Archive for April, 2010

The Decision Tree: How can we make better choices for our health?

April 13, 2010

Today, we have more opportunities to engage with our health than ever. But too often, the science comes at us in a babble of research and recommendations that is abstract, fearful, and disempowering. It doesn’t engage us. It doesn’t compel us to act.

But what if health information came at us when it helped illuminate our options, rather than overwhelm them? And what if health information was customized to our own circumstances and persons, tailored to our own wishes, values, and metrics? That’s the idea behind the Decision Tree, which is a new book and a new idea about personalized medicine and health. There are new tools and technologies that can help us craft a personal strategy for making the best choices that lead to the best outcomes. This is a Decision Tree – and it’s a powerful way to think about our health.

To begin, we created The Decision Tree widget, a simple tool lets you build your own Decision Tree for a variety of health concerns, from obesity to heart disease. The widget is a great way to give people an idea of what the Decision Tree actually means, to put the idea to work. It’s not diagnostic or prescriptive – it won’t tell you what to do. But it will give you an idea of what a personalized decision-making tool might accomplish, and how we can better tailor information to a specific decision or choice. Because our health, when it comes right down to it, isn’t a static thing – it’s not something that we “maintain” like it’s stuck in one place. Our health is the consequence of a multitude of actions, and when we better understand the repercussions of each different choice, we can better navigate our way to better health.

Thomas Goetz is the Executive Editor of WIRED magazine, and the author of The Decision Tree.

Charting the Course for Personalized Health Care Amidst the Turbulent Winds of Change

April 7, 2010

Can you recall a time in modern history marked by such dynamic forces of change in medical research, health, and health care? Today, during this period of fierce economic hardship, the U.S. is experiencing a dramatic up-tick in investment, incentives, and innovation aimed at developing better knowledge for health and applying it in new ways.  Much of this change can be attributed to massive public investment in health information technology and a new bolus of support for biomedical research – however, private R&D sector and global competitiveness forces are also in play. Health reform proposes massive shifts in health care policy, including larger roles for government in providing access to health care and the regulation of private insurance markets.

Recently, we published two papers that address these tectonic plates of change in health care and the plausible ways they may affect the course of personalized health care. In the first (1), we outline the policy changes in health care that are underway – these represent waves of opportunity for personalized medicine. There is no doubt we will be a much more connected environment – biologically, technically, and socially. The future of applying precise knowledge about the patient’s own biology to medical practice is highly dependent on the tools of the information age. We also presented some new ideas and concepts about the use of health care data to serve discovery, translational, and outcomes research.  Liberating clinical care data for research is a key element of opening doors for innovation to prosper. (2) One thing is certain – research and health care will increasingly be operating in data rich environments. Will this translate into relevant clinical knowledge and represent opportunities for personalized medicine?

Seizing these transformative changes in the health care setting should be viewed as the opening to interject new scientific approaches in answering questions that previously couldn’t be tested.

I encourage you to examine these papers and offer your comments. What do you think these incredible forces of change will mean for personalized health care?

  1. Downing GJ.  Policy perspectives on the emerging pathways of personalized medicine. Dialogues Clin Neurosci. 2009;11:421-428.
  2. Nadler JJ, Downing GJ. Liberating health data for clinical research applications. Sci Transl Med. 10 February 2010 2:18cm6.

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