iiinova — where your digital self keeps evolving

David Owens @drdowens.bsky.social · 02/06/2026

Definitely not belittling the health risks of heat. Heat acclimation is designed to help people cope in hot environments; heat training can help athletes to excel. Judicious and sensible exposure to heat stress can enhance fitness and performance. 5/5

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David Owens @drdowens.bsky.social · 02/06/2026

This is especially used in elite endurance sports in which training at altitude or training in heat give similar benefits (go high or go hot). 4/5

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David Owens @drdowens.bsky.social · 02/06/2026

In elite sports we use heat training for two distinct purposes: 1) Heat Acclimation: prepares the body to perform in hot environments. 2) Heat Training as a Stressor: uses heat as a catalyst to boost overall performance. The stress triggers beneficial adaptations including enhanced VO2 max 3/5

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David Owens @drdowens.bsky.social · 02/06/2026

We now have a much greater understanding of the impact of heat stress on human physiology. Adaption to heat is one of the most effective physiological human adaptions, blood volume increases up to 10% within 2 weeks of heat stress, along w changes to sweating + other physiological pathways. 2/5

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David Owens @drdowens.bsky.social · 02/06/2026

In 2013 I was match doctor for British Lions v Barbarians rugby match in Hong Kong. The relative heat index was close to the limits in which the match could go ahead Over the next few weeks the Lions S&C team noticed a surprising improvement in some metrics of performance. A 🧵 1/5

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David Owens @drdowens.bsky.social · 29/05/2026

IMO this tendency, especially when amplified in an attention economy driven by social media algorithms fed by emotion, both positive and negative, is feeding epidemics of health anxiety, especially in the younger demographic End

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David Owens @drdowens.bsky.social · 29/05/2026

AI engines score better in fields with established and consistent evidence base such as cancer and vaccines (possibly surprisingly) Problematic results increase significantly in fields with nuance uncertainty and noisy opinion increasing significantly in searches around nutrition and wellness 5/6

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David Owens @drdowens.bsky.social · 29/05/2026

Surprisingly current models are not great at numbers and frequently mix up scientific references. One specific risk is that of ‘reference hallucination’ in which AI engines ‘make up’ plausible sounding academic references giving added weight to factually incorrect responses. 4/6

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David Owens @drdowens.bsky.social · 29/05/2026

The focus on language fluency can cause them to hallucinate (a technical term for giving the wrong answer). They like to please so they would rather make stuff up and be confidently wrong than admit ignorance. 3/6

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David Owens @drdowens.bsky.social · 29/05/2026

AI search engines are designed to construct plausible language rather than filter truth or fact. They have no innate intelligence, no internal mechanism for causal reasoning. They make algorithmic predictions of the next word based on their training data set. 2/6

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David Owens @drdowens.bsky.social · 29/05/2026

50% of AI searches for health information give responses which are problematic. 1 in 5 responses are potentially dangerous. Result of a large recent review published in the BMJ A🧵 1/6 www.otandp.com/blog/is-ai-a...

otandp.com

Is AI a Reliable Source of Medical and Health Advice?

Can you trust AI for health advice? Learn why AI shows variable accuracy, misinformation, and cannot replace personalised care from healthcare professionals.

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David Owens @drdowens.bsky.social · 16/05/2026

Am I arguing for drugs in sport: No Am I arguing against drug testing: No. I am arguing in favour of nuance and empathy and education. In my opinion the current focus on a reductionist. black and white judicial process is holding elite athletes to an unreasonable standard End

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David Owens @drdowens.bsky.social · 16/05/2026

The justification given for banning cannabis is usually given as 2+3 as there is no (very questionable) performance benefit. How do we ban cannabis because of the health risks but allow people to race motorbikes, box and ski jump? How does cannabis violate the spirit of snow boarding? 9n

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David Owens @drdowens.bsky.social · 16/05/2026

The World Anti Doping Agency (WADA) has three criteria for banning substances. A banned substance should meet two of the three following criteria. 1 Potential to enhance performance 2 Health risk to the athlete 3 Violation of the spirit of the sport 8n

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David Owens @drdowens.bsky.social · 16/05/2026

Many 'drug cheats' have tested positive for social drugs which have no performance benefit. They are effectively being punished for doing what young people do. 7n

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David Owens @drdowens.bsky.social · 16/05/2026

and most importantly are guilty regardless of how the banned substance enters their body, including being given by a medical professional. Once guilty they are banned for years from competing and earning a living within their chosen profession. 6n

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David Owens @drdowens.bsky.social · 16/05/2026

However, I have also lived with the nuance and seen the other side. Elite athletes are subject to invasions of privacy unique to any other field of human endeavour (at least that I know of). They are tested randomly including at home, must provide their location for testing at all times 5n

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David Owens @drdowens.bsky.social · 16/05/2026

To be clear this is systemic cheating and all the athletes and certainly the team doctor should have understood their obligations and duties. I have been involved for many years in elite rugby. I am not trying to belittle the challenge of doping in sport. 4n

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David Owens @drdowens.bsky.social · 16/05/2026

his team mates were worried about testing positive for cannabis (actually only banned in competition) and/or tramadol (not banned at that point). They were caught because samples from different players had the same DNA. They were guilty of being uninformed. 3n

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David Owens @drdowens.bsky.social · 16/05/2026

An extensive investigation showed no evidence that any of the players had used or were trying to conceal the use of performance enhancing drugs The accepted explanation is that the captain who was clean was taking the ultimate hit for the team by giving urine samples on behalf of his team mates 2n

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David Owens @drdowens.bsky.social · 16/05/2026

Six rugby players from Georgia and the team doctor banned from rugby for a total of 33 years in a 'doping scandal' before the 2023 world cup. Described by World Rugby as 'the most extensive anti-doping investigation ever undertaken in Rugby'..........Now for the nuance. A drugs in sport 🧵1/10

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David Owens @drdowens.bsky.social · 12/05/2026

My takeaway prescription is simple. Stay engaged. Do things with and for other people. Exercise in nature whenever possible. Define things in the positive not negative. Find what you love and do it. Move more than you currently do and push yourself outside of your physical comfort zone sometimes.

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David Owens @drdowens.bsky.social · 12/05/2026

Advances in wearable technology in addition to insights from big data analysis allow us to better quantify the health effects of exercise Large-scale datasets show thresholds for benefit lower than previously recognised in addition to previously undetectable dose-response relationships 2/3

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David Owens @drdowens.bsky.social · 12/05/2026

Imagine a drug that has been proven to significantly reduce heart disease, cancer, diabetes, dementia, depression and increase life expectancy by several years. That intervention does exist …. Exercise. The evidence for benefit in 10 easy questions👇 1/3 www.otandp.com/blog/the-hea...

otandp.com

The Health Benefits of Exercise in 10 Easy Questions

Explore the role of exercise in preventative medicine and how it lowers the risks of chronic disease, extends life expectancy & transforms health in 10 FAQs.

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David Owens @drdowens.bsky.social · 05/05/2026

In the last 20 years the world record for the marathon has fallen by almost 6 minutes while time for the 5K has fallen by less than 2 seconds. Why such a discrepancy? In this article I explain the factors that make sub two-hour marathons the new elite normal. www.otandp.com/blog/sub-2-h...

otandp.com

Sub-2 Hour Marathon: Science, Shoes and Fuelling strategy

The sub-2-hour marathon holds evidence-based lessons for us about training intensity, strength, recovery and why exercise is the most underused medicine.

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David Owens @drdowens.bsky.social · 04/12/2024

30 years ago today TimTrodd and I opened the doors of the clinic that would become OT&P. Lots of water under that bridge. Thank you to Tim, to all my colleagues past and present and especially to everyone who has allowed me the privilege of being their doctor.

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David Owens @drdowens.bsky.social · 18/11/2024

💯 So much potential So little imagination

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David Owens @drdowens.bsky.social · 18/11/2024

Honestly I get that and I would never judge anyone for the decisions they make I just love the place warts and all and I am staying I also live on the beach Spring tide tonight

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David Owens @drdowens.bsky.social · 18/11/2024

Agreed Regulation and control is the default position Such a shame I have worked with some incredible young local athletes who just don’t get the recognition they deserve So many great potential role models whether rugby, running surfing whatever Embrace the young and give them opportunities 👍

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David Owens @drdowens.bsky.social · 18/11/2024

I love HK and continually battle with people from overseas who think of our stunning city as simply a densely populated housing estate Where is the imagination in selling this opportunity. HK should be the International Centre for adventure racing End bsky.app/profile/drdo...

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David Owens @drdowens.bsky.social · 18/11/2024

Last week I was invited to a ceremony at the Hong Kong Sports institute in which various government ministers put forward arguments for HK as a hub for sports and sports medicine. How does this sit with a tendency to ban sport and reduce opportunities for physical activity for young people? 3/4

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David Owens @drdowens.bsky.social · 18/11/2024

Where is the government data? I spoke to a young surfer who I coached in rugby Over the last 10 years he has rescued 15 people (including two life guards) of whom none were surfers My hypothesis: Banning surfers will increase the risk to swimmers on Hong Kong beaches 2/4

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David Owens @drdowens.bsky.social · 18/11/2024

3 reasons why this policy makes no sense 1) Banning surfing will increase fatalities on HK beaches 2) HK is trying to establish itself as a hub for sports/ sports medicine 3) HK is a stunning location for outdour sports 🧵 1/4

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Reposted by David Owens

Ford Prefect @bartyslaartfarst.bsky.social · 16/11/2024

HK's reaction to any perceived or actual safety risk is never to address those risks intelligently, respecting the needs of all, but to outright ban one group altogether, or make it almost impossible for them to continue. Look at TransitJam's battles on behalf of cyclists, for example.

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David Owens @drdowens.bsky.social · 16/11/2024

Agreed We saw this with the HK Covid response. A focus on regulatory control rather than education and failure to recognise that risk can never be eliminated only ever mitigated All interventions have unintended consequences and potential to do more harm than good

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David Owens @drdowens.bsky.social · 16/11/2024

Big Wave Bay. A beautiful Hong Kong beach with great surf at this time of year Who are the people who sit in committees and propose these regulations. What possible motivations drive them to make these insane laws which inhibit physical activity and damage population health.

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David Owens @drdowens.bsky.social · 24/04/2024

My first article on the impact of wearable technology👇 I am already seeing patients who have had their diagnosis made or confirmed by smart watch Increasing accuracy and impact will be driven by advances in technology in addition to AI driven algorithms www.otandp.com/blog/impact-...

otandp.com

The Impact of Wearable Technology on Healthcare by Dr David Owens

Explore how wearable technology is transforming healthcare through personalised data, improving diagnostics, and enhancing personal health management.

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David Owens @drdowens.bsky.social · 24/04/2024

My second article on AI in healthcare 👇 AI will disrupt and accelerate change but ultimately how it is used as a tool will determine maximal impact IMO it will be in administrative and system based processes that AI will have the greatest early impact www.otandp.com/blog/ai-and-...

otandp.com

AI and Machine Learning: The Evolving Reality of Predictive Healthcare by Dr David Owens

Exploring AI's impact on healthcare, focusing on challenges and solutions in data integration, ethics, and regulation for better patient care.

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David Owens @drdowens.bsky.social · 13/11/2023

The contrast between the cityscape and the natural beauty of the surrounding mountains is one of the many things I love about Hong Kong West dogs tooth to Lantau Peak is probably my very favourite Hong Kong hike

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David Owens @drdowens.bsky.social · 21/10/2023

All doctors in elite rugby have a duty of care. They must act in the interests of the player. Any doctor who abuses this process to gain a team advantage is not 'pushing the boundaries' they are guilty of serious professional misconduct and can be struck off the medical register

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David Owens @drdowens.bsky.social · 21/10/2023

Most concussions are diagnosed with HIA 1 but a smaller number present later HIA 2/3 All HIA and the process of calling HIA are audited and subject to peer review 6n

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David Owens @drdowens.bsky.social · 21/10/2023

A player who passes a HIA must report to the 4th official before 12 mins but can not enter the field until exactly 12 mins of real time (not ball in play time) Any player undergoing a HIA1 will have a further assessment later same day (HIA 2) and 48-72 hours (HIA 3) 5n

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David Owens @drdowens.bsky.social · 21/10/2023

Video review looks for criteria 1 & 2 signs. Any criteria 1 signs (eg. loss of consciousness)result in permanent removal no need to complete the HIA The HIA involves a standardised screen of symptoms, cognitive testing recall balance physical examination & review of the video by both MDD and TD 4n

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David Owens @drdowens.bsky.social · 21/10/2023

The MDD must have experience and training in pitch side trauma and HIA and be independent of the teams A HIA may be called by the referee, MDD, the team doctor (TD) but not the opposition TD The decision to call a HIA is subject to explicit criteria including multi angle video analysis 3n

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David Owens @drdowens.bsky.social · 21/10/2023

In elite rugby an independent match day doctor (MDD) oversees screening for concussion which may or may not be associated with foul play Foul play is the responsibility of the referee team, the TMO and post match the citing officer. This process is completely independent of the medical process 2n

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David Owens @drdowens.bsky.social · 21/10/2023

For anyone interested in head injury assessment (HIA) in elite rugby here is a summary: Concussion is a brain injury. It is the single greatest time loss injury in elite rugby The HIA process has significantly reduced the incidence of concussed players remaining on the field post injury.... 1n

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Prof. Michael Fuhrer @michaelsfuhrer.bsky.social · 12/10/2023

Perhaps the most important lesson of the pandemic: For epidemic disease, small reductions in transmission have an *exponentially magnified* effect on infections. For endemic disease, small reductions in transmission are *reduced* to an even smaller effect on infections. 1/

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David Owens @drdowens.bsky.social · 09/10/2023

I found Blue Island very powerful

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David Owens @drdowens.bsky.social · 09/10/2023

There are 2 cities that I truly love Terence Davies may be less celebrated than John, Paul, George or Ringo but Of Time and the City was a cinematic masterpiece to the city in which I was born What movie would best celebrate the love that so many of us feel for Hong Kong?

theguardian.com

A poet of pain, ecstasy and epiphany, Terence Davies is a colossal loss to British cinema

Thank goodness Davies experienced his late-career appreciation – he was a director of high seriousness and singularity and a man of vulnerability and true good humour

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