STAT+: How AI can distort clinical decision-making to prioritize profits over patients

More than a decade ago, Ken Mandl was on a call with a pharmaceutical company and the leader of a social network for people with diabetes. The drug maker was hoping to use the platform to encourage its members to get a certain lab test. 

The test could determine a patient’s need for a helpful drug. But in that moment, said Mandl, director of the computational health informatics program at Boston Children’s Hospital, “I could see this focus on a biomarker as a way to increase sales of the product.” To describe the phenomenon, he coined the term “biomarkup”: the way commercial interests can influence the creation, adoption, and interpretation of seemingly objective measures of medical status. 

These days, Mandl has been thinking about how the next generation of quantified outputs in health could be gamed: artificial intelligence tools. 

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