And yet something else looming in the background right now is the way medicine is practiced in the world today is changing, and has to change. I accept the proposition that from Galen to the 20th century medical doctors generally caused more harm than benefit (much of it due to the fact that they spread disease amongst their patients). Modern medicine is exceptional in that it actually works on a biophysical level. But a lot of the “low hanging fruit” has been picked, and due to the nature of medical research much of the “cutting edge consensus” is wrong. Medicine, like many fields, has been subject to information overload, and I’m skeptical of the ability of any human to keep up. The practice of medicine needs to be augmented by computational analytic tools, as well as a deeper understanding of the natural distortions which occur because of the nature of funding and the institutional framework of biomedical research in the United States, which exhibits an unfortunate trend toward careerism. Add on top of it the political, legal, and ethical variables, and medicine is a tangle which is far more than just applied human biology.
Those computational tools ought to allow us to directly receive biological information about ourselves from sophisticated software in cloud servers. Since computers will be needed to make sense of the flood of data why go to a doctor's office to have a doctor interpret what the computer screen says when you can read it yourself?
In another post Razib draws attention to websites that enable people to engage in Do It Yourself (DIY) biological science. It is just this sort of (rapidly growing) way of doing bottom-up genetics and health research that FDA regulation threatens.
In light of my last post, I want to point to some groups attempting to create some “bottom-up” biological science in the real world. In the Los Angeles area you have SoCal DIY Bio, and in northern California you have BioCurious. And you also have the DIYgenomics website. Apparently the Gene Sequencer for the SoCal DIY Bio needs to be repaired, so I thought I’d pass word on.
Imagine a future in which people use home medical testing devices and online genetic and medical testing services to collect information that they use to enroll themselves as long term research projects. Plummeting costs of full genome sequencing and advances in microfluidics promise to make genetic and other biological testing very cheap and widely available - if only regulators stay out of the way. But the threat of a large scaling up of regulatory restrictions on direct-to-consumer (DTC) genetic testing and medical testing could put the kibosh on all that.
I see the issue of DTC genetic testing as important for a few main reasons:
The bottom-up research holds great potential. The genetic testing company 23andme is already conducting 400 genetics research projects using customer genetic testing data. Imagine a world where many different teams (including people who are amateurs in genetics research) develop software to search for genetic correlations with diseases, behavior, or assorted traits and then the teams ask for volunteers. This effectively democratizes research. The research that advances most quickly is the research that the most people decide to help with genetic and medical testing results and by filling out web forms about their histories, preferences, habits, and abilities.
In the future a large chunk of medical research will get done by millions of people who will pay their own money to get themselves and friends and family tested. They'll pay this money in order to provide to scientists the raw test results needed to do analyses. People with a malady will pay for genetic and other testing that will provide researchers with the data that will otherwise to be too expensive to collect.
|Share |||Randall Parker, 2011 March 16 12:30 AM Policy Medical|