Dear Doctors: If it's true that, according to a 2024 study, there are some 200,000 deaths (amazingly!) each year from medical errors in the United States, might AI be used to reduce them? I've read it can help with ventilator mishandling, patient instruction omissions and detecting diagnostic oversights.

Dear Reader: Your question about artificial intelligence broaches a topic that is generating both cautious enthusiasm and widespread concern. It may seem like an emerging debate, but the idea of AI as a medical tool dates back to the mid-20th century. What started as a largely theoretical idea in 1950 had, by the turn of the century, evolved into a range of algorithms and pattern-recognition models. These were designed to assist with imaging analysis, diagnosis and even some aspects of clinical care. It wasn't until a significant leap in data and computing resources in the 2010s that modern deep-learning approaches would be able to turn theory into practice.

Before we look at how AI may be useful in medical care, we should clarify the statistics you cited. Despite a widespread desire for an authoritative number, estimates of deaths due to medical error vary widely, depending on how those errors are defined. Some studies stick solely to point-of-care mistakes. Others include system-level failures, such as a lack of coordinated care, a lack of access to appropriate care, medical insurance practices, faulty or incomplete safety nets and inadequate follow-up care. The analysis associated with that 200,000 figure takes this broader view and does not reflect only point-of-care mistakes.

Proponents of AI believe these tools can be harnessed to improve medical care. Pattern-recognition models, in particular, have already proven effective at analyzing medical imaging scans, often with gains in both speed and accuracy. A study done here at UCLA found that AI models were able to identify pancreatic tumors in CT scans months, and sometimes years, before the human eye could see them. Another real-world use is screening for diabetic retinopathy, a complication of diabetes in which high blood sugar levels damage blood vessels in the retina. AI systems have also shown promise as early warning tools for sepsis, in detecting heart arrhythmias in ECGs and for reading mammograms in breast cancer screenings.

While acknowledging the possible benefits of these powerful tools, many clinicians and researchers advise a measured approach to adopting them. Medicine is, at its core, a deeply personal science, and context matters. For that reason, most experts emphasize that artificial intelligence should be used as an aid, not treated as an authority.

When incorporated thoughtfully and with proper oversight, AI systems have the potential to improve medical care. They can scan large amounts of data quickly and identify patterns associated with early-stage diseases or conditions that might otherwise go unnoticed. They can improve accuracy in imaging review, detect early signs that a patient’s vital signs are signaling future problems, identify gaps in follow-up care and reveal breakdowns in coordination before they lead to harm. As AI tools evolve, keeping humans firmly in the equation will be key not only to their success but to their eventual acceptance.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctors: My wife started getting sick a few days before Halloween. We were worried that it was going to turn into a bad respiratory illness, but it stayed in her nose and throat. That's a common cold, right? Why is having a cold so different from when you get the flu?

Dear Reader: Both of the illnesses you mention in your letter -- the flu and a cold -- fall into the broad category of upper respiratory infections. Because different types of viruses cause each one, the body's response can vary a lot. The flu can cause serious illness and can lead to hospitalization and even death. The common cold, by comparison, is shorter in duration, with symptoms that are not as bad. Having a cold isn't fun by any means, but it's not a serious threat to health. To understand why, we need to take a closer look at the microbes involved.

Influenza, commonly known as the flu, is caused by specific subtypes of the influenza virus. Most often this is influenza A and influenza B. The flu hits hard and fast due to the nature of the influenza virus. People shed the influenza virus through droplets primarily spread by coughing or sneezing. When others inhale the flu virus, it absorbs through their mucous membranes. Then the flu virus penetrates deep into the tissues that line the airways. The virus can evade early immune detection by shielding itself from the sentinel cells of the immune system. By the time the immune system finds this invader, the viral infection has grown, so the body triggers a powerful inflammatory response to fight it.

The common cold, by contrast, is a milder infection. Symptoms usually start gradually over a day or two. Colds are most often caused by rhinoviruses. These viruses tend to stay in the upper airways and trigger fewer and less intense immune responses. The immune system also recognizes the infection earlier, so the body has a slower and more measured inflammatory response.

An interesting fact: There are several types of rhinovirus that can cause the common cold. That’s why it’s possible to have two colds in a row. You aren’t catching the same cold twice, but responding to two separate rhinoviruses.

Medical care for a cold and the flu also differ. Treatment for a cold focuses on managing your symptoms. Usually, over-the-counter meds help ease pain and relieve sinus and nasal congestion. Getting plenty of rest helps, as does drinking lots of fluids to replace what the body uses to produce mucus. For a mild case of the flu, a similar treatment, along with cough medicine, can be enough. But for serious flu symptoms, you want to check with your doctor. They may recommend a prescription of antiviral medications. Starting these medications in the first two days of an influenza infection can shorten the illness. If someone with the flu has worsening symptoms, including chest pain or high fever, they should seek immediate medical care.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

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Dear Doctors: I am a 74-year-old female and was diagnosed with popliteal artery stenosis in my left calf. When walking briskly, it is bothersome to painful. I stop, stretch and can continue, up to 4 miles most days. My internist has suggested I start taking Wegovy. Is this a known treatment?

Dear Reader: Let’s begin with defining your diagnosis. Popliteal artery stenosis is a form of peripheral artery disease, or PAD. This is a fairly common condition. The arteries in the legs, arms or pelvic area get narrower. This reduces blood flow to the area. (The medical term “stenosis” means narrowing.) Risk factors for PAD include high blood pressure, poor blood lipid profiles, diabetes, being overweight or obese and smoking. Family history of cardiovascular disease is also a factor, and older adults have higher risk of PAD.

The popliteal artery reaches from the lower thigh to the upper calf. It lies just beneath the two heads of the gastrocnemius, the large calf muscle, as it passes behind the knee. Popliteal artery stenosis restricts blood flow to this large muscle. The muscle doesn’t get enough oxygen or nutrients, which allows waste products to build up. This can lead to the pain and cramping that you describe. When you pause to rub your calf, you are giving the tissues in the calf time to recover from the lack of oxygen caused by the stenosis. This is why your symptoms improve after a break.

With the recommendation of using Wegovy, a semaglutide medication, your doctor is following new data on reducing cardiovascular risk. New research has found that these medications can improve the metabolic health factors that contribute to atherosclerosis, and thus PAD. A recent study looked at 792 people living with diabetes who also had peripheral artery disease. The participants who used a semaglutide medication reported a marked decrease in PAD symptoms. They were also able to walk for longer distances. A different study that followed 1,363 people with PAD over the course of almost four years had similar results.

While these results are encouraging, it is important to understand that this is an off-label use of semaglutide medication. While it has shown distinct benefits, it hasn’t been through rigorous testing for safety and efficacy for this specific use. Also, semaglutides are not right for everyone. People with a history of medullary thyroid cancer should not take them. They may not be right for people with some gastrointestinal conditions, such as severe gastroparesis. They can also cause side effects that are worth knowing about. Side effects can include nausea, diarrhea, headache, stomach pain and heartburn.

In making your decision, ask your doctor what research they are using for this recommendation. Ask about the guidelines for its use, and what to do if anything goes awry. You can also get a second opinion from a doctor with experience in PAD if you’re still not sure.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)