Category Archives: data saving lives

Google’s Calico – extending health life years

  • Calico is about extending healthy life years, not just life
  • Larry Page’s view is that ageing is the cause and diseases are the consequence of this ageing
  • Google will use all data it has access to – from search terms, to location data and including genomic data when it becomes more readily available
  • Curing cancer is not as big an advance as you might think” saying it would only add about three years to average life expectancy.

Source: http://mashable.com/2013/10/24/google-calico/
S
ource: http://www.technologyreview.com/view/519456/google-to-try-to-solve-death-lol/

Google Wants You to Live 170 Years

BY DANI FANKHAUSER

Along the lines of self-driving cars and smart glasses, Google‘s newest venture promises to wow the tech scene. Only, it’s not quite tech, at least in the traditional sense. The venture is called California Life Company, or Calico for short, and its goal is to extend human life by 20 to 100 years.It sounds surreal, until consider that we already extended human life by 20 years over the past century. The average girl born today will live to be 100, a once outlying achievement.

Other research outlets have made relevant discoveries over the years, including worms thatdivide stem cells without aging and that resveratrol, found in red wine, seems to defend against diseases related to aging and could be manufactured as a more potent synthetic drug.

Meanwhile, companies such as Elixir Pharmaceuticals, Sirtris Pharma and Halcyon Molecular set out to extend human life, only to shut down (or be acquired, then shuttered by the buyer), many times running out of money before bringing a product to market.

Don’t be quick to assume Google’s involvement is strictly to benefit the common good, however. CEO Larry Page is pushing to spend on long term rather than incremental R&D. There’s money to be made here. The regenerative medicine industry is valued at $1.6 billion, and anti-aging products are virtually resistant to economic cycles. Therapies available today may be expensive,untrustworthy and could produce horrific results.

But one thing is true: The quest to live just a bit longer is in demand.

But living longer comes with its own challenges. One imagines doubling our elderly population and the strain that would put on their families and on resources in general. On the other hand, by allowing people to age slower, it’s possible a solution could extend our productive years, rather than the elderly years — so, an extra decade of being 30, rather than an extra decade of being 90 — a more attractive option for both individuals and culture as a whole.

Mashable spoke with experts in the space, who predict Calico will indeed approach the latter (Google declined to comment for this story). It won’t likely be one magic bullet solution, but rather, a group of solutions — a suite of products that will catch our imagination just as Google Glass and self-driving cars have.

The Problem With Aging

In a TIME profile, Larry Page said that solving individual diseases, even ones as pervasive as cancer, would not increase life expectancy by much. To reframe, cancer is the symptom; the true disease is aging itself. As we age and our cells wear down, it causes other old-age diseases.

Currently, much of our technology that extends life actually extends life in poor health, while thenumber of years lived in good health remains unchanged.

Our retirement age of 65 was originally set because hardly anyone ever reached that age.

“Today we spend an incredible amount [of money] out of keeping people alive in a bad state of health,”

“Today we spend an incredible amount [of money] out of keeping people alive in a bad state of health,” says Aubrey de Grey, chief science officer of the SENS Research Foundation, who presented a TED Talk on anti-aging.

This might explain why many people have no interest in living longer.A Pew study shows 56% of Americans would not choose to slow the aging process, even if such medical treatments were available.You may have read about the suicide of 60-year-old sports blogger Martin Manley. His website reveals his distaste for the physical and mental limitations of old age.But de Grey doesn’t expect a solution from Google to follow this trend, adding length to the “unwell” years of life while the number of healthy years remains the same.

“We will not be able to extend life without extending health,” he says. “Longevity is a side effect.”

Why Google?

For most of us, Google’s investment into longevity was a surprise (but note, Google will not be operating Calico, only backing it). Others already in the space were able to see the connection.

What Google brings to the table is data. “Not just one set of data, multiple forms,” says Harry Glorikian, founder of life sciences consulting firm Scientia Advisors. “Search data, GPS data, all sorts of other pieces, electronic breadcrumbs that you produce all out there to get a picture of you.”

This data could be paired with each person’s genome — a partial genome can be mapped today for $99 via 23andMe (another Google investment), but many are hoping a full genome will cost as much in the next few years.

Daniel Kraft, medicine and neuroscience chair of Singularity University, affirms that this will require people to relinquish some privacy, in hopes of helping others and themselves, but predicts it to be something many will do.

“Lot of folks will be happy to share elements of health history,”

“Lot of folks will be happy to share elements of health history,” he says.

For an example of how data can impact health, just look to Google’s Flu Trends, which predicted flu outbreaks based on search data, although it turned out to be accurate only in certain cases.

Finally, note that Google isn’t entirely new to this space. Singularity University has had a lot of cross-pollination with Google, Kraft says, and Ray Kurzweil, director of engineering at Google, is an advisor to Maximum Life Foundation, says founder David Kekich.

Glorikian notes that, much like how Google’s development of Glass inspired developers to create uses for it, the Calico announcement will bring further attention and energy to life extension.

“When one of these behemoths points to a certain place, everyone has to believe that there’s something there,” Glorikian says.

The Solution Won’t Be a Magic Pill

We won’t see an anti-aging product from Calico come to market in a year — it’s a long-term venture. The company is likely assembling a team (the announcement only mentioned leadership of Art Levinson, who is former CEO of biotech company Genentech) and deciding what kind of research to do. Of course, there are several types.

First, there is the idea of the engaged patient. You have the “ability to manage your prevention if you know the risk of certain diseases,” says Kraft. Again, think genome mapping.

Second, de Grey maintains that a medical solution will be discovered before a solution involving nanotechnology — and the medical solution will allow some of us to live long enough to also benefit from future solutions. A medical solution might involve cell therapy, gene therapy or injections. Nanotechnology could include tiny robots that repair our cells or assist organs.

Who Will Pay for It?

An early criticism of Calico was that it sounded like something that would increase the split between the rich and the poor, leaving millionaires to live as long as they like (a few extra years to spend all that money doesn’t hurt), while less privileged people would settle for traditional lifespans or shorter (many children in developing countries continue to die without lack of access to clean water).

The rich already have the option of cryonics, preserving their bodies after death in hopes future technology will revive them. It costs $200,000.

It is possible individuals will not need to cover costs of anti-aging treatments themselves? Much like health care today, it makes for a convincing job perk.

De Grey expects these solutions to be paid for by neither the individual or the employer, but rather, the government. Between social security and Medicaid, the government spends billions on treatment for old-age illnesses and providing for the aging population. Perhaps a product that slows aging will be seen as preventative care — over time, it may prove cheaper and could save government money down the road.

“These therapies will pay for themselves so quickly,” de Grey says.

Further Questions

An extra 100 years to live that you didn’t expect is a daunting idea. But because many of these solutions will piggyback over time, it’s not likely to be a sudden burden. As any technology comes to market, we as a culture must learn to use it both safely and with respect for others.

But still, asking the ethical questions is an important step. With an extra set of productive years, should people have second careers (or second marriages)? If you’ll be in this world for longer, does it reduce the drive to have children? Will a larger population mean more competition for resources?

A popular Steve Jobs quote communicates life’s brevity as a benefit to the human race:

“Death is very likely the single best invention of life. It’s life’s change agent.”

But even with increased lifespan, death is never too far away. When asked about the difference between solving death and solving aging, de Grey was quick to point out the obvious: “I’m not working on a solution to stop people from getting hit by cars.”

Thesis: Food composition is not as important as physical structure in determining satiety, and therefore overweight and obesity

vanishing caloric density: energy dense foods that meltdown rapidly in the mouth, often lack satiety (Dr. Drewnowski)

the problem with sugared soft drinks: energy consumed as fluid calories are not counted by the body as contributing to satiety, in the same way that energy consumed in solids.

Putting these two data points together, It would therefore seem that non-solid foods don’t satiate.

It makes sense that industry includes these forms of food in our diet, as the less satiety we experience, the more food we eat.

This also explains why fruit juice, but not solid fruit, leads to weight gain. It’s nothing to do with fibre slowing the absorption of calories in the gut, it’s to do with the satiating effects of calories derived from solids vs liquids.

This thesis makes sense in evolutionary terms, as the only pre-agricultural sources of liquid calories would have been honey – water being the mainstay.

sharing drives behaviour change

http://medcitynews.com/2013/10/calico-communities-legislation-tech-drive-new-era-health/

  • peer support is a powerful model to support behaviour change
  • social media-backed sharing of progress reinforces achievements
  • Stevens is the CEO of KEAS > workplace health interventions

Calico, communities, legislation and tech drive a new era of health

October 14, 2013 12:45 pm by  | 0 Comments

America’s healthcare system has historically taken only baby steps to empower individual health and wellness ownership – until now. Recent events are about to alter existing healthcare paradigms and I believe this to be the most pivotal of moments. With Google’s Calico, the Affordable Care Act (ACA), Penn State’s wellness debacle and the rise of health-oriented social, healthcare entities are now taking a microscope to existing practices and infrastructures. What will they find? An industry destined for a radical makeover that will result in a prevention-based and consumer-driven healthcare network.

 Let’s take a look at the players involved, from the good (social networking and technology), the bad (Penn State’s wellness initiative) and the TBD (Calico and the ACA).

The Emerging Models
Legislation, technology, communities, and social networking are forcing a healthcare overhaul. Consider Google’s Calico: It has the opportunity to create the largest online community to share health information, turning personal health on its head. With a greater global consumer reach than any other organization, Google has the access and resources to throw at this opportunity, making it the ideal company to coordinate this effort – and being led by Art Levinson, the Bill Gates of biotech, doesn’t hurt.

Addressing the issue of aging in a share- and prevention-oriented effort is a response to the growing presence of the “empowered patient.” Calico could finally deliver on the promise for people to have the ability to seize proactive command over their health with a full understanding of their health data and risk factors. Previously constrained by outdated regulations and a healthcare system that doesn’t prioritize prevention, the tables are finally turning. The potential can live up to the hype.

The October 1 launch of ACA-mandated healthcare exchanges is another step toward preventative care and information sharing. While the ACA is polarizing on both sides, (the outcome of its execution remains yet to be seen) the core of the ACA will impact the resulting healthcare industry in a way that empowers individuals to own their well-being and fosters collaboration with all patient caregivers.

The Anti-Model 
Pennsylvania State University recently (and wisely) repealed a recent decision that established apunitive-based health and wellness program. Love or hate it, even the ACA agrees with the ‘carrot’ versus the ‘stick’ (companies can offer a reward of up to 30 percent of health costs for employees who participate in programs like risk assessment). Given the backlash and media attention Penn state received, it was an unfortunate way to learn what not to do.

Additionally, HIPAA is about to be a relic. Designed in a bygone era, HIPAA will be rendered obsolete thanks to the ACA. Because the ACA will provide benefits to those with pre-existing conditions, HIPAA’s privacy laws will only exist as roadblocks to individual health and wellness. The future of healthcare is driven by information sharing. It’s time for HIPAA to die

The Proven Models
Peer support in healthcare is proving to be wildly successful. As consumers, we increasingly seek the wisdom of crowds to create and sustain meaningful behavior change. El Camino Hospital in Mountain View, CA, recently launched a healthcare program for its employees in which social networking was a one of the tent poles in the program. During an 8-week time frame, over 1,000 participants lost over 1,000 pounds and began eating more fruits and vegetables. What was the number one motivating factor? Sharing progress updates with colleagues.

Today, 80 percent of healthcare costs are associated with preventable illnesses such as obesity, diabetes, hypertension and high cholesterol. It’s no wonder people are demanding to take back ownership of their health. Social networking, communities, technology and legislation are propelling old school healthcare into a consumer-driven and preventative-based model. I say bring it on — it’s about time.

What doctors can learn from each other – value based healthcare

http://www.ted.com/talks/stefan_larsson_what_doctors_can_learn_from_each_other.html

http://www.ichom.org

  • 17-fold difference in outcomes for prostate surgery in Germany (5% vs 50%)
  • Continuous improvement not only improves quality of care over time, but also improves the quality of care for all who participate in it
  • Agents of change are the clinicians
  • Physicians are always very competitive – “always best in class”
  • They are extremely motivated to improve if they are shown not to be the best.
  • Physicians also thrive from peer recognition – “if one cardiologist calls another cardiologist at a competing [lagging] hospital and asks how they can improve, the leading cardiologist will share”
  • These qualities and dynamics establish an environment supportive of continuous cycle improvement
  • BCG have formed the International Consortium for Health Outcomes Measurement (ICHOM) with Michael Porter (Harvard Business School) and Karolinska Institute (Sweden) but reps from UK, USA, HK, BEL, SWE, NO, DK, DE, NL, AU, SG, Switzerland
  • They will establish data sets providing international outcome comparisons: 4 (2013), 8 (2014), 16 (2015) – 40% of disease burden in 4 years.
  • measuring value (vs costs) in healthcare – the things that matter to patients – will make clinicians part of the solution, not the problem

ContinuousCycleImprovement

 

“The best minds of my generation are thinking about how to make people click ads… That sucks.” Jeff Hammerbacher

“After a couple years at Facebook, Jeff Hammerbacher grew restless. He figured that much of the groundbreaking computer science had been done. Something else gnawed at him. Hammerbacher looked around Silicon Valley at companies like his own, Google (GOOG), and Twitter, and saw his peers wasting their talents. “The best minds of my generation are thinking about how to make people click ads,” he says. “That sucks.” (…)

“Any generation of smart people will be drawn to where the money is, and right now it’s the ad generation,” says Steve Perlman, a Silicon Valley entrepreneur who once sold WebTV to Microsoft for $425 million and is now running OnLive, an online video game service. ” (…)

Hammerbacher: “If instead of pointing their incredible infrastructure at making people click on ads,” he likes to ask, “they pointed it at great unsolved problems in science, how would the world be different today?”

— Jeff Hammerbacher, founder and the Chief Scientist of Cloudera, one of Facebook’s first 100 employees, cited in Ashlee VanceThis Tech Bubble Is Different, Bloomberg BusinessWeek, April 14, 2011

The gist of my concerns…

Post-change makers festival closing event, here’s a first go at capturing my main beefs with the health system – a little rough around the edges but captures the gist:

 

  Appearance Reality Vision
Mission Brittle health system Bankrupt sickness market Sustainable learning wellness market
Universality Universal healthcare Safety net + PHI Universal
Payment Fee for care Fee for activity Fee for outcomes
Leadership Run by experts Run by amateurs Run by the finest minds
Levers Doctors in hospitals prescribing pharmaceuticals and performing procedures Unmanaged social determinants with doctors spruiking pills and procedures Actively managed social determinants featuring broccoli magnates

That said, and given the issues and concerns we discussed, I suspect some (if not all) of what needs to happen, has to happen alongside or entirely outside the existing system. Hmm.

I just returned from the closing event for this: http://changemakersfestival.org/

I didn’t have a chance to properly speak with Jenny about our discussion, but got the impression that there simply wasn’t the kind of support for think tanks here that existed overseas.

That said, I did have a reasonable chat with Nicholas Gruen – an very interesting economist and thinker – and suspect there may be an alternate angle to pursue… will keep you posted.

Jointly Health – analytics for remote monitoring

Jointly Health is the first Big Data Analytics and Closed-Loop Decision Support Platform for Remote Patient Monitoring

From their website:

Company Overview

Jointly Health is a venture-backed company headquartered in Orange County, CA. In collaboration with Qualcomm Life, Jointly Health provides a very disruptive, end-to-end Remote Patient Monitoring and Analytics Platform that can detect changes in health states much earlier and with greater specificity. Jointly Health also makes this information actionable by healthcare professionals inside their existing workflow.

First Application

The first application of Jointly Health is to reduce preventable hospital admissions in patients with complex chronic disease. In the U.S. there are 4 million preventable hospitalizations resulting in $88 billion in preventable costs and unquantifiable amounts of human   suffering. Remote patient monitoring has the potential to reduce these hospitalizations but is plagued by missed intervention opportunities, false alarms and inefficiencies. Jointly Health solves these problems.

Uniqueness

Jointly’s proprietary platform utilizes a number of advanced technologies including Predictive Analytics, Complex-Event Processing, Real-Time Analytics, Signal Processing and Machine Learning and has four distinct advantages.

1. Can collect a wide variety of remote health data at high velocity and volume. This includes multiple types of physiological data, human observational, environmental, contextual, and other meta data.

2. Has an adaptable ecosystem that enables our customers to build complex disease models which we can then execute.

3. Can remotely detect changes in health states much earlier and with greater specificity.

4. Provides healthcare professionals with a closed-loop decision support system for intervention optimization.

————-

From: http://www.medgadget.com/2013/11/futuremed-day-4-the-end-of-the-beginning.html

Kreindler elaborated on the value of high speed data for applications including remote patient monitoring and analytics to proactively detect deteriorating health states before they being to detract from quality of life. The energetic talk concluded by touching on how Jointly Health, in collaboration with Qualcomm Life, harnesses big data and analytics to make “information actionable.”

 

His Brother’s Keeper – The PatientsLikeMe story

Heyworth is the founder and former CEO of the ALS Therapy Development Institute (ALS TDI), a non-profit biotechnology organization driven to developing treatments for amyotrophic lateral sclerosis (ALS). The first half of Heyworth’s talk focused on his emotional motivation for ALS TDI, which began when his younger brother Stephen was diagnosed with ALS. Heyworth’s investigation into the options available for managing his brother’s disease revealed a disturbing fact: as much as 80% of ALS research outcomes could not be replicated, making much of the support for ALS clinical trials statistically unsubstantiated.

Heyworth raised the question of how we can move forward when there are faults in the data at the heart of our assumptions. The fact that ALS, considered one of the best-researched medical conditions, might have no real supportable data drove Heyworth to establish ALS TDI in 1999 with the aim to champion a new model of disease research based outside of academia and for-profit organizations. Heyworth’s story was captured by author Jonathan Weiner in His Brother’s Keeper and by the PBS documentary So Much So Fast.  Heywood’s discussion also touched on his work as co-founder of PatientsLikeMe, an online resource for disease-specific medical information. The tool allows patients to track their diseases and share this information with others dealing with the same conditions. PatientsLikeMe disrupts the current system of clinical trials with patient-driven databases that provide insight into the efficacy of specific treatments.

Taken from: http://www.medgadget.com/2013/11/futuremed-day-4-the-end-of-the-beginning.html

Urologists… WTF?

If the urologists behaved any more egregiously, they’d be drifting into crimes against humanity. It’s good to see the Cancer Council calling this out for what it is: “A disservice to men”. It’s also time for these ghouls to cease veiling their self-interest as their patients’.

http://www.medicalobserver.com.au/news/cancer-council-urges-men-to-think-carefully-before-prostate-testing

Cancer Council urges men to think carefully before prostate testing

Catherine Hanrahan   all articles by this author

A DRAMATIC increase in prostate cancer cases has prompted Cancer Council NSW to call for men to think carefully before being tested, but urologists refute the suggestion men are being treated unnecessarily.

A new study shows the number of prostate cancer diagnoses in Australia jumped 276% over the 20 years from 1987 to 2007.

This is a result of increased testing, lead author Associate Professor Freddy Sitas of Cancer Council NSW, said.

He said that even if a positive result is correct, unless they operate, doctors have no foolproof way of knowing if the cancer is aggressive or relatively harmless.

“Saving lives is our priority, but we urgently need a better test,” Professor Sitas said.

“The tests have saved men with aggressive forms of the disease, but at a high cost.”

A 27% drop in the death rate was observed over the study period, he said.

However, the increase in new cases is much greater than this.

“This indicates that many men were diagnosed with cancers that would not have harmed them.”

However, the Urological Society of Australia and New Zealand has strongly refuted claims by the Cancer Council NSW that men have been done a “great disservice” by the growth in prostate cancer diagnoses, and have been subjected to unnecessary treatment.

“Twenty years ago we didn’t have a test to diagnose prostate cancer, which meant most men presented with advanced, incurable disease,” Professor Mark Frydenberg, the Urological Society’s Vice-President, said.

Many low risk cancers were more typically observed, not treated, he said, with active surveillance, now considered a mainstream pathway.

The University of NSW’s Professor Mark Harris says: “Until we have a better method of screening, men need to be fully informed about the pros and cons of testing.”

Cancer Epidemiol 2013; online 1 November

The behaviour change arms race…

Behavior change is difficult, but to date it has dominated by industries, such as the processed food industry, who have mastered the art of mass market behaviour change through a withering combination of product research, development and engineering, marketing, advertising and promotion, all founded on an unstoppable and lucrative business model. At this moment in history, industry is the unopposed, global behaviour change super power. Serious capital investment with serious returns but with the unfortunate side-effect of producing a global epidemic of non-communicable disease.

The institutions charged with protecting the public’s health have been caught flat footed. Rather than trying to neutralise industry’s behaviour change efforts, medically-dominated health systems have instead chosen to layer their own lucrative pharmaceutical and surgical business model on top.

Doctors quite legitimately pay lip service to the “diet and exercise” mantra because they know it doesn’t work. And why doesn’t it work? Because anyone can say eat healthier food and exercise, thus making it difficult to justify their years of training and high fees. It’s much better for doctors to note “diet and exercise”, but then pump the drug and surgery options.

So what needs to happen?

A countervailing super power must be established. Not one founded around a powerful business model, but rather a movement of interested citizens, concerned by the grotesque monentization of the population’s health. In effect, a competing super power in the behaviour change arms race.

Key characteristics:

  • protect the children
  • use evidence, but don’t wait for conclusive results
  • empower with data
  • apply political dark arts

Funding sources:

  • social impact bonds
  • crowd sourcing
  • private health insurers
  • government (not a good time for this)

Inspirations

  • Purpose.com
  • GetUp.org.au