Hallucinations

In the 21st century hallucinations have become a daily experience. The origins of the word can be followed back at least to the Latin verb “alucinor”, best translated with “to hallucinate”. As a verb to can conjugate it, meaning that I can do it, you can do it, s/he can do it, and we may do it in groups. Roman emperors did it, American presidents do it and, of course, AI does it. Hence, it is a great subject to study.
In “Nature” 2025 we find ways to limit hallucinations of AI systems. The strategy consists mainly in repeated queries of the same type, but from different angles. It is a bit like cubism applied to informatics. On “github.com” we can follow the rankings of AI-models using LLMs based on the “hallucination-leaderboard” developed by Vectara. On “huggingface.com” you can test the Hughes Hallucination Evaluation Model. For example it is possible to run a test of your own small text documents (just like any blog entry on this webpage) and what the AI systems will do them in an attempt to summarize your ideas. According to the “hallucination-leaderboard” we are confronted with a 1.3%-4% hallucination rate of the top 25 LLMs as AI-systems. In text based systems the quantity of “errors” is a first indicator only. The seriousness of the omission, addition of wrong information or an erroneous judgment will be left to the reader or analyst to uncover.
There is now a lot to do to test various AI-systems on their “trustworthiness” in summarizing my own work. My very own daily hallucinations have become a large data base as a test case for the capacity of LLMs to make sense of them.
Based on the series of passed blog entries I shall test the capacity of AI to predict the n+1 blog entry. It would be great to know today what I am going to write about tomorrow etc. Thanks to AI I shall have (finally) a sort of intellectual life after death (not sure whether I should want this). Enough of hallucinations and on hallucinations for now, back to serious readings or fictionalized science. (Image: extract from Delphine Diallo, Kush, 2024 at Hangar Gallery Brussels).

Science and Fiction

We associate with science and fiction the extrapolation of scientific trends into some futuristic settings. The most striking examples of science fiction in novels or video use some scientific findings (dinosaurs, genetic engineering) and project this knowledge into another fictional setting. The usual personal relationships follow rather predictable plots of romance, deception, violence or war.
The novel “Wellness” (Hill 2024) is also a kind of science fiction as it is based on social science evidence and builds its fictional plot firmly embedded into the social and psychological research. The attachment of references (and defending the print of those in translation) underlines the commitment to write a new type of “social science fiction”.
In this innovative style the scientific basis of psychology and sociology is then extrapolated into a fictional arrangement. Research on subjective well-being with the U-shaped form over the life course and the extrapolation of the placebo effect, which is instrumentalized for a business, derive from key topics in the social sciences. In fact, the novel and the background scientific literature in the bibliography could well figure in a social science course at university entry level. These readings constitute a 360-degree-view on personal development and social structures. Of course, social sciences move on and add new evidence on an almost daily basis, but the selection and arrangement of the characters create an innovative social science fiction, without some unrealistic technological extrapolation.
It strangely feels like we are already part of this social science fiction (compare “Klara and the sun” by Ishiguro) as politicians advocate and campaign with placebo topics in elections and project us into some more happy past or future.
The social science fiction of Nathan Hill resembles for me the great utopian novel by George Orwell “1984” published in 1948. A title “2032” instead of “Wellness” could have worked quite well, as the first edition of Nathan Hill’s social science fiction was published already in 2023. (Image: Extract of: Lo Spagnolo, 1665-1747, Hecuba makes Polymnestor blind, MRBAB).

Review Year

It is a nice common practice to wish „A happy New Year“ to people at the beginning of another calendar year. It is also a good practice to review the last twelve months yourself or with friends. We spend,however, much less time to listen to friendly or enemy fire as a kind of evaluation of what were the successes and failures of last year. In monarchies in the middle ages a clown or a fool was allowed to present criticisms with funny packaging. Nowadays, comedians have taken over this important role to review experiences and policies that worked or went awfully wrong. All media join in in this tradition and summarize what happened before the next busy months take over. Yes, it is important to devote time to this procedure. There is a risk that it becomes „the same procedure as every year“, but it is never to late to learn from failures or simple mistakes. Failed last year, fail better next year. 

Investment Disinvestment

Asume we live in a world of fixed amounts of investments. The option to invest in a new project or product will automatically reduce the amount of investment in another product. The investment decision, therefore, is subject to opportunity costs. A recent study by Naci et al. (2025) applies this rationale to the investment in new drugs compared to financing other traditional treatments. The results for the U.K between 2000 and 2020 revealed that the „quality-adjusted life-years (QALYs)“ is not in favor of the investment in new drugs. The relatively small numbers of beneficiaries of the new drugs is compared to the many other persons who could have benefited from the less costly previous treatment. Investment in one new drug causes disinvestment in other ones. The overall balance for the UK turned out to be negative. Particularly the disinvestment in prevention of diseases appears to have very detrimental effects in view of the results based on this study. Preventative measures are relatively cheap compared to the estimated 20.000 pounds for one additional quality adjusted year of life for a new drug. The message is: choose your health investments wisely to avoid ever rising health costs and health insurance. (Image: rest room Belgium)

Health Tech

Health technology assessment (HTA) is an interesting scientific field. The new digital opportunities allow people to participate in medical and medication trials in their homes or even in bed. Their health data and the administration of medication is also encouraged and sometimes supported through digital devices. The pharma and health industries have many devices ready to go. The differences to the traditional forms of medical trials, however, is an issue as we want to compare the results from both kinds of trials. Participants of trials, might prefer or struggle with these novel kinds of study designs. In any case the results will be impacted in several forms (Study Link). In the best of all worlds for the researcher the effects will cancel out each other, but is rather unlikely. Some participants will reach more positive effects with the use of digital tools, whereas others are challenged and might even abandon during the trial. Monitoring during the study (for example through digital inhalors) is another advantage of such distributed trials. Rather than taking adherence to a trial medication for granted, digital tools allow a more precise monitoring of subgroups as well. Data and effort invested in the trial is preserved through the easier access to person’s information, assuming continuous readiness to stay on in the trial.
Our own smartphones are still underexploited in terms of health monitoring and use in research designs. The possibilities to link data to other external data sources shall further advance the research potentials in many interesting ways. Data protection and data security become even more important with the ever smarter phones and connected devices.

Book Value

What is the value of a book? For the author of a book each book s/he has written or sweated the value of the accomplishment is pretty high. From the publisher’s perspective a book is an investment and sometimes a very risky one. The book store makes choices and takes the risk to devote time and effort to select the bestselling books or the best one suited to the local or passing audiences. Next in line are librarians who either stock everything published in a specific language or country (legal deposit) or select from the offer according to perceived interests of their subscribers. On the way to their audience many mistakes may occur. Books miss their targets or librarians go wild in their efforts to guard or discard books. In any case, many books do not find their audience. Some sit on shelves for years and will never be touched by anybody. Other ones pass from one hand to the other rapidly with long waiting lists.
Even if many conservationists don’t like it, it is the use of books that honors books and authors. Pocket books play a specific role in this link of readers and writer. Use rather than conservation, is the prime role of these lighter versions of books. They also have to endure heavy weather, scratches and folding of persons focused on content rather than precious form.
Last but not least in line comes the market for recycled books. Re-use of read or unread books has increased over years and some readers are happy to discover a discarded book from a previous owner (public or private). The value of a book lies in most cases in the eye of the reader. This then makes it an object of competitive marketing and continuous auctioneering.
(Image: pocket books at display of Popular heritage Lost and Found at the Royal library of Belgium 2024.

Patient Empowerment

The empowerment of patients is a well-established practice in the treatment of diabetes. Measuring your own blood sugar and adjusting your medication to the self-monitored data is common practice. For patients with high blood pressure this patient empowerment is less prevalent. A medical study carried out in Valencia (Spain) by Martínez-Ibáñez et al. (2024) has tested the effects of such a self-monitoring and self-medication experiment.
The results publishes in (JAMA) gave rise to considerable attention in the profession as the empowerment of patients is one way out of the likely increasing shortage of medical professionals in aging societies. Whereas other studies found that total costs to the medical system might increase, the study in Spain provides evidence of the cost-reduction effect of such an empowerment. 24 months after the beginning of the trial. After the establishment of a “medication based on an individualized prearranged plan used in primary care” the self-administering participants achieved a significant decrease in their blood pressure that lasted until the end of the study after 2 years. The drop-outs of the study seem to follow a random pattern.
The conclusion gives support to the potential of patient empowerment in the widespread treatment of higher blood pressure beyond the regular visits of medical doctors. The monitoring of changes in lifestyle add to this to keep the costs of health care under control in aging societies.

Hospital Bias

Asking people about differences between private and public hospitals, you are most likely getting answers that the private hospitals deliver superior patient outcomes. Whereas private hospitals seem to have a positive stigma attached to them, public hospitals commonly have a negative stigma. Scientific evaluations are helpful to set the record straight again. The study published in “The Lancet Regional Health” in 2024 shows that in the simple descriptive statistics on several patient outcome indicators, this is what the data showed between 2026 and 2019. However, a more precise statistical analysis reveals that there is also a selective admission to the private and public hospitals in England. Using so-called instrumental variables approaches that account for the selection process between admission to the 2 types of hospitals (private versus public) most of the differences between the hospital types disappear. The underlying mechanism is a sorting of different patients into the private or public hospitals. Put in easy words, for a routine intervention people tend to chose the private hospital, but the more rare and difficult operations were more likely admitted to public hospitals. The number of co-morbidities (heart disease) is also of importance as they might negatively affect patient outcomes. Jumping to conclusions and reinforcing stigma about public or private provision of services hinders progress and an equitable provision of services.
The analysis of a potential selection bias can reveal the “creaming” effect of private provision of (health) services. Just caring for the “easy” or routine cases and avoiding the more difficult and costly cases has economic advantages, but for society as a whole the costs overall remain the same. A good public service in health is a definite asset.

(Image: Exposition Isa Genzken 2023 in Neue Nationalgalerie Berlin)