at Wharton, about what corporate board members should learn from this strong performance by A.I. directors. The interview has been condensed and edited. You write that the conversation between the A.I. agents and that between the human boards looked a lot different. How? The main thing is that A.I. can process so much information so fast. It’s beyond our human capacity to be at the board meeting bringing precisely the right numbers at the right time. What was most surprising was the conversation was much more collegial. We had to explain to bots how to interact, when to speak and when to stay quiet. So following this algorithm, everyone participated, and the chairman always summarized the different viewpoints and kept moving it to some kind of a decision. In human groups, who speaks and why depends on so many other things. The bots respond just in terms of the substance. They don’t care about being smarter than others, they don’t want to dominate the room, they don’t take things personally. Is the takeaway that we should have more A.I. board members? A fully A.I. board? Some companies have announced A.I. board members. You can bring A.I. bots into the room for analytical purposes. Independent directors can feed the hundreds of pages of documentation to prepare for a meeting into a bot and talk to the bot. Also the chairman, if they anticipate a difficult meeting with controversial issues, can model it with a bot meeting and see how it plays out — though of course you won’t capture the political agendas quite as easily. Have corporate directors who you’ve discussed this with accepted the premise that an A.I. system could function like a board member? I think they feel comfortable for now that they won’t be replaced, at least for legal reasons. They just feel they may fall behind if they don’t master it. Do you think they should be more concerned? I think A.I.’s judgment is not enough, because with the decisions boards usually make, there is no ground truth. You don’t know what’s right, what’s wrong. And it’s all decided in the context of competition. My decision might not be perfect, but it needs to be just somewhat better than my competitors. And then all the support relationships with key stakeholders, government, investors and so on. I don’t see how those can be replaced in the foreseeable future. Quiz: Age recognitionClick an answer to see if you’re right (the link will be free). As governments enact new regulations aimed at protecting minors on social media, the online gaming platform Roblox rolled out a new system this week that estimates users’ ages by analyzing images of their faces. Roblox has about 150 million daily active users. How many are 13 years old or younger? We hope you’ve enjoyed this newsletter, which is made possible through subscriber support. Subscribe to The New York Times. Thanks for reading! We’ll see you Monday. We’d like your feedback. Please email thoughts and suggestions to dealbook@nytimes.com.
|
