In This Doctor’s Office, a Physical Exam Like No Other (NY Times 8 May 2019) - Commentry by Henrik Vogt

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wigglethemouse

Senior Member (Voting Rights)
New York Times article about Stanford research published in Nature and led by Mike Snyder whose team is also helping Ron Davis with multiomics. This study was a very long longitudinal study to capture changes in the body over time, before diseases were diagnosed. Some changes led to early preventions. Article is NOT about ME.

https://www.nytimes.com/2019/05/08/science/precision-medicine-overtreatment.html

I am posting this as the NY Times published Henrik Vogt's opinion and it was very negative.

They call him "outspoken critic of precision medicine"

It seems to me that he is now trawling ME researchers even if their paper is not about ME research. Is this a new tactic to discredit by the BPS brigade? This isn't even their field!

Sorry, I'm not able to cut and paste snippets from the article as my laptop does not have access to article - maybe someone else can.

Article was on Facebook and I could read it using Facebook app on phone (phone to small for me to cut and paste)
 
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Okay got this quote from Henrik Vogt in the NY Times
But critics questioned whether Dr. Snyder’s big-data firehose will actually make patients healthier — or just leave them floating in a sea of uncertainty and anxiety.

“They carpet-bomb the body with tests and basically assume that the discovery of everything they hit is beneficial,” said Dr. Henrik Vogt, a postdoctoral researcher at the University of Oslo. “But there may be lots of collateral damage they don’t consider.”

Dr. Vogt, an outspoken critic of precision medicine, also noted Dr. Snyder and his colleagues did not compare the outcomes of their volunteers to people who were getting standard medical care. The extra cost and effort might not have led to comparatively better health.

“It’s hard to know what the results mean,” Dr. Vogt said.
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Here is the Nature paper the article is based on - A longitudinal big data approach for precision health (Snyder et al 8 May 2019)
https://www.nature.com/articles/s41591-019-0414-6
Abstract
Precision health relies on the ability to assess disease risk at an individual level, detect early preclinical conditions and initiate preventive strategies.

Recent technological advances in omics and wearable monitoring enable deep molecular and physiological profiling and may provide important tools for precision health.

We explored the ability of deep longitudinal profiling to make health-related discoveries, identify clinically relevant molecular pathways and affect behavior in a prospective longitudinal cohort (n?=?109) enriched for risk of type 2 diabetes mellitus.

The cohort underwent integrative personalized omics profiling from samples collected quarterly for up to 8?years (median, 2.8?years) using clinical measures and emerging technologies including genome, immunome, transcriptome, proteome, metabolome, microbiome and wearable monitoring.

We discovered more than 67 clinically actionable health discoveries and identified multiple molecular pathways associated with metabolic, cardiovascular and oncologic pathophysiology.

We developed prediction models for insulin resistance by using omics measurements, illustrating their potential to replace burdensome tests.

Finally, study participation led the majority of participants to implement diet and exercise changes.

Altogether, we conclude that deep longitudinal profiling can lead to actionable health discoveries and provide relevant information for precision health.
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Vogt made a comment about how the poor could not afford this.

I'm all for this type of consideration but as I skimmed the article I was thinking how this is the real future of medicine (I mean that in the sense of real contribution to what keeps us healthy) it might even become real in the this is how it's done sense and I think if it continues to be pursued the technologies will evolve to make it more cost effective.

I'm no great expert but it seems to me that a lot of technologies when new start out with cost effectiveness issues and perseverance in further refinements/new ways of approaching how things get done is what's needed.

Hopefully, people like Vogt don't have their way getting this avenue of research prematurely shut down.
 
Snowdrop said:
I'm all for this type of consideration but as I skimmed the article I was thinking how this is the real future of medicine (I mean that in the sense of real contribution to what keeps us healthy) it might even become real in the this is how it's done sense and I think if it continues to be pursued the technologies will evolve to make it more cost effective.
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This is the company Mike Snyder has just unveiled to start the journey
https://q.bio/
The Physical of the Future

For the first time ever, get a comprehensive picture of your health — in 75 minutes or less.

Prevention is Better Than the Best Treatment

The healthcare system is designed to treat us when we are sick. Q wants to make it easier to identify signs of disease at the earliest stages, before symptoms arise — when intervention produces the best outcomes.

Q uses a systems biology approach called panomics to build a comprehensive, quantitative snapshot of your health by combining advanced non-invasive imaging, chemistry, genetics, vitals and your medical history.

By tracking these snapshots over time, our platform identifies what is changing in your body — and how fast — in order to better understand your immediate and future health risks.
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Yep, take electricity as an example.

When it was first used domestically the person who did need their own hydroelectric facility, as no one had thought of a grid.

Totally impractical, no one could afford it, and it wasn't even as if they'd invented HD games consoles back then.

No point to it at all.

Or so Vogt would have said.

New technologies are always impractical, expensive and useless to most people.

It's not until they catch on, if they do, that they becomes useful and affordable to people.

Personalized medicine will be the same, ATM inconvenient and expensive, prohibitively so, but when it catches on......
 
wigglethemouse said:
It seems to me that he is now trawling ME researchers even if their paper is not about ME research. Is this a new tactic to discredit by the BPS brigade? This isn't even their field!
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He's a salesman for the Lightning Process and science is his main competitor. Given how low the NYT has been falling the past few years, it's pretty fitting that they'd promote the ignorant brain farts of someone who can't tell obvious pseudoscience from actual science.
 
“They carpet-bomb the body with tests and basically assume that the discovery of everything they hit is beneficial,” said Dr. Henrik Vogt, a postdoctoral researcher at the University of Oslo. “But there may be lots of collateral damage they don’t consider.”
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I agree with this statement. I had an Internist carpet-bomb me with blood tests and a CT scan. They found seven things wrong with me, and since then I've spent the past almost seven months going to specialists and testing. I still have more tests to go at the end of this month. Never again.
 
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Snowdrop said:
Vogt made a comment about how the poor could not afford this
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Making it clear he does not understand how science and technology progress. This guy is a textbook example of the low standards in medicine beyond a better-than-average memory are hurting people because idiots like him with piss-poor judgment are taken seriously.

The first genome cost $1B to decode. Now it costs less than $1K and falling. His opinion is worth less than a stream of cow burps, which is filled with methane and can actually do useful stuff.

The NYT is working extra hard to become a parody of journalism.
 
Snow Leopard said:
Right. What is measured has to be specific and sensitive with regards to being part of a meaningful disease model.
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In clinical practice, sure. The benefits are for research, though, precisely because if we knew where to look for the answer, it wouldn't be called research. This is all about expanding the search space beyond what we can immediately see and measure.

It's a simplistic worldview that assumes we know most of what there is to know and that we simply need greater understanding of those things. It's the same kind of thinking that lead some people to declare with utmost confidence that late 20th century physics had basically run its course and only had to dot a few i's and cross a few t's, when it had in fact barely left the starting line.

Those Luddite predictions are always wrong and here once more. And coming from a fool like Vogt who denies that ME even exists as we experience it, it's just mindless drivel brought by self-interest because he wants there to be nothing be found, created a belief system around this certainty.
 
The question I have is why is someone from Norway who likes to "bait" ME patients responding to a news article about research not related to ME, but carried out by a researcher whose other projects are ME related. Whether you agree or disagree with his statements I find that disturbing. Hopefully I am wrong.
 
wigglethemouse said:
The question I have is why is someone from Norway who likes to "bait" ME patients responding to a news article about research not related to ME, but carried out by a researcher whose other colleagues are working on ME. Whether you agree or disagree with his statements I find that disturbing. Hopefully I am wrong.
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Well it shows where his priorities lie, that's for sure.
 
I agree with a distinction between research and the clinic.

'Measure everything' is not a valid clinical approach. But it is not necessarily so invalid for research, especially when we have so few leads and hypothesis generating data to start with.

Certainly not saying we should blindly throw vast sums of money at research and hope something randomly pops up, there still needs to be some restraint and targeting. But much much less so than would be appropriate in the clinic.
 
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