BIO 2006 Dispatch 4—Real Medical Tricorders Soon
Chicago--April 12--Yesterday, at the Biotechnology Industry Organization's annual convention (BIO 2006), I attended a panel on the intriguing topic "Molecular Imaging: Disruption on the Horizon." Thomas Meade, a biochemist at Northwestern University began his talk, "Seeing is Believing: Diagnostics in the 21st Century," by showing a photo of a doctor carrying a little black bag. "My great uncle had all of his diagnostic equipment in that little black bag," explained Meade. "We are trying to return a time when all the diagnostics a doctor needs can be carried in a little black bag."
We're not there yet, but Meade wowed the audience (or at least me) with a movie of a living 14 day mouse embryo in which features as small as 8 cells could be seen. The embryo image could also be manipulated so that individual organs could be viewed in isolation. Meade obtains his supersharp images by using various smart contrast agents. He foresees a time when diagnostics can be made so powerful that they become therapies. Essentially contrast molecules will be combined with therapeutic molecules that will only become activated if the diagnostic detects illness, say, cancer.
Michael Klimas from GE Health outlined a transition from detecting "late disease" model which deploys medicine in reaction once illness has been diagnosed to an "early health" model which allows for preventive steps to be taken before a person becomes sick. Vastly improved diagnostic imaging will drive this transition. For example, the new ultrafast 64-slice CT scanner enables "virtual angiography" and detects coronary disease without contrast molecules. However, Klimas is concerned that insurance companies may not want to cover such early health images because they will argue that the person is not actually sick.
Michael Silver from the health care intelligence company Sg2 predicts that imaging will become a vital tool in early detection of cancer and that such scans will be done in a physician's office rather than in a hospital.
Meade explained that in vitro diagnostics, e.g., blood tests, will initially detect disease. Then patients will be shuttled immediately to medical imaging to determine the extent and severity of disease. "In 20 years pathologists will be out of business because you won't have to cut, slice or dice to diagnose an illness. No more biopsies," boldly predicted Meade. The age of a Star Trek medical tricorder is just around the corner.
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Will the profession of doctor end up disappearing in favor of medical technician?
I can't wait for this thing. I've been through two courses of antibiotics for what my doctor is now convinced is a form of the flu. (Let's hope not H2N1. I'll wave to you on CNN if it is.) With this thing I could have saved $50 and been feeling better three weeks ago, not to mention that I would have avoided infecting half of central Texas. Good, cheap tests that make diagnosis quick and accurate will make a gigantic difference in our health care costs.
A cool thing I heard about a few years ago: A schizophrenia diagnostic tool that worked like a breathalyzer.
I'm not sure what the current status is.
(Insert obligatory libertarian disclaimer that mental illness doesn't actually exist and that it's all a lie invented by the state, and I know this because I intercepted some of their mind control rays and decoded the secret message.)
Insert obligatory libertarian disclaimer that mental illness doesn't actually exist and that it's all a lie invented by the state...
thoreau, from this response, I would have to assume that you accept the currently prevaling medical model of mental illness. I won't bother trying to dissuade you, but let me refer you to Peter Breggin, a psychiatrist who has written extensively on the failings of this model, and of the many harmful drugs used to 'treat' people under this model.
Just to be clear (no pun intended), Breggin is not a scientologist. (Neither am I).
However, Klimas is concerned that insurance companies may not want to cover such early health images because they will argue that the person is not actually sick.
That may be the argument, but it isn't the reason. Ideally the reason to cover diagnostic procedures is to catch problems early and save money in the long run.
One current problem with that line of thinking is that most people with good health insurance don't keep the same medical insurance policy long enough for the benefits to accrue. Instead they change policies every time they change jobs.
Given the volatility of today's employment market I think one of the reforms needed is to divorce medical insurance from the "job benefits" pool.