The intersection of technology and medicine is not new. Stethoscopes, x-rays, and cochlear implants are examples of innovations that have signalled medical progress over the last few centuries. As physicians, scientists and engineers moved from observing and defining disease, to increasingly sophisticated ways of treating various conditions, they married clinical evidence with patient need and found better ways to make medical decisions and deliver care.
The epicenter of today's revolution in health care, however, is the collection and review of massive pools of complex patient data (also known as "big data") that allow for more precise, individualized treatment strategies.
This works because we are mining data that goes well beyond typical clinical trial information.
Nat Turner, co-founder of Flatiron Health, a company and Roche partner specialized in organizing the world's oncology information and making it useful for patients, physicians, life science companies and researchers, recently explained that most of the learning that occurs in health care comes from clinical trials, yet 96 per cent of patients do not participate. This represents a tremendous loss of critical information: "It's a huge problem: If 100 patients walk in the door, we're only learning from four of them."
Clinical research explores and confirms the safety and efficacy of treatments within defined populations and guidelines. By contrast, collecting a large volume of data coming from many sources unleashes the potential of real-time, real-world evidence that can help support physician decision-making and improve patient outcomes. As Napoleon Bonaparte once asserted, "War is ninety percent information." The same is true when the battle being waged is against illness; information, and the know how to use it, is power -- and promise.
A cancer patient once described their moment of diagnosis as: "It was like a roar in my head and then I disappeared into treatments I didn't control and protocols I didn't understand. I trusted my doctors but felt myself slip away as they worked to save the life of someone I eventually barely recognized and that often even seemed somewhat beside the point."
That moment was 20 years ago. Today, a laser-like focus on who a patient is, including their individual biology and DNA, is critical to customizing their treatment plan. This is the crux of precision medicine. For the almost 200,000 Canadians diagnosed with cancer this year and their physicians, looking for new ways of generating and aggregating information and applying it to a specific patient fundamentally changes the conversation about treatment. Rather than simply addressing a "subtype of cancer," physicians can turn their focus to the person -- her expectations, her fears, the best ways for her to live with the effects of her treatment, and planning for her next few months or years.
Our quest as a scientific community, as we amass information, should be to create shared, global best practices which enable physicians to make better treatment decisions. It means cooperating across international borders and disciplines, harnessing the trillions of data points that will help more people get and stay well.
Does the rise of big data mean the end of more traditional clinical research? Of course not. There is much to learn from many methods of research. What is ahead, however, is an opportune time to for scientists, researchers, physicians and anyone interested in the future of health care to rethink what we expect from the information we collect and how well equipped we are to apply it.
If we, as scientists and physicians, are to fulfill the promise inherent in the ideology that "data is the new drug," we need to be radical in our thinking and committed to translating the unprecedented volume of information we have about diseases to develop safer, more effective and more individualized treatments. As we at Roche say, let's "do now what patients need next," continuing to explore this powerful and promising intersection of technology and medicine.
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