ResearchKit, the open-source iPhone software gives developers a platform for apps that collect health data and create programs that help users improve their health
For many of us who have smartphones, tracking things like our steps, meals, sleep, medication, weight and menstruation has become second nature. And for researchers who rely on data like this to study everything from chronic disease to healthful lifestyles, all of that information has been going to waste for years, locked away in the proprietary data clouds of telecommunication companies.
Now medicine is entering a new digital age, one of Big Data and high-tech personalised treatments that are tailored to an individual’s genetic make-up. But more data does not necessarily mean better data, so amid the increasing complexity it will be as important as ever to measure correctly which treatments work and which do not.
That the dry world of statistics is becoming a battleground of ideas and commercial interests, affecting the future of medical care and the lives of people around the world, may shock some. For Dr Ellenberg, who has spent her professional life emphasising the life-saving importance of accuracy, it is no surprise at all. “We’ve got all this data,” she says. “The answer isn’t to ignore it. The answer is to figure out how to limit the number of mistakes we make.”
By offering lab-type diagnostics to almost any population with access to a smartphone, such devices would be particularly useful in remote and resource-poor areas. But they are bound to give hypochondriacs yet another reason to fiddle with their handsets.
Cancers often tend to be fueled by changes in genes, or mutations, that make cells grow and spread to other parts of the body. There are now an increasing number of drugs that block mutations in cancer genes and can halt a tumor’s growth.
While such an approach has worked in a few isolated cases, those cases cannot reveal whether other patients with the same mutation would have a similar experience.
Now, medical facilities are starting coordinated efforts to find answers. And this spring, a federally funded national program will start to screen tumors in thousands of patients to see which might be attacked by any of at least a dozen new drugs. Those whose tumors have mutations that can be attacked will be given the drugs. The studies of this new method, called basket studies because they lump together different kinds of cancer, are revolutionary, much smaller than the usual studies, and without control groups of patients who for comparison’s sake receive standard treatment.
This year they picked 11 companies to highlight across cancer, gastrointestinal, fibrosis, pain, and rare disease areas.
By way of background, Nature Biotechnology is the most widely cited journal for biotech, ranked #1 by “impact factor”, and its editors drove the startup selection process. Their methodology involved evaluating the list of new startups that raised significant Series A rounds last year, as “substantial funding” was their view of “commercial excitement” or validation. Then they selected companies where the underlying science was derived from academic labs and was sufficiently innovative to be compelling – essentially their editors’ assessment of the most exciting science. Nature senior editor Laura DeFrancesco and her colleague Aaron Bouchie then wrote up narratives describing each of the companies.
The European Patients’ Academy on Therapeutic Innovation (EUPATI), a consortium of 30 organizations from around Europe dedicated to providing information and resources on the medical research and development process to people affected by disease. The expert training course is designed to teach patients—current and former—or family members of patients all about the clinical trial process, from preclinical research and development all the way through the clinical trial and approval pipelines. The hope is that trainees will go on to become actively involved in the clinical research and development process—whether it’s by working with pharmaceutical companies or serving on regulatory agencies’ committees—or to serve as resources for other patients confronted with similar problems.
Viruses that will attack bacteria. Renewing interest in phages could probably help tackle resistant bacteria. It is not new but has been forgotten for a long time… Some Western researchers are believing in phages, hoping, with modern methods, to turn them into tailored treatments for infection.
First, despite the incompetent rollout of healthcare.gov (the website that allows people to use the federal exchanges), the proportion of Americans who lack cover has fallen from 16.2% to 12.3% since 2009.
Second, the previously terrifying pace of medical inflation has slowed. The amount that America spends on health care grew by 3.9% a year in nominal terms between 2009 and 2011—having grown by 7.3% a year in 2000-08.
Antibiotics have saved countless lives in the last 80 years, but they’re not as effective as they once were. We use too many of them, and so bacteria are developing resistance more quickly than we can come up with new drugs. Why are we using too many of them? Because they are too cheap. We even use antibiotics to make cattle grow faster… The price of the new antibiotics should be much higher to discourage their use in farms and protect human health.
“When we look back on this epidemic, I hope we’ll recognize that fear caused our initial hesitance to respond — and caused us to respond poorly when we finally did. I know how real the fear of Ebola is, but we need to overcome it. We all lose when we allow irrational fear, fueled in part by prime-time ratings and political expediency, to supersede pragmatic public health preparedness.” Craig Spencer
The proposed laws have been introduced in statehouses by both Democrats and Republicans and include a range of approaches, from requiring schools to post immunization rates to entirely eliminating religious and philosophical exemptions.
The year’s largest measles outbreak has been traced to Disneyland in Anaheim, California where visitors were exposed to the disease in mid-December. The vast majority of cases have been in that state, which allows both philosophical and religious exemptions.
In all, 10 of the 17 states with reported measles cases have allowed parents to opt out of vaccines on philosophical grounds, creating a far easier way out of immunizations than states that only exempt families with extensively documented religious objections or health conditions that preclude vaccinations. Read moreWhat is measle?
The BEA analyzed health spending by disease from 2000 to 2010, sorting diseases and diagnoses into categories. As shown by the chart above, which is adapted from BEA data, Americans spent the most–$234 billion–on circulatory diseases such as hypertension and heart disease in 2010. Next came general preventive care and general medical care for everyday problems such as the common cold or flu, at $207 billion. Musculoskeletal problems such back pain or arthritis came in third at $170 billion. Some prominent disease categories represented smaller shares of spending. For example, cancer represented 6.7% of spending, or $116 billion, and mental health conditions including dementia and depression accounted for 4.6% of spending, or $79 billion. Read the WSJ article or The BEA report or have a look at The chart
Despite sharp increases in spending on cancer treatment since 1970 in the United States compared to Western Europe, US cancer mortality rates have decreased only modestly. This has raised questions about the additional value of US cancer care derived from this additional spending. Researchers Samir Soneji and Jae Won Yang calculated the number of US cancer deaths averted, compared to the situation in Western Europe, between 1982 and 2010 for twelve cancer types. They also assessed the value of US cancer care, compared to that in Western Europe, by estimating the ratio of additional spending on cancer to the number of quality-adjusted life-years saved. Read the abstract
What scientific, legal, and business challenges does the immunotherapy companies face? Stewart Lyman looks at some of them: intellectual property concerns, technology issues, huge manufacturing costs, pressures on pricing and reimbursement, obsolescence and limited patient populations. Find out more
GlaxoSmithKline and Novartis said they had completed a series of asset swaps worth more than $20 billion that will reshape both drugmakers. GSK is forming a consumer health joint venture with Novartis, while at the same time buying the Swiss company’s vaccines business and divesting its cancer drugs portfolio to Novartis. The two companies originally announced the transactions in April 2014 to bolster their best businesses and exit weaker ones as the drugs industry contends with healthcare spending cuts and increased generic competition. More details
If you want to understand the politics of health care in the United States, you really need to understand this finding from a recent Economist/YouGov poll that shows why it’s so difficult for wonky ideas — of either a left-wing or right-wing slant — to gain much toehold with the American people. The way people in the policy community see it, this is totally backwards. Better explanations to catch up!
Rob Knight is a pioneer in studying human microbes, the community of tiny single-cell organisms living inside our bodies that have a huge — and largely unexplored — role in our health. “The three pounds of microbes that you carry around with you might be more important than every single gene you carry around in your genome,” he says. Find out why. Human microbiota (Wikipedia entry)Rob Knight’s Lab
Lillian Pravda was born with a cataract and endured several surgeries. The more time she spent in the hospital, the more she learned not all children were as fortunate as she was to have access to care. At age 8, Lillian set out to help children in need of sight-saving eye surgeries and vision services, making sure they would get the care they need and deserve.