“Personalized medicine” is a broad term, and can apply to any tool or practice that offers a more personalized approach than what people usually expect from the doctor’s office. One of the widest uses thus far is employing biomarkers from a patient to make personalized decisions about what drug is best to treat a specific disease. Other data that may be of use to the personalized approach includes genetic data, prior treatment history, environmental factors, and behavioral preferences. These data can add up to make big differences in ideal treatment.
In the futurist community, you hear a lot about long-term approaches to ameliorating the diseases of aging, such as SENS, but somewhat less about important near-term approaches, such as personalized medicine and exercise. Living long enough to take advantage of future advances in biotech means taking conventional medicine seriously — more seriously than is the default. This involves looking into therapies and approaches with your unique circumstances in mind. We’re seeing a slowly emerging revolution of thought and practice where early-adopters are taking advantage of this.
Today, the market share of personalized medicine is about $300 billion, and is growing roughly 10% annually. Besides the use of personalized medicine in hospitals, we are seeing a smaller cadre of pioneers who take the whole concept of “personalized medicine” to the next level by intensely studying their personal health. The tent-pole for this new trend is the Quantified Self movement, which implores, “to understand something, you have to measure it”. Quantified Seflers may measure their own activity level, sleeping patterns, nutrition, weight, subjective feelings of well-being, to test the efficacy of various interventions. This movement was kicked off by WIRED editors Kevin Kelly and Gary Wolf, and has since become popular in geeky/health-conscious enclaves around the US. As an example, one favorite area of discussion among QS is whether eating large amounts of butter enhances intelligence.
Within our own futurist community, one leader who has pursued personalized medicine with gusto is Christine Peterson, founder of the Life Extension Conference and the online HeathActivator series. Her conference series includes some of the best speakers in science-based, personal approaches to medicine and health. To get an idea of some of the subjects they talk about, check out their videos page. It turns out that there are important metrics many people might not know about, such as hormone levels and intestinal fauna levels, which are intimately connected to both mood and health.
One of the newer initiatives in the area of personalized medicine is MetaMed, offering a service where private researcher teams are hired to investigate a medical problem for a specific individual in light of all their personal data, such as treatment history and genome. Citing figures that US health outcomes are among the worst for countries of comparable wealth and education level, MetaMed’s CSO, Michael Vassar, says he wants to “humiliate” the current system by providing a superior alternative. The is that if you have a team to look at your specific physiology or maladies in light of the latest research, you’ll get a lot more mileage on top of that usual doctor’s appointment.
Statistics on medical misdiagnosis, incorrect prescriptions, and improperly recommended treatments are grim. In the United States, about 98,000 people die every year from preventable medical errors. An additional 106,000 die every year from adverse effects of medications. That adds up to about 200,000, making medical error the third leading cause of death in the United States, after heart disease and cancer. In contrast, the fourth leading cause of death in the US, respiratory disease, kills about 130,000 annually. Medical mistakes cost a lot of lives — doctors don’t have time to keep up with the latest research, which means there is a lot they don’t know.
The current medical system only gives a bare minimum of attention to the patient. The average doctor visit is just 11 minutes long, with 4 minutes of that being the patient talking. Doctors do not have the time to research a particular disease or make personalized recommendations to the patient based on their unique circumstances or genetics. One study of 149 breast cancer patients found that more than 52% of second opinions found that the original diagnosis inadequate, offering new recommendations that differed from the treatment plan from their original health care provider. That’s a big margin of error for something as serious as breast cancer.
Misdiagnosis can have a huge impact on someone’s life. One study found that 16 out of 20 HIV counselors in a sample set didn’t even know that false positives in HIV tests were possible! Medical workers routinely misinterpret the statistical significance of tests, causing them to overestimate the probability of diseases like breast cancer by an order of magnitude or more. One misdiagnosis of terminal cancer even caused a New Zealand couple to throw away their life savings on a bucket list!
To avoid the cost of misdiagnosis, and improve patient health in general, MetaMed offers patients a seven-pronged investigation into the specific medical issue of their choice:
1) The diagnosis. Is it complete and correct?
2) Test results. What do they mean? Some tests have false positives and false negatives, and a better understanding of test results can save patients weeks or months of unnecessary worrying.
3) The risks. What are the risks associated with your condition? How much danger do they represent, in exact numerical terms?
4) Prognosis. How will your disease progress, taking into account all the particulars of your medical history, age, gender, and genetics? Internet searches often only present the best and worst case scenarios.
5) Genetic factors. What should you know about the way your genetics interacts with your disease and its course? Different gene variants can influence the course of a disease in fundamental ways.
6) Literature. What does the literature say? Chances are that your doctor is 10-20 years out-of-date when it comes to information on your disease. What does the new research say?
7) Treatment. In light of personalized information on all the above, what are the ideal treatment options? Are there drugs that haven’t been approved by the FDA but have positive results in international studies?
Medicine is a minefield for human biases and misconceptions, a basic lack of understanding of statistics being the first pitfall in a long chain. Doctors consistently overestimate the significance of diagnostic indicators, and 85% can’t solve basic Bayesian word problems. Doctors and nurses both overestimate the quality of care they provide as well as their patients’ health literacy. Layer upon layer of mistaken beliefs leads to advice which may, in some cases, be worse than nothing.
Take your health into your own hands! Measure yourself, understand your body, do research into the latest medical literature if you can, and if you really need help, call a company like MetaMed to conduct research on your behalf. Who knows how many years of expected life are being lost due to poor decisions regarding our health? Make sure these lost years are not yours. Don’t rely on your doctor — do the research yourself, and get involved in a community that looks deeper than the surface of health.
Michael Anissimov is a trend-watcher and futurist living in Berkeley, CA.