Macmillan and ORCHA have launched a digital health app library to help cancer patients assess apps to support them throughout their care.
Development and Usability Evaluation of an E-Learning Tool for Blended Learning in Pediatric Endocrinology: Formative Pilot Study
Background: Residents in pediatric endocrinology subspecialty units encounter diverse educational scenarios spanning theory, skills, and attitudes; yet, brief residencies frequently limit their exposure to certain clinical cases. Research in medical education demonstrates that e-learning can address such challenges efficiently. We implemented a blended learning model grounded in the Kolb learning cycle that uses structured, case-based e-learning. Objective: We aimed to evaluate the utility and usability of blended learning using a novel e-learning tool. Methods: We used a problem-solving approach and used the physical separation of case-based e-learning (interactive, patient scenario–based online modules) and theoretical content delivery as the educational model for residents in a pediatric endocrinology and diabetology unit. Residents worked asynchronously (on their own time, not simultaneously with others) on clinical scenarios and completed formative assessments (practice tests designed to provide feedback for learning rather than grades) with immediate feedback using a flipped classroom teaching method, in which students review material before group instruction. In addition, all cases could be discussed with specialists during face-to-face learning opportunities through a blended learning approach that combines online and in-person elements. We evaluated Kirkpatrick level 1 (reaction, how participants respond to training) and level 2 (learning, measured as an increase in knowledge or capability) outcomes using the postgraduate Medical E-learning Evaluation Survey (MEES) and the User Experience Questionnaire (UEQ), which assesses users’ perceptions of e-learning platforms. Results: Questionnaires from 12 pediatric residents and 1 questionnaire from a fourth-year medical student were evaluated. The main strengths identified were the tool’s support for applying content to daily clinical work (12/13, 92% users), provision of timely summaries (n=9, 69% users), access to reliable information sources (n=9, 69% users), and immediate feedback on responses (n=8, 62% users). Key weaknesses included device compatibility for e-learning (n=5, 38% users), limited content personalization (n=4, 31% users), and a lack of a navigation aid (n=4, 31% users). No significant functional issues were reported. The UEQ evaluation showed that dependability received the lowest rating, while attractiveness and stimulation received the highest rating. Conclusions: Our e-learning proposal provides a practical way to apply theoretical knowledge through interactive clinical cases. Evaluations show that users are highly motivated to engage with e-learning, highlighting our tool’s adaptability and effectiveness for postgraduate medical education in pediatric endocrinology. Identifying strengths and weaknesses will guide future improvements. Evaluating various aspects of e-learning remains crucial, as these aspects can affect learning outcomes. However, more longitudinal evaluations of e-learning are necessary to achieve a comprehensive understanding of its effectiveness.
<img src="https://jmir-production.s3.us-east-2.amazonaws.com/thumbs/6e71bb0793753160fbbcd61e16945cfc" />
A 2-Tiered Rescue Protocol to Mitigate Difficulty-Based Failures of ChatGPT (GPT-5) and Gemini on the German M2 Medical Examination: Evaluation Study
Background: Large language models (LLMs) have demonstrated expert-level performance on medical licensing examinations, but most benchmarks focus on final accuracy. Critical gaps remain in understanding model efficiency (latency), the efficacy of tiered “rescue” protocols for error correction, and the systematic correlation between performance and human-rated question difficulty. The German M2 examination, paired with the AMBOSS platform’s user data–driven difficulty ratings, provides an opportunity to map AI performance against human cognitive load. Objective: This study aimed to move beyond singular accuracy scores by (1) evaluating and comparing the baseline (tier 1; T1) accuracy and response latency of next-generation rapid-response LLMs, (2) analyzing the efficacy of a 2-tiered rescue (tier 2; T2) protocol in correcting initial errors, and (3) correlating model performance with the user data–driven AMBOSS difficulty rating. Methods: We evaluated 4 LLMs (Gemini 2.5 Flash, Gemini 2.5 Pro, GPT-5 Instant, and GPT-5 Thinking) on the complete 316-item German M2 (Fall 2024) medical examination, including all multimodal (image-based) questions. A zero-shot copy-paste prompting strategy was used, and outputs were evaluated against ground-truth answers using a strict exact-match criterion. A 2-tiered protocol was used: T1 (Gemini Flash and GPT-5 Instant) provided baseline responses. If incorrect, a T2 (Gemini Pro and GPT-5 Thinking) model was deployed as a “rescue.” Performance was analyzed using the McNemar test, the Wilcoxon signed-rank test, the Fisher exact test, and logistic regression. Results: Baseline (T1) accuracy was identical at 91.5% (289/316; 95% CI 87.85%‐94.06%) for both Gemini 2.5 Flash and GPT-5 Instant, with 27 errors each. However, Gemini Flash (mean 1.57, SD 1.06 s) was significantly faster than GPT-5 Instant (mean 2.07, SD 1.89 s; <.001). Additionally, GPT-5 Instant expended significantly more time on incorrect answers compared with correct ones (=.002), whereas Gemini Flash showed no such hesitation (=.81). The T2 rescue rate for GPT-5 Thinking (13/27, 48.2%; 95% CI 30.74%‐66.01%) was higher, though not statistically significant (=.41), than that for Gemini 2.5 Pro (9/27, 33.3%; 95% CI 18.64%‐52.18%). This rescue protocol elevated final accuracy to 94.3% (298/316; 95% CI 91.18%‐96.37%) for the Gemini system and 95.6% (302/316; 95% CI 92.70%‐97.34%) for the GPT-5 system (=.48). A strong, inverse relationship with difficulty was found: for every 1-point increase in difficulty, the odds of a correct T1 response decreased by 42.1% (odds ratio 0.579, 95% CI 0.425‐0.788; <.001) for Gemini Flash and 47.7% (odds ratio 0.523, 95% CI 0.379‐0.720; <.001) for GPT-5 Instant. This negative correlation persisted even after the rescue (=.01 and =.006, respectively). Conclusions: Expert-level LLM performance on the German M2 examination masks a critical vulnerability: a decrease in accuracy correlated with increased question difficulty. A 2-tiered “rescue” system is an effective strategy to mitigate these difficulty-based failures and achieve >95% accuracy.
Words matter: Building better mental health conversations
The post Words matter: Building better mental health conversations appeared first on Mental Health America.
Digital Reassurance Seeking in OCD
– by Jordan Karr, PhD
We all need reassurance once in a while. Receiving reassurance from a friend, loved one, or expert can reduce short-term distress, foster a sense of connection, and help us move forward in a productive way. On the other hand, excessive reassurance seeking can lead to a painful cycle of stress and doubt. For individuals with obsessive-compulsive disorder (OCD), reassurance is fleeting and is quickly followed by a resurgence of perceived threat and a compelling drive to seek additional reassurance.
As an OCD and anxiety specialist, I am no stranger to reassurance traps. I see them in the patient who repeatedly consults doctors but never fully trusts their answers; the partner who keeps asking, “Do you still love me?” while scrutinizing every response; and the teenager who needs her homework checked repeatedly but does not learn to tolerate uncertainty. While the content of excessive reassurance seeking may vary, its function remains the same, relieving anxiety momentarily while allowing obsessions to rebound more strongly in the long run. In each example, we see an individual desperately trying to protect something they hold dear while being misled by one of OCD’s most convincing lines: “What if this time the reassurance sticks?”
Psychologists have long argued that excessive reassurance seeking helps maintain OCD, anxiety, and depression (Abramowitz et al., 2002; Burns et al., 2006). What is new is the landscape. Today, reassurance is available instantly and endlessly through search engines, medical websites, social media, and artificial intelligence tools. Emerging research suggests that online reassurance seeking may be as prevalent as interpersonal reassurance seeking (Parsons & Alden, 2022). These digital reassurance traps present in a variety of forms, including:
- Excessive symptom-checking on WebMD
- Checking a loved one’s location on Find My Friends to make sure they are still alive or where they promised they would be
- Asking Google Gemini whether an intrusive thought makes you a monster, a pedophile, or a bad Christian, Muslim, or Jew
- Analyzing the contents of a partner’s Instagram to see whether their feelings have changed
- Endlessly searching Reddit for answers to existential questions
- Obsessively checking likes and read receipts to monitor the durability of a relationship
- Finding creative ways to ask ChatGPT whether you might be responsible for spreading a virus or causing someone harm
- Compulsively checking the news to confirm whether a feared event has taken place
Why do some individuals seek reassurance primarily from others in face-to-face contexts while others turn to the internet? Findings from one study suggest that individuals may be more likely to seek interpersonal reassurance when they desire emotional support, whereas online reassurance seeking is more likely when individuals feel ashamed or fear judgment from others (Parsons et al., 2025). In the same study, shame was reported more frequently among individuals with OCD. The perceived anonymity of the internet creates a compelling environment for seeking reassurance about our most distressing fears and the fears we feel ashamed to have.
Wait, hold on… shouldn’t having access to all the information on the internet be empowering? After all, there’s that famous saying, “Knowledge is Power.” Well I’m not sure what Francis Bacon would say if he could scroll on TikTok, but in the age of the internet, more information does not always mean more power or knowledge. In fact, information overload seems to trigger excessive reassurance seeking online (Yang & Luo, 2024). Once digital algorithms detect health-related concerns, users may be exposed to increasingly frequent and targeted content, further amplifying health anxiety and driving additional reassurance seeking online (Zhang et al., 2024).
Despite these challenges, evidence-based treatments offer hope. Exposure and response prevention (ERP), the gold-standard treatment for OCD, helps individuals tolerate uncertainty and break free from compulsive behaviors. ERP therapists are prepared to respond to clients who compulsively seek reassurance while taking care to avoid reinforcing a client’s anxiety and setting boundaries when appropriate. On the other hand, AI chatbots are available 24/7 and will continue to reassure users when it would be clear to a skilled therapist that more reassurance is harmful. Some helpful activities I have encouraged clients to try include:
- Going for a walk and leaving your phone behind
- When you have the urge to seek reassurance, use a timer to delay. Start with 5 minutes and gradually increase the time as you go.
- Imaginal exposure: Writing out OCD’s worst case scenario while refraining from seeking reassurance.
- Embracing the uncertainty: When you have the urge to seek reassurance, lean into the uncertainty by responding “maybe that will happen, maybe not.”
- Watch a movie that triggers obsessions but leave your phone in the other room
- Try a fast from social media. Start with a short fast and increase the length of each fast as you gain confidence.
- Agreeing with the obsessions: Whatever your OCD throws at you, respond by saying “Sure, that is true!”
Clinicians working with youth should also attend to parental accommodations that inadvertently facilitate online reassurance seeking. Supportive Parenting for Anxious Childhood Emotions (SPACE) is an evidence-based, parent-focused intervention that emphasizes increasing supportive statements while reducing unhelpful accommodations. Setting reasonable limits on smartphone use while responding with empathy and confidence can help youth build resilience and independence (i.e. “I know it’s tough to be away from your phone and I know you got this!”).
Finally, because shame plays a central role in digital reassurance traps, incorporating self-compassion practices may be beneficial. Compassion-focused exercises help individuals respond to their struggles with kindness rather than self-criticism, complementing ERP by fostering emotional resilience. I sometimes ask clients to imagine that a close friend or loved one is feeling ashamed because they are experiencing obsessions and are stuck in an OCD loop. Then, I invite them to write down how they would support this friend while paying special attention to how compassion feels in their body. By practicing compassion for others, we strengthen the same muscles in our brains that help us turn compassion inward.
If you are getting stuck in digital reassurance traps, you are not alone! Many of these technologies are brand new and we are learning how to integrate them into our lives in a healthy way. If you need help managing compulsive online habits, finding a therapist trained in ERP could be a useful step!
References
Abramowitz, J. S., Schwartz, S. A., & Whiteside, S. P. (2002). A contemporary conceptual model of hypochondriasis. Mayo Clinic Proceedings, 77(12), 1323–1330. https://doi.org/10.4065/77.12.1323
Burns, A. B., Brown, J. S., Plant, E. A., Sachs-Ericsson, N., & Joiner, T. E., Jr. (2006). On the specific depressotypic nature of excessive reassurance-seeking. Personality and Individual Differences, 40(1), 135–145. https://doi.org/10.1016/j.paid.2005.05.019
Parsons, C. A., & Alden, L. E. (2022). Online reassurance-seeking and relationships with obsessive-compulsive symptoms, shame, and fear of self. Journal of Obsessive-Compulsive and Related Disorders, 33, 100714. https://doi.org/10.1016/j.jocrd.2022.100714
Parsons, C. A., Kim, H. J., Singh, S., Lkhagva, T., Wang, J., & Alden, L. E. (2025). Covert or connected: Motivations for online and interpersonal reassurance-seeking in OCD. Journal of Anxiety Disorders, 115, 103057. https://doi.org/10.1016/j.janxdis.2025.103057
Yang, X., & Luo, X. (2024). Unpacking cyberchondria: The roles of online health information seeking, health information overload, and health misperceptions. Telematics and Informatics, 97, 102225.
Zhang, X., Zheng, H., Zeng, Y., Zou, J., & Zhao, L. (2024). Exploring how health-related advertising interference contributes to the development of cyberchondria: A stressor–strain–outcome approach. BMC Public Health, 24, 534.
Jordan Karr, PhD, is the owner of River Falls Therapy in Portland, OR. He is a licensed psychologist in Oregon and Virginia, and specializes in evidence-based therapies for OCD and anxiety disorders. Dr. Karr has experience working in outpatient, community-based, and school-based settings.
The post Digital Reassurance Seeking in OCD appeared first on International OCD Foundation.
Is there an exodus underway at Epic?
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Good morning health tech readers!
<![CDATA[Meta-analysis ranks add-on atypical antipsychotics for MDD, comparing symptom response and dropout risks to guide smarter next-step treatment.]]>
New Center for Therapeutic Genetics to Develop Rare Disease Genetic Medicines
It’s estimated that nearly 400 million people across the globe live with a rare disease. Though many of these diseases are progressive, debilitating, and even life-threatening, less than five percent of them have an effective and approved treatment.
Nearly half of the rare disease patients are children and it’s estimated that 30% of children with a rare disease will not survive past their fifth birthday. Though there have been some major successes in developing and providing treatment for some children with rare disease, including Baby KJ Muldoon—who was the first patient to receive a personalized CRISPR gene editing therapy—N = 1 therapies are challenging on many levels, and these stories cannot be the functional standard practice for treating patients with rare disease.
“What if treating genetic disease could be as routine as life-saving surgery?” ask David Liu, PhD, core institute member at the Broad Institute, and Winston Yan, MD, PhD, physician-scientist at the Broad institute and director of the new Center for Therapeutic Genetics (CTG) which is working to answer this very question.
“Scaling and sustaining treatment for ultra-rare disease is a hard problem that many scientists, clinicians, patients, and drug developers are working on,” says Yan.
Along with Yan and Lui, the CTG is founded by leaders in genetic medicine, including Cat Lutz, PhD, vice president, of The Jackson Laboratory’s rare disease translational center, Timothy Yu, MD, PhD, physician and researcher at Boston Children’s Hospital, and Wendy Chung, MD, PhD, chief of pediatrics at Boston Children’s Hospital. Their aim is simple: to develop genetic medicines that can treat patients with rare diseases in a scalable and repeatable way, while sharing the methods, data, and training learned through this practice.
“What we have here is a group of leaders who believe that by approaching genetic medicines not as products, but as a standardized clinical procedure, and by sharing what we learn openly across institutions, we can make precision genetic medicine faster, safer, less expensive, and more accessible to patients and families in need,” says Yan.
The impetus behind developing the CTG is centered on patient care and utilizing ever growing biotechnology.
“We receive messages every week from parents asking for help: Can we do for their child what has been done for other children who have received treatments?” shares Liu. “The honest answer today is usually ‘not yet,’ often not because the science doesn’t exist, but because we don’t yet have the infrastructure to bring these treatments to many patients. CTG is our commitment to closing that gap, so that eventually every family who needs this kind of treatment has a path forward.”
Though the center is in its founding phase and not yet working with patients, the programs are anticipated to include the development of precision gene-editing treatments for multiple diseases, including rare forms of genetic epilepsies, supported by a recent $34.5 million award from the ARPA-H THRIVE program.
“What we are building together is scalable treatment, something our institutions will learn to do well and repeat again and again. At Boston Children’s, we see children every day for whom a diagnosis is only the beginning of a much longer journey,” says Chung.
By utilizing technology, like CRISPR or base editing or prime editing, the goal is to develop a scalable system, not just one-off treatments. The founders of CTG aim to develop programmable and modular medicines that can be customized to the patient needs, not unlike the tailored pre-operational plans that are developed for each patient undergoing a standard practice surgery.
“We used to see precisely tailored therapies for children with genetic diseases as remarkable exceptions. CTG is built on the conviction that they don’t have to be—that the methods we develop for one rare disease will carry to the next, and eventually to the many,” says Yu.
Lutz concurs, adding, “We are at a moment in genomic medicine where, for many rare diseases, the question is no longer whether we can treat them, but whether we will build the systems to do it.”
Standardizing precision medical care using programmable genetic medicines for treating rare diseases is only the beginning. Best practices and processes for addressing rare disease can translate to treating more widespread diseases as well.
“CTG exists to close a major gap in care and ensure that what we learn from one disease accelerates treatment for the next,” concludes Chung.
The post New Center for Therapeutic Genetics to Develop Rare Disease Genetic Medicines appeared first on Inside Precision Medicine.
The Download: Chinese AI divides the White House, and a record copyright payout
This is today’s edition of The Download, our weekday newsletter that provides a daily dose of what’s going on in the world of technology.
China’s AI models have Trump’s AI world at war with itself
Last weekend, several current and former advisers to President Donald Trump on AI publicly lobbed insults at the country’s leading AI companies. David Sacks branded Anthropic’s models “lobotomized” and “woke.” Emil Michael, a top Pentagon official, called OpenAI’s new head of strategic futures a “supreme village idiot.”
It began because no one can agree on what to do about Kimi, a free, open-source model that Chinese AI company Moonshot launched last week. It appears to rival the intelligence of models from OpenAI and Anthropic, which are very much not free.
Every time a new smart, free model from China gets released, US companies see less reason to fork out money for models from Anthropic or OpenAI. That’s creating economic and political problems for the president—and dividing the top AI strategists in his orbit.
Read the full story on why no one can agree what to do about Kimi.
—James O’Donnell
This article is from The Algorithm, our weekly AI newsletter. Sign up to receive it in your inbox every Monday.
The must-reads
I’ve combed the internet to find you today’s most fun/important/scary/fascinating stories about technology.
1 Anthropic’s record $1.5 billion copyright settlement has been approved
The plaintiffs said Anthropic used pirated works to train Claude. (Reuters $)
+ And won the largest known copyright payout in history. (Engadget)
+ Yet many authors and creators still don’t view it as a win. (TechCrunch)
+ But AI copyright anxiety could limit creativity. (MIT Technology Review)
2 The Trump administration is weighing a ban on Chinese AI models
The launch of Kimi K3 has revived calls for restrictions. (Axios)
+ But officials are divided on the proposals. (Fast Company)
+ China’s bet on open-source is paying off. (MIT Technology Review)
3 China is mulling tighter export controls on AI models and chips
It wants to stop the West from acquiring its tech and startups. (FT $)
+ Beijing has held talks with tech firms about potential restrictions. (Reuters $)
4 Trump’s AI safety head has resigned after just three months
Chris Fall had led CAISI, the federal AI Safety Institute, since April. (Axios)
+ No reason was given for his exit. (CNBC)
5 Google is working on a new chip to run Gemini models more efficiently
The chip, called “Frozen V2,” may be deployed in 2028. (Information $)
+ Alphabet stock popped on the report. (CNBC)
6 New Orleans police have explored arming drones with weapons
A draft drone manual paves the way for weaponised quadcopters. (404 Media)
+ Shoplifters could soon be chased by drones. (MIT Technology Review)
7 The EU has handed AliExpress a record fine over unsafe product sales
The €550 million fine is the largest-ever under the Digital Services Act. (BBC)
+ Alibaba has vowed to appeal the fine. (SCMP)
8 Election advice from AI chatbots is “inaccurate and unreliable”
That’s the conclusion from tests in Hungary earlier this year. (Guardian)
9 Red light therapy is showing promise for healing and healthy aging
Better skin and reduced vision loss are also on the cards. (Economist $)
10 Neill Blomkamp’s new horror clip is all AI-generated—and it sucks
The acclaimed director wants to make “a full feature in this format.” (Gizmodo)
Quote of the day
“This would be a terribly self-defeating form of intervention if it were to happen.”
—Tech investor Chamath Palihapitiya slams plans to restrict Chinese AI models in a post on X.
One More Thing
AKILAH TOWNSEND
Inside Chicago’s surveillance panopticon
Early on the morning of September 2, 2024, four people were shot and killed on a westbound train in Chicago. Police swiftly activated a digital dragnet—a surveillance network that connects thousands of cameras across the city—and arrested the suspect just 90 minutes later.
Law enforcement and security advocates say this vast monitoring system protects public safety and works well. But activists and many residents say it’s a surveillance panopticon that creates a chilling effect on behavior and violates guarantees of privacy and free speech.
Go inside the surveillance network that’s dividing Chicago.
—Rod McCullom
We can still have nice things
A place for comfort, fun, and distraction to brighten up your day. (Got any ideas? Drop me a line.)
+ NASA has shared a stunning timelapse video of the Psyche spacecraft’s view of Mars.
+ This comparison of American and European Urbanism shows good city design is a choice.
+ Musician Luca Stricagnoli recently performed a marvellous acoustic guitar medley of Prodigy songs.
+ Two Australian paddleboarders saved a stranded wallaby after it was swept out to sea—and caught the whole rescue on video.
<![CDATA[Clinicians weigh telepsychiatry for schizophrenia, urge early long-acting injectables, and reveal tips on samples, coupons, and prior authorizations.]]>