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  #1   ^
Old Fri, Apr-14-17, 09:26
WereBear's Avatar
WereBear WereBear is offline
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Default The Creative Destruction of Medicine - call for revolution

The entire book is The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care by Eric Topol.

Quote:
Beyond reading email and surfing the Web, we will soon be checking our vital signs on our phone. We can already continuously monitor our heart rhythm, blood glucose levels, and brain waves while we sleep. Miniature ultrasound imaging devices are replacing the icon of medicine—the stethoscope. DNA sequencing, Facebook, and the Watson supercomputer have already saved lives. For the first time we can capture all the relevant data from each individual to enable precision therapy, prevent major side effects of medications, and ultimately to prevent many diseases from ever occurring. And yet many of these digital medical innovations lie unused because of the medical community’s profound resistance to change.


I haven't read it yet, but it sounds intriguing and exactly what we have been discussing here, and seeing happen in our own lives. How many of us (raises hand) diagnosed and/or treated our own health issues after medical science failed us?

From reviews on Goodreads.com:

Quote:
I come from high tech, where there are zillions of innovations, few get any traction, and a small number change the world. This book is by far the best marriage I've seen of potent innovator thinking with medicine, social media, and information science.

A lot of people are going to say this book is wacky, because it hits the nail on the head in a way that busts the paradigm into pieces. And that's the point: "creative destruction" is a somewhat disturbing term - the point (IMO) isn't destruction per se, it's more what I call "dis-integration" ... the valuable parts of an industry coming apart at the seams, in a way that enables creating new solutions to people's needs.

...

As one example, the whole idea of a large-scale clinical trial is pretty much doomed, long-term, because as we continue to identify *specifically* what's wrong in an individual patient, it'll be harder and harder to find lots of exact match patients for a trial, and besides, a large-scale trial with 70% efficacy just shows that such trials are a shotgun approach: you select a bunch of patients without knowing which ones are really a good fit for your treatment. An educated guess. The smarter medicine gets, the less useful clinical trials will be.


It's part of a longer review where the person makes some excellent points. And so here we are: having reached the limitations of the "gold standard" of medical research.

Makes sense to me. Because finding out about this book led me to another interesting one:

Quote:
“No one should be screened for any disease, ever, unless the test is accurate, the result has meaningful predictive value, and there is something meaningful to be done if the test is positive.”
― Nortin M. Hadler, The Last Well Person: How to Stay Well Despite the Health-Care System
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  #2   ^
Old Fri, Apr-14-17, 10:15
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Meme#1 Meme#1 is offline
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Revolution is needed because doctors run patients through like cattle. My DD3 just went to her 5th doctor appointment and this one was worse than the others. He wouldn't let her talk and kept cutting her off in midsentence. I think so many doctors are just clueless unless it hits them in the face.

She and I discussed how most doctors know nothing about nutrition, supplements or deficiencies so her and I made a plan to put all her vitamins in a daily pill box so as not to forget and she is really working on the D and Mag.

A few things she told me about his comments really told me that he was being condescending to her... As if she was making it up and when she mentioned anxiety that has flared with her feeling of this illness, he told her to go a physiatrist instead of trying to figure out if her IBS and overall feeling of exhaustion and weakness was the cause.

Seriously, I'm beginning to really wonder if there is even one doctor out there willing to able to help a patient figure out a complicated illness.
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  #3   ^
Old Fri, Apr-14-17, 11:28
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WereBear WereBear is offline
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Quote:
Originally Posted by Meme#1
Seriously, I'm beginning to really wonder if there is even one doctor out there willing to able to help a patient figure out a complicated illness.


Sounds like you are doing her more good than the doctor. Which is more common than anyone in the medical profession is willing to admit.

I once got into an online conversation with someone all indignant about "The Woo" which turned out to be things we find quite normal, like low carb eating, blue light interfering with sleep, and taking supplements.

As I shared my experiences, this person turned out to be impressed that this had all worked so well for me, and his outlook changed somewhat. He didn't know there was solid science behind it all, because he was solidly "mainstream" in the kinds of things he read for health reasons.

Which had failed all of us so spectacularly.
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  #4   ^
Old Fri, Apr-14-17, 19:29
M Levac M Levac is offline
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I'd like to add something. We must question everything including standard definitions for whatever disease. For example, cancer is now being questioned as a genetic disorder and instead argued as a metabolic disorder. In this case it's likely that it is a metabolic disorder instead of a genetic disorder, but the point is to question the official definition, not to jump blindly on any alternative as if that was the true definition now. Another example is the various gut disorders, i.e. IBS, Crohn's, etc. Yet another is the various brain disorders, i.e. Alzheimer's, Parkinson's, etc.

The question is, how can we be sure that the official definition was developed from genuine fact, solid experiment, irrefutable evidence? Who developed this definition and how did he do it? When was it developed, was it a hundred years ago using antiquated tools and methods, but most importantly completely absurd premises about health, nutrition and pathogenesis, i.e. blood letting to get rid of bad humors? We're still mired in blatantly wrong premises about a ton of disorders, i.e. saturated fat - cholesterol - heart disease, or calories - obesity.

Here's a hypothetical situation to illustrate the need to question everything.

I get sick, don't know what, get diagnosed with an incurable disease, nothing I can do, that's it for that. I can get some palliative treatments, but that's about it. Could be cancer, Alzheimer's, whatever, the point is the standard definition for that stuff is "incurable". Why?

It's easy. First, the cause is something like genetic, nothing we can do about that, so we ignore the cause and look no further into it. It's quite convenient because we go straight to life-long palliative treatment for mucho dinero. I'm being cynical here, but the patient also agrees to all that, but most importantly he agrees to remain sick for the rest of his miserable life. That would make sense if the patient lost a limb or something, but that's not the case here, it's a disease. And even if it was loss of limb, the patient wouldn't just take it without doing something about it, he'd likely look at prosthetics. In the case of incurable diseases, there's no such thing as a prosthetic brain for example.

Next, it's the pathology itself, how the disease acts. In the case of cancer, we believe cancer acts completely utterly and absolutely independently of the body it inhabits. Based on this belief, we now have only a few choices to treat it, i.e. surgery, chemo. The point here is that we ignore how the disease acts because we can't do anything about it, except cut it out, and then it's palliative treatment to make life less painful.

Finally, treatments are extremely invasive to the point of high risk of death, i.e. cutting an entire organ out is likely to lead to death, ya? So, we ignore treatments because we can't do anything about that either.

In effect, we ignore everything and anything because of the fatality of it all.

Now let's consider an alternative with the metabolic theory of cancer.

First, it's not genetic, so we can do something about it. Next, the method of action of the disease here is metabolic, so we look at metabolism to find the precise causes and mechanisms. Finally, there's many more treatments available here, especially non-invasive (i.e. diet, supplements, direct ketone injection, etc), that will first treat the disease, then return the patient to good health, and ultimately cure the so-called chronic degenerative incurable disease. All this as a result of questioning the standard definition of the disease.

But in the case of the metabolic theory of cancer, it's still missing a few elements in my opinion. Consider obesity. We know full well that the primary cause is dietary carbohydrates. Note the word "primary". In the metabolic theory of cancer, there's an "only" cause without consideration for secondary causes such as pathogens for example. Well, we also know full well how pathogens cause all kinds of disorders of their own, especially virus that can take over DNA and use it for its own purpose. Well, for our purpose, cancer used to be deemed genetic in nature, now it's metabolic in nature, but that only means it's epigenetic in nature where an external factor acts on DNA to do its thing. Dietary carbs are just one of many external factors that can do this.

There's a similar questioning of Alzehimer's, where instead of some unknown cause, it's primarily a function of hyperinsulinemia and competition between insulin and amyloid for the enzyme insulin-degrading enzyme (IDE).

The whole point here is to question not just standard definitions, but also alternative definitions that can just as easily lead us down the wrong path for a few decades, again, and again.

ps I won't read the book, I'm confident I don't need to.
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  #5   ^
Old Sat, Apr-15-17, 04:55
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JEY100 JEY100 is offline
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This book was published in 2012, so much has happened since, and more books with variations on the same theme coming out this year. The author Dr Eric Topol, is an interesting guy. The cardiologist at Cleveland Clinic who first publically questioned Vioxx, which ultimately led to his departure. He has from early days been involved with companies offering digital or wireless monitoring of patients, has another more recent book, and writes for Medcsape, for theheart.org section.

Last edited by JEY100 : Sat, Apr-15-17 at 05:00.
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  #6   ^
Old Sat, Apr-15-17, 05:18
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WereBear WereBear is offline
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Thank you, Janet! Sounds like his heart is in the right place
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