Google's new AI podcast creator, NotebookLM

forestglip

forestglip

Senior Member (Voting Rights)
Staff member
NotebookLM is a Google AI product where you can upload sources, like PDFs of studies, then press generate audio, and it makes a quite realistic sounding podcast conversation between two people discussing the source(s). Might be a useful tool for summarizing long papers.

I tried it with the NIH deep phenotyping study. It seems they basically only talk about effort preference in the podcast. Though of course that was front and center in the paper.

Link to audio (might need to log in to listen)

Here's a text excerpt from the transcript. I made up the names. There's no built in way to download a text version from what I could tell, so I used Google Cloud's speech2text software.

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"[Greg] this is all starting to make a lot more sense but it also releases a huge question for me if PI-ME/CFS is rooted in this miscommunication between the brain and body what does that mean for treatment? can we actually rewire those signals so if this is about like faulty wiring in the brain yeah can we rewire it can we actually change how the brain and body are talking to each other?

[Jenny] that that is the million dollar question and this research offers you know a glimmer of hope I think

[Greg] okay I'm definitely ready for some hope here what are we talking about

[Jenny] well if the issue is with how the brain is perceiving and responding to effort right what if we could retrain those neural Pathways what if we could kind of reset that internal alarm system that's that's stuck on high alert

[Greg] so instead of just managing the fatigue with like medication or rest we're talking about actually targeting the underlying cause of that miscommunication

[Jenny] exactly yeah and there are some intriguing possibilities here the researchers suggests that therapies focused on the nervous system things like certain types of physical therapy or even brain stimulation techniques might hold the key

[Greg] okay now we're really thinking outside the box how would those therapies actually work?

[Jenny] well you can think of it like Physical Therapy but for your brain okay instead of strengthening muscles you're retraining neural circuits gradually increasing activity levels in a way that teaches your body to tolerate more exertion without triggering that that massive crash

[Greg] so kind of like desensitizing your system to those effort signals

[Jenny] exactly and there's growing evidence that these kinds of therapies can be effective for other conditions involving dysregulation of the nervous system that's really interesting

[Greg] this is all so promising but it also makes me think if we're talking about the brain's role in all of this what about the psychological aspect could things like stress or even our mindset play a role in PI-ME/CFS

[Jenny] yeah that's it that's a great question and one that researchers are really just beginning to explore there's definitely evidence that stress and Trauma can impact our immune and nervous systems and we know that those systems are right at the heart of PI-ME/CFS

[Greg] so our mental state could potentially influence how our body experiences and responds to illness

[Jenny] yeah out of even at a physiological level this it's this fascinating complex interplay of the mind and body and understanding this connections could be really really crucial for you know developing truly effective treatments down the line"
 
I tried with another paper:

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: the biology of a neglected disease, 2024, Arron et al

Link to audio

Text excerpt:

[Greg] it's like trying to you know run a marathon with a dead phone battery you're not gonna get very far. so you've got these gut issues feeding into inflammation which then makes oxidative stress worse and on top of it all your cells can't even make energy properly it's it's complicated

[Jenny] no kidding makes you realize why there's not just like one easy fix for this

[Greg] right it's not as simple as just taking a pill although some of the treatments being researched do involve medication

[Jenny] oh yeah the article does mention some promising directions for treatment what makes these different from what they were trying before which wasn't always so helpful

[Greg] well for one it's actually acknowledging that mecfs is real that it's not you know all in your head

[Jenny] which it never was but

[Greg] exactly so for something like gut dysbiosis they're looking at things like diet, prebiotics, probiotics to try and restore that balance in the gut

[Jenny] makes sense fight the bad bacteria with I guess good bacteria

[Greg] exactly and because inflammation is such a key player here their researching anti-inflammatory medications but also lifestyle changes stress reduction even just you know making sure you're getting enough sleep

[Jenny] right that stuff matters for everyone but

[Greg] especially in this context

[Jenny] yeah it makes sense I remember the article mentioned antioxidants too specifically vitamin E

[Greg] antioxidants they're like imagine your body's own rust proofing system go back to that analogy so if oxidative stress is rust antioxidants help protect against it

[Jenny] okay that makes sense and for the mitochondrial piece anything for that

[Greg] that's where CoQ10 comes in it's this compound naturally occurring and it's basically vital for energy production in the mitochondria so they're studying if giving people extra CoQ10 can help improve their energy

[Jenny] so not a cure but hopefully

[Greg] steps in the right direction

[Jenny] exactly it seems like finally there's some real momentum behind ME/CFS research which frankly is long overdue
 
I had trying exactly this on my Todo list! From what I’ve heard from others it is extremely good at sounding convincing but can err towards common held arguments or beliefs rather than what is necessarily in the sources. Looks interesting though, especially for high level overviews if you’re aware it may be sketchy on the detail.
 
I’ve been experimenting with my own summariser scripts but I haven’t yet hooked them up to use cloud TTS or share these files yet.

Here’s example output for these two papers, any feedback to help tailor my prompts very welcome.

——
https://www.nature.com/articles/s41467-024-45107-3
This research paper explores the biological underpinnings of post-infectious myalgic encephalomyelitis/chronic fatigue syndrome (PI-ME/CFS), a debilitating condition characterized by persistent fatigue and other symptoms following an infection.

**Key Findings:**

* **Altered Effort Preference:** A defining feature of PI-ME/CFS was an altered preference for exertion, rather than physical limitations. This was linked to dysfunction in brain regions (temporoparietal junction) associated with integrating willed actions and actual movements, potentially caused by dysregulation in the brain's catecholamine system.
* **Autonomic Dysfunction:** PI-ME/CFS participants exhibited signs of autonomic nervous system dysfunction, such as reduced heart rate variability and impaired baroreflex function (which controls blood pressure), suggesting a role of the nervous system in the disease.
* **Immune Activation:** The study found evidence of chronic immune activation in PI-ME/CFS, with increased naive B cells (immune cells that haven't encountered a specific pathogen) and decreased switched memory B cells (immune cells that have "memorized" previous infections) in the blood.
* **Sex-Specific Differences:** Biological differences between male and female PI-ME/CFS participants were observed in immune cell populations, gene expression in muscle and blood cells, and metabolite profiles. This suggests that biological sex may play a role in how the disease manifests.
* **Cognitive Complaints without Impairment:** While PI-ME/CFS participants reported significant cognitive difficulties, their performance on objective neuropsychological tests was normal. This disconnect between subjective experience and objective performance requires further investigation.

**Methods Used:**

The study employed a comprehensive "deep phenotyping" approach, involving a wide array of tests and analyses:

* **Clinical Evaluation:** Participants underwent detailed medical and psychological evaluations, including symptom questionnaires and performance validity testing.
* **Physiological Testing:** Tests included autonomic function assessment (heart rate variability, blood pressure responses), cardiopulmonary exercise testing (CPET), muscle function (grip strength), and actigraphy (measuring activity levels).
* **Neuroimaging:** Functional magnetic resonance imaging (fMRI) was used to assess brain activity during a grip strength task.
* **Biomarker Analysis:** Blood, cerebrospinal fluid, muscle, and stool samples were analyzed for immune markers, catecholamines (neurotransmitters), metabolites, lipids, and gene expression.
* **Microbiome Analysis:** The gut microbiome composition was analyzed using shotgun metagenomics.

**Limitations:**

* **Small Sample Size:** The study included only 17 PI-ME/CFS participants and 21 healthy volunteers. This limits the statistical power and generalizability of the findings.
* **Cross-Sectional Design:** The study provides a snapshot of biological differences at a single point in time. Longitudinal studies are needed to understand how these factors change over the course of the illness.
* **Absence of a Diagnostic Biomarker:** ME/CFS diagnosis remains based on symptom criteria, potentially leading to variability in participant selection and making it difficult to compare findings across studies.

**Implications:**

This research contributes significantly to our understanding of PI-ME/CFS by providing evidence of distinct biological abnormalities. The findings highlight the role of the central nervous system, autonomic dysfunction, immune activation, and sex-specific differences in the disease. While more research is needed to validate and expand upon these findings, this study offers valuable insights that could guide the development of targeted therapies for PI-ME/CFS.

——
https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4622074

This scientific review paper explores Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), a chronic and complex illness characterized by debilitating fatigue and a range of other symptoms that significantly impact patients' lives. The paper highlights the lack of standardized diagnostic criteria and proven treatment avenues for ME/CFS, making it a "neglected" disease.

**Key Findings:**

* ME/CFS is a heterogeneous disease, with varying symptoms and severity among patients.
* The most characteristic symptom is Post-Exertional Malaise (PEM), a worsening of symptoms following even minor physical or cognitive exertion.
* The exact cause of ME/CFS is unknown, but it is believed to be multifactorial, with potential triggers including viral infections, environmental toxins, and genetic predisposition.
* The paper suggests a complex interplay of pathophysiological mechanisms involved in ME/CFS, including gut dysbiosis, systemic inflammation, immune dysfunction, oxidative stress, mitochondrial dysfunction, and hormonal alterations.
* The authors emphasize the importance of recognizing and validating patients' experiences, as ME/CFS is often misunderstood and misdiagnosed.

**Methods Used:**

The paper is a review article, summarizing and synthesizing findings from existing research on ME/CFS. It does not involve original research or data collection.

**Limitations of the Study:**

* The review relies on existing research, which is limited and often inconsistent.
* ME/CFS is a complex and heterogeneous disease, making it difficult to draw definitive conclusions.
* The lack of standardized diagnostic criteria and validated biomarkers hinders research progress.
* There is a need for larger, more rigorous studies with longer follow-up periods and well-defined patient cohorts.

**Key Takeaways:**

* ME/CFS is a serious and debilitating illness that requires more attention and research funding.
* Energy management (pacing) is currently the most effective approach to symptom management.
* More research is needed to understand the underlying causes and develop effective treatments.
* Raising awareness and reducing stigma associated with ME/CFS is crucial.

The paper calls for increased research efforts to better understand ME/CFS, develop accurate and timely diagnostic tools, and identify effective treatment strategies.
 
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Trish said:
I'm not impressed with those 2 transcripts. I may be missing something, but what's the point?
Click to expand...
I think it’s worth experimenting with these tools to see if there’s ways of increasing accessibility to and awareness of long scientific papers for those who cannot or do not want to read them.
Whether they’re actually any good at this is of course another question :)
 
I don’t think they’re any good at actual analysis or critical thinking. They tend to echo what is in the paper or common tropes from their training data.
We may have some luck if we instruct them to find flaws. But then it’s not really analysis but doing what we ask of them. Does that make sense?
Could definitely be fun to try though.
 
Trish said:
I'm not impressed with those 2 transcripts. I may be missing something, but what's the point?
Click to expand...

Yep, basically what @hotblack said. I was thinking for people that have no interest or ability to read a paper, but would enjoy listening to a conversation between two people. I agree the above conversations aren't anything special, but they get the main point across at least, and might improve with time.
 
Trish said:
It might be interesting to try it on a rubbish paper like PACE or the Larun Cochrane review. See if it picks up the flaws.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)60096-2/fulltext
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003200.pub8/full
Click to expand...

Here's a snippet from PACE:

[Greg]: Okay, and then there's the big one, the one I know a lot of people are wary of: graded exercise therapy. GET.

[Jenny]: Yeah. And it's understandable - when you're constantly fatigued, exercise feels like the last thing you want to do, right?

[Greg]: But the key word here is "graded."

[Jenny]: Exactly. It's not about suddenly running a marathon. It's about starting slowly, gradually increasing your activity levels,

[Greg] always in consultation with a therapist, tailoring the plan to what you can handle.

[Jenny]: Exactly. The goal is to reverse that cycle of deconditioning that can happen with chronic fatigue.

[Guest]: So starting small, building up stamina over time. Okay, that makes more sense.

[Jenny] It's about building capacity, not pushing past your limits.

[Greg]: So we've got our therapies - APT, CBT, GET. But the big question is: did they work?

[Jenny] That's what the PACE trial was trying to find out. And the results, well, they were a bit of a shock.

[Greg]: A shock? Don't leave us hanging, what did they find?

[Jenny]: All right, so both CBT and GET, they actually showed significant improvements.

[Greg]: You mean people actually felt better? Less fatigued?

[Jenny]: Less fatigued, better physical function compared to the other groups.

[Greg]: Wow.

Audio
 
forestglip said:
Here's a snippet from PACE:

[Greg]: Okay, and then there's the big one, the one I know a lot of people are wary of: graded exercise therapy. GET.

[Jenny]: Yeah. And it's understandable - when you're constantly fatigued, exercise feels like the last thing you want to do, right?

[Greg]: But the key word here is "graded."

[Jenny]: Exactly. It's not about suddenly running a marathon. It's about starting slowly, gradually increasing your activity levels,

[Greg] always in consultation with a therapist, tailoring the plan to what you can handle.

[Jenny]: Exactly. The goal is to reverse that cycle of deconditioning that can happen with chronic fatigue.

[Guest]: So starting small, building up stamina over time. Okay, that makes more sense.

[Jenny] It's about building capacity, not pushing past your limits.

[Greg]: So we've got our therapies - APT, CBT, GET. But the big question is: did they work?

[Jenny] That's what the PACE trial was trying to find out. And the results, well, they were a bit of a shock.

[Greg]: A shock? Don't leave us hanging, what did they find?

[Jenny]: All right, so both CBT and GET, they actually showed significant improvements.

[Greg]: You mean people actually felt better? Less fatigued?

[Jenny]: Less fatigued, better physical function compared to the other groups.

[Greg]: Wow.

Audio
Click to expand...
:rofl::banghead:
Thanks, as bad as I expected.
 
And here’s the output from my script. Along with a second which was modified to attempt to critique the paper, I didn’t guide it by explicitly telling it the paper was flawed though…

——
The PACE trial was a randomized controlled trial designed to assess the effectiveness and safety of four different treatments for Chronic Fatigue Syndrome (CFS):

1. **Specialist Medical Care (SMC):** This involved providing patients with general medical care from doctors experienced in treating CFS. This included providing education about CFS, advice on managing symptoms, and access to medications.
2. **Adaptive Pacing Therapy (APT):** This therapy is based on the idea that people with CFS have a limited amount of energy and helps them plan their activities to stay within those limits.
3. **Cognitive Behavioral Therapy (CBT):** This therapy helps patients identify and change thoughts and behaviors that might be contributing to their fatigue.
4. **Graded Exercise Therapy (GET):** This therapy involves gradually increasing the amount of physical activity a person does.

**Key Findings:**

* Both CBT and GET, when provided alongside SMC, were more effective in reducing fatigue and improving physical function compared to APT plus SMC or SMC alone.
* APT plus SMC was not more effective than SMC alone.
* No differences were found between the treatment groups in terms of serious adverse events or serious deterioration in health. This suggests that all four treatments are safe when delivered by qualified clinicians.

**Methods Used:**

* Researchers recruited 641 patients from six specialist CFS clinics in the UK.
* Participants were randomly assigned to one of the four treatment groups.
* Treatment lasted for 52 weeks, and participants were assessed at regular intervals throughout the study.
* The two primary outcomes were fatigue, measured using the Chalder Fatigue Questionnaire, and physical function, measured using the Short Form-36 Physical Functioning subscale.

**Limitations:**

* Participants and clinicians were aware of the treatment allocation, which could have introduced bias.
* Primary outcomes were self-reported, which could also introduce bias, although the researchers took steps to minimize this.
* The study was conducted in secondary care settings, so the findings might not be generalizable to people with CFS who are not referred to specialist clinics.

**In conclusion,** this study provides evidence that CBT and GET, when added to SMC, are effective treatments for CFS. APT was not found to be an effective addition to SMC. It is important to note that the findings of this study do not suggest that CFS is a psychological illness. Rather, they highlight that these therapies can help people with CFS manage their symptoms and improve their quality of life.

——

The PACE trial was a well-designed and conducted study that provides strong evidence for the effectiveness of cognitive behavior therapy (CBT) and graded exercise therapy (GET) as treatments for chronic fatigue syndrome (CFS). However, the study also has some limitations that should be considered when interpreting its findings.

**Flaws in Findings**

* **Subjective Outcomes:** The primary outcomes of the study were based on participant-reported questionnaires, which can be influenced by subjective factors such as expectations and recall bias. This is always a limitation for studies on a condition like CFS, which lacks objective markers.
* **Clinically Meaningful Differences:** While statistically significant, some argue the differences between CBT and GET compared to other interventions were modest and may not represent clinically meaningful improvements for all patients.
* **Generalizability:** The study was conducted in secondary care settings, which means the findings may not be generalizable to patients with CFS who are treated in primary care or other settings.

**Limitations of Methods**

* **Blinding Limitations:** It was not possible to blind participants or therapists to the treatment allocation. While research assessors were masked, they had to collect some outcome data directly from participants, potentially introducing some bias.
* **SMC Intervention:** The specialist medical care (SMC) intervention, which served as a control, was not as well-defined or standardized as the other therapies, and participants in the SMC group received more sessions. This could have potentially led to an underestimation of the effectiveness of CBT and GET compared to usual care.
* **Exclusion Criteria:** The study had very strict exclusion criteria, excluding patients with comorbid psychiatric conditions common in people with CFS. This limits generalizability to more complex patient presentations.

**Other Limitations**

* **Long-Term Effects:** The study only assessed outcomes up to 52 weeks. Long-term follow-up is needed to determine the durability of treatment effects and the potential for relapse.
* **Individualized Treatment:** CFS is a heterogeneous condition, and not all patients respond to the same treatment. Future research should focus on identifying subgroups of patients who are most likely to benefit from specific treatments.

**Overall, the PACE trial provides valuable evidence to support the use of CBT and GET for CFS. However, the study's limitations highlight the need for continued research to develop more effective and personalized treatments for this debilitating condition.**
 
For this prompt I explicitly said the study was flawed and to provide a rebuttal. I get the feeling knowledge of the paper from training data has been picked up here. Given how much on the open web this paper has been discussed it’s probably not great to assume any actual analysis by the LLM here!

The PACE trial, while well-intentioned, suffers from several methodological flaws that compromise the validity and reliability of its findings. Here's a concise critique:

**1. Subjective Outcome Measures:**

The study heavily relies on participant-reported outcomes, notably the Chalder Fatigue Questionnaire and the Short Form-36 Physical Function subscale. Relying on subjective measures for a condition like Chronic Fatigue Syndrome (CFS), which is characterized by fluctuating symptoms and potential cognitive impairment, introduces significant potential for bias. Patients' perceptions of improvement might be influenced by their expectations of the therapy they received, rather than actual physical changes.

**2. Unblinded Assessment:**

The study acknowledges the inability to blind research assessors to treatment allocation. This lack of blinding is a critical flaw, as assessors aware of the assigned treatment are prone to confirmation bias – consciously or unconsciously interpreting data in a way that supports the treatment they believe the participant received.

**3. Loose Definition of "Recovery":**

The study's definition of "recovery" is based on a relatively small improvement in scores on subjective scales. A clinically meaningful improvement should involve substantial and practical changes in a patient's daily life, not just marginal shifts in questionnaire responses.

**4. Inadequate Control Group:**

The Specialist Medical Care (SMC) control group received more frequent medical attention than the other groups. This difference in care intensity could confound the results, making it difficult to determine if the observed improvements are attributable to the specific therapies or simply to increased medical attention.

**5. Generalizability Issues:**

Participants were recruited from specialized secondary care clinics, meaning they likely represent a more severe and treatment-resistant subset of CFS patients. This limits the study's generalizability to the broader population of individuals with CFS, many of whom are managed in primary care settings.

**6. Lack of Consideration for Overlapping Conditions:**

CFS often co-occurs with other conditions like fibromyalgia, depression, and anxiety. The study doesn't adequately address how these overlapping conditions might influence both the experience of CFS and the response to the tested therapies.

**7. Potential for Harm:**

While the study reports no difference in serious adverse events, critics have raised concerns about the potential for Graded Exercise Therapy (GET) to worsen symptoms in some individuals with CFS. The study's reliance on subjective outcomes might mask subtle but significant deteriorations in health status.

**In conclusion:**

The PACE trial’s methodological limitations cast doubt on its claim that CBT and GET are effective treatments for CFS. Further research with robust blinding, objective outcome measures, and appropriate control groups is necessary to draw definitive conclusions about the efficacy and safety of these therapies for CFS.
 
Trish said:
I'm not impressed with those 2 transcripts. I may be missing something, but what's the point?
Click to expand...
It's very good at making an easy-to-understand summary of a long text. And really when you look at the transcript of the intramural study, this is all the takeaways MDs will take from it. It completely ignores everything else and focuses on the old recycled trope, while somehow presenting it as some new insight. It's basically psychosomatics 101 with the traditional model of imaginary loopy whatever.

It's especially built to be friendly and very accessible enough that someone with barely any education will understand it. Like a friendly podcast of the "explain it like I'm 5 years-old" type.

But it takes it at face value. It makes no analysis of fact-checking or anything beyond the content of the document, it just presents the key ideas as they are explained in the text. So when your multimillion study spanning many years is summarized as a simple rehashing of the same old invalid tropes, you know you goofed up big time. But this is what Walitt meant people to understand from it.
 
Trish said:
I'm not impressed with those 2 transcripts. I may be missing something, but what's the point?
Click to expand...

I think for Google the point is that it extends their control over what people see online and where they see it. So if you want to know something, you don't go to Wikipedia or some other website where humans have collected human knowledge, or god forbid a library; you stay on a Google site and use Google's technology to generate the answer you want, so Google can analyse your behaviour and use the data it collects to persuade investors to give it more money.
 
Eleanor said:
so Google can analyse your behaviour and use the data it collects to persuade investors to give it more money.
Click to expand...
Definitely a goal here.
However I find it quite funny they are destroying a very profitable business in the process. Ad and web search was there bread and butter but it has been very very much undermined by the proliferation of AI generated content.
There may be a future where we are funnelled through a Google agent for everything and they may find a way of monetising this. But nobody has yet. And there are no guarantees it’s Google that come out on top.
 
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