AI tools need more data to work, must for mammograms
Top US cardiologist, scientist and author on why limited real-world data remains a trust gap, though AI shows promise in diagnosis, empathy and preventive care.
As per Johns Hopkins data, in the US, of the 12 million serious diagnostic errors in a year, 800,000 people are either disabled or dead, Dr Topol said. (File photo)
AI in medicine has been germinating for at least a decade but what is missing is real world medical validation for effective diagnosis, according to Dr Eric Topol, top US cardiologist, scientist and author of ‘Super Agers-An Evidence Based Approach to Longevity.’
Responding to a query by The Indian Express at a virtual media interaction regarding how Indian patients can build trust on AI driven diagnoses, especially in low resource settings, Dr Topol said that there is limited real-world data for accurate projections. “There is very little compelling data from the ‘real world of medicine, which can be messy’ to test these models. We don’t have them yet for these LLMs (large language models) to give top-notch differential diagnoses. But they keep getting better,” he said. Excerpts:
Why should AI tools be an adjunct for mammograms?
Referring to his recent report in The Lancet, where he made a strong case that every mammogram performed globally should include AI support because the latter enhanced accuracy beyond the performance of radiologists, he cited compelling evidence from the follow-up of the Mammography Screening with AI randomised trial. It assessed the reading of two radiologists compared with one radiologist plus an AI algorithm. “The results indicate a new standard-of-care for breast cancer screening,” he said.
Dr Eric Topol is a top US cardiologist, scientist and author of Super Agers-An Evidence Based Approach to Longevity. (Express photo)
“In the MASAI trial, the use of AI led to a 29 per cent improved detection of breast cancer with no increase in false positives or recall rate. At the two-year follow-up, there were 12 per cent fewer interval cancer diagnoses, a reflection of the higher rate of early detection. That is indicative of some AI-mediated prevention. Several prospective real-world studies back up what was found in MASAI, including those in Germany, Hungary, South Korea, Sweden, and the USA: better cancer detection without an increase in recall rate. Meanwhile, algorithms have been validated that predict the risk of cancer over the next five years in a patient with a normal mammogram,” he said.
Topol describes AI as providing “digital eyes” that see features, such as calcifications or subtle density changes that humans might miss. In his paper, he highlighted how AI can detect breast arterial calcification, allowing the mammogram to detect early cardiovascular disease risk, which is the leading cause of death in women
What’s the right lens on longevity?
For Dr Topol longevity is not just about an extended lifespan but staying healthy in advanced years. “In the US, the average health span ends around age 64–65, when most people develop at least one age-related disease, while the average lifespan is about 79. That leaves roughly a 15-year gap spent in declining health. We now have the capability to predict disease risk in ways that were not possible before. By integrating large-scale, individualised health data, it is increasingly feasible to map a person’s likely health trajectory over the next 20 years. This opens the door to preventive care. Yet, healthcare systems — particularly in the US — are not yet structured enough to take advantage, especially compared to some other high-income countries,” Dr Topol said.
Dr Topol said he was excited about the opportunity to prevent age-related diseases in the future and touched upon various aspects like biomarkers for Alzheimer’s Disease and the capability to predict disease risk in ways that was not possible before. One of the most significant breakthroughs in neuroscience is the biomarker p-Tau217, a blood test that provides an early signal of Alzheimer’s disease risk. Building on this, studies are enrolling high-risk individuals identified through p-Tau217 and randomising them to intensive lifestyle interventions with continuous coaching versus standard care. “Not long ago, we didn’t even have the tools to identify these individuals, let alone design such trials. That shift highlights just how rapidly the field is advancing,” Dr Topol said.
What about empathy in LLMs (Large Learning models)?
The one thing that has surprised him about AI is the transmission of empathy by LLMs. “See anybody in the world can access chatbots and get good or bad information. What I did not anticipate was transmission of empathy by LLMs. There were 13 studies and AI responses were more empathetic than that of the physician. These machines would not have a clue of what empathy is but are very good at transmitting it through a language better than physicians. So eventually physicians will have to be coached through AI to be more empathetic,” he said.
Anuradha Mascarenhas is a Senior Editor at The Indian Express, based in Pune. With a career spanning three decades, she is one of the most respected voices in Indian journalism regarding healthcare, science and environment and research developments. She also takes a keen interest in covering women's issues .
Professional Background
Education: A gold medalist in Communication and Journalism from Savitribai Phule Pune University and a Master’s degree in Literature.
Author: She authored the biography At The Wheel Of Research, which chronicles the life and work of Dr. Soumya Swaminathan, the former Chief Scientist at the WHO.
Key Focus: She combines scientific accuracy with storytelling, translating complex medical research into compelling public and human-interest narratives.
Awards and Recognition
Anuradha has won several awards including the Press Council of India's national award for excellence in journalism under the gender based reporting category in 2019 and the Laadli Media award (gender sensitivity -2024). A recipient of the Lokmat journalism award (gender category-2022), she was also shortlisted for the RedInk awards for excellence in journalism-2021. Her debut book At The Wheel Of Research, an exclusive biography of Dr Soumya Swaminathan the inaugural chief scientist of World Health Organisation was also nominated in the Popular Choice Category of JK Paper AUTHER awards. She has also secured competitive fellowships including the Laadli Media Fellowship (2022), the Survivors Against TB – New Research in TB Media Fellowship (2023) and is part of the prestigious 2025 India Cohort of the WomenLift Health Leadership Journey.”
Recent Notable Articles (Late 2025)
1. Cancer & Specialized Medical Care
"Tata Memorial finds way to kill drug-resistant cancer cells" (Nov 26, 2025): Reporting on a breakthrough for triple-negative breast cancer, one of the most aggressive forms of the disease.
Discipline, diet and purpose; How a 97-year-old professor defies ageing'' (Nov 15, 2025) Report about Prof Gururaj Mutalik, the first Head of Department at Pune's B J Government Medical College who at 97 credits his longevity to healthy habits and a strong sense of purpose.
2. Environmental Health (The "Breathless Pune" Series)
Long-term exposure even to 'moderate' air leads to chronic heart, lung, kidney issues" (Nov 26, 2025): Part of an investigative series highlighting that even "safe" pollution levels are damaging to vital organs.
"For every 10 µg/m3 increase in PM2.5 level, there was 6-8% jump in medicine sales" (Nov 23, 2025): Using commercial data to prove the direct link between air quality and respiratory illnesses in Pune.
3. Lifestyle & Wellness News
"They didn't let cancer, diabetes and heart disease stop them from travelling" (Dec 22, 2025): A collaborative piece featuring survivors who share practical tips for traveling with chronic conditions.
At 17, his BP shot up to 200/120 mmHG; Lancet study flags why child and teen hypertension doubled between 2000 and 2020'' (Nov 12,2025)--A report that focusses on 17-year-old-boy's hypertensive crisis and reflects the rising global trend of high blood pressure among children and adolescents.
4. Scientific Recognition & Infrastructure
For promoting sci-comm, gender diversity: IUCAA woman prof highlighted in Nature" (Nov 25, 2025): Covering the global recognition of Indian women scientists in gender studies and physics.
Pune researchers find a spiral galaxy like the Milky Way from early universe'' (December 3, 2025)- A report on how Indian researchers discovered a massive galaxy that existed when the universe was just 1.5 billion years old , one of the earliest to have been observed so far.
Signature Beat: Health, Science & Women in Leadership
Anuradha is known for her COVID-19 reportage, where she was one of the first journalists to provide detailed insights into the Covishield and Covaxin trials. She has a dedicated interest in gender diversity in health and science, often profiling women researchers who are breaking the "leaky pipeline" in STEM fields. Her writing style is scrupulous, often featuring interviews with top-tier scientists and health experts from various institutions.
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Dr Eric Topol is a top US cardiologist, scientist and author of Super Agers-An Evidence Based Approach to Longevity. (Express photo)
