Synopses & Reviews
Until very recently, if you were to ask most doctors, they would tell you there were only two kinds of medicine: the quack kind, and the evidence-based kind. The former is baseless, and the latter based on the best information human effort could buy, with carefully controlled double-blind trials, hundreds of patients, and clear indicators of success.
Well, Eric Topol isnt most doctors, and he suggests you entertain the notion of a third kind of medicine, one that will make the evidence-based state-of-the-art stuff look scarcely better than an alchemist trying to animate a homunculus in a jar. It turns out plenty of new medicinesalthough tested with what seem like large trialsactually end up revealing most of their problems only once they get out in the real world, with millions of people with all kinds of conditions mixing them with everything in the pharmacopeia. The unexpected interactions of drugs, patients, and diseases can be devastating. And the clear indicators of success often turn out to be minimal, often as small as one fewer person dying out of a hundred (or even a thousand), and often at exorbitant cost. How can we avoid these dangerous interactions and side-effects? How can we predict which person out of a hundred will be helped by a new drug, and which fatally harmed? And how can we avoid having to need costly drugs in the first place?
It sure isnt by doing another 400-person trial. As Topol argues in The Creative Destruction of Medicine, its by bringing the era of big data to the clinic, laboratory, and hospital, with wearable sensors, smartphone apps, and whole-genome scans providing the raw materials for a revolution. Combining all the data those tools can provide will give us a complete and continuously updated picture of every patient, changing everything from the treatment of disease, to the prolonging of health, to the development of new treatments. As revolutionary as the past twenty years in personal technology and medicine have beenremember phones the sizes of bricks that only made calls, or when the most advanced genotyping” we could do involved discerning blood types and Rh-factors?Topol makes it clear that we havent seen a thing yet. With an optimism matched only by a realism gained through 25 years in a tough job, Topol proves the ideal guide to the medicine of the futuremedicine he himself is deeply involved in creating.
AMONG THE INNOVATIONS COVERED:
At home brain-monitors helping us improve our sleep.Sensors to track all vital signs, catching everything from high blood pressure to low blood sugar to heart arrhythmia without invasive measurements to inconvenient and nerve-wrackingor even dangeroushospital stays (which kill some 100,000 every year, due to infections caught there, or patients getting someone elses medicine). Improved imaging techniques and the latest in printing technology are beginning to enable us to print new organs, rather than looking for donors. Genetics can reveal who might be helped by a drug, unaffected by it, or even killed by it, helping avoid problems as were seen with Vioxx.
How the advent of wireless internet, individual data, and personal genomics are revolutionizing medicine, from the laboratory to the clinic to the home
What if your cell phone could detect cancer cells circulating in your blood or warn you of an imminent heart attack? Mobile wireless digital devices, including smartphones and tablets with seemingly limitless functionality, have brought about radical changes in our lives, providing hyper-connectivity to social networks and cloud computing. But the digital world has hardly pierced the medical cocoon. Until now. 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. In The Creative Destruction of Medicine, Eric Topol—one of the nation’s top physicians and a leading voice on the digital revolution in medicine—argues that radical innovation and a true democratization of medical care are within reach, but only if we consumers demand it. We can force medicine to undergo its biggest shakeup in history. This book shows us the stakes—and how to win them.
Now with a new postscript covering the unfolding health care revolution
Mobile technology has transformed our lives, and personal genomics is revolutionizing biology. But despite the availability of technologies that can provide wireless, personalized health care at lower cost, the medical community has resisted change. In The Creative Destruction of Medicine, Eric Topolone of the nations top physicianscalls for consumer activism to demand innovation and the democratization of medical care. The Creative Destruction of Medicine is the definitive account of the coming disruption of medicine, written by the fields leading voice.
About the Author
Eric J. Topol, M.D., is the director of the Scripps Translational Science Institute and co-founder and vice-chairman of the West Wireless Health Institute in La Jolla, California. He is a practicing cardiologist at the Scripps Clinic and a professor of genomics at The Scripps Research Institute. One of the top 10 most cited researchers in medicine, Topol was elected to the Institute of Medicine of the National Academy of Sciences and has led many of the trials that have shaped contemporary treatment for heart disease.
Table of Contents
PART I: Setting the Foundation
1. The Digital Landscape: Cultivating a Data-Driven, Participatory Culture
2. The Orientation of Medicine Today: Population Versus Individual
3. To What Extent Are Consumers Empowered? Clicks and Tricks
PART II: Capturing the Data
4. Physiology: Wireless Sensors
5. Biology: Sequencing the Genome
6. Anatomy: From Imaging to Printing Organs
7. Electronic Health Records and Health Information Technology
8. The Convergence of Human Data Capture
PART III: The Impact of Homo Digitus
9. Doctors with Plasticity?
10. Rebooting the Life Science Industry
11. Homo Digitus and the Individual