Here is a real world example BEFORE LLM's
Metformin and Alzheimer's Disease
The link between metformin and Alzheimer's disease is a fascinating and ongoing area of research that exemplifies how a drug's "secondary findings" or "off-label" effects can lead to new therapeutic avenues.
- Primary Use: Metformin has been a first-line treatment for Type 2 diabetes for decades. Its primary mechanism of action is to lower blood glucose by increasing insulin sensitivity and decreasing glucose production in the liver.
- Secondary Findings and Observations: Over time, observational studies began to show a correlation: people with diabetes who were taking metformin seemed to have a lower risk of developing dementia and Alzheimer's disease compared to those who weren't. This was a "secondary finding" from analyzing large-scale health data, as the drug was not originally prescribed for cognitive issues.
- The Research Connection: This observation sparked significant research into how metformin might affect the brain. Scientists have since found several potential mechanisms, including:
- Neuroprotective effects: Metformin has been shown to reduce neuroinflammation, oxidative stress, and neuronal cell death in animal models.
- Metabolic link: There's a strong connection between insulin resistance (a hallmark of Type 2 diabetes) and Alzheimer's disease. Metformin's ability to improve insulin sensitivity might also benefit brain health.
- AMPK activation: Metformin activates an enzyme called AMPK, which plays a critical role in cellular energy metabolism. This activation may help clear abnormal proteins (like amyloid-beta and tau, which are associated with Alzheimer's) from the brain
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The initial discovery of the link between metformin and Alzheimer's disease was not due to AI or LLMs. It was a classic example of observational research using large-scale medical records, sometimes referred to as "real-world data."
The Role of Large Medical Records
For years, researchers have been analyzing large datasets from health systems, insurance companies, and national health registries. These datasets contain anonymous information on millions of patients, including their diagnoses, prescriptions, and health outcomes over many years. When studying these records, scientists began to notice a compelling pattern:
- People with Type 2 diabetes who were prescribed metformin appeared to have a lower risk of developing dementia and Alzheimer's disease compared to those with diabetes who were not taking the drug or were on other medications.
This observation, repeated across various studies and different populations, was the key "secondary finding." It was the direct result of a human researcher or team asking a question of a large database, identifying a correlation, and then forming a hypothesis to test in a more controlled, mechanistic way.
The Role of AI and LLMs
While AI and LLMs were not involved in the initial discovery of this link, they are crucial tools in the subsequent research. Their role is to accelerate the process of understanding the "why" and "how" behind the observation.
- AI for Deeper Analysis: AI and machine learning algorithms can be used to analyze these same vast datasets with greater speed and precision. They can identify subtle correlations that might be missed by human researchers, and they can help to control for confounding variables that could skew the results. For example, AI can analyze a patient's entire health history to determine if other factors (like cholesterol or blood pressure) are more responsible for the observed link.
- LLMs for Synthesis and Hypothesis Generation: While a correlation in the data is a starting point, it doesn't explain the biological mechanism. LLMs are not used to make the initial "discovery," but they can be invaluable for synthesizing the latest scientific literature to help researchers formulate new hypotheses. They can quickly process thousands of scientific papers to find connections between metformin's known effects on the body and the biological processes involved in Alzheimer's.
In summary, the initial observation was a product of traditional data analysis on large, ORCL/EPIC-like databases. The deeper understanding of that link is where modern AI and LLMs are playing an increasingly significant role.
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You want to own/manage the data and the LLM's. ORCL is now one of my top 5 holding for this reason. |
