Big Data and Predictive Medicine

Transcription

1 Big Data and Predictive Medicine Prof., PhD University Hospital Zurich University of Zurich Higher School of Economics Moscow, Russia June 19, 2014

2 Progress toward data-based predictive medicine! Why is this important? " Event anticipation and timely intervention for prevention " New prevention guidelines " Optimal management of chronic disease " Huge economic relevance! Why now? " Paradigm shift - Vigorous involvement of hard-science community - Gradual acceptance from medical community " Availability of inexpensive remote biosensors " Potential for collaborative modeling using very large data " Commercial interest is widespread and growing 1

3 The costs of chronic disease Heart disease and stroke Diabetes Lung disease Alzheimer's US$432 B/y US$174 B/y US$154 B/y US$148 B/y 2

4 Cost of multiple chronic conditions 3

5 Effects compounded by aging population 4

6 Example: diabetes global prevalence growth 5

7 Some facts on diabetes! (Adults US 2011) " 25.8 M " Leading cause of - kidney failure - non-traumatic lower limb amputations - new-case blindness " Major risk factor for heart disease and stroke " Seventh leading cause of death in the US " Costs - Direct medical $116 B (~2.3 times higher than non-diabetic) - Indirect $58 B (disability, work loss, premature mortality) 6

8 Confronting the problem! Current medical practice cannot cope with growth in load! Society cannot afford the costs! Target: prevent chronic and acute complications! Few alternatives " Prevention Lifestyle modification " Scientific breakthroughs " More efficient (and effective) chronic disease management methods 7

9 Remote management Several attempts at intelligent remote management systems in the past have had mixed results What has changed? 8

10 State of the art Single-lead EKG Heart Rate Heart Rate Variability Respiratory Rate Skin Temperature Body Posture Fall Detection/Severity Steps Stress Sleep Staging 9

11 Data acquisition from sensor 10

12 Data acquisition from sensor 11

13 Revolutions! Technology health solutions! Availability of inexpensive biosensors! Smartphones! Internet everywhere availability of high-quality rich health-related data multiple continuous, time-dependent biomarkers continuous learning accurate predictive disease progression models accurate predictive event models! Technology devices + modeling " Legal (regulatory) obstacles " Ethical issues 12

14 Evolution! Sensor evolution! From bulky kg-scale devices (1970s) to implantable, continuous measurement devices (~2015) unattended, hassle-free continuous measurement from occasional snapshots to continuous time metric evolution! Intelligence evolution! From simple, snapshot-based, linear models to complex pattern discovery, detection, abstraction, and generalization Critical alert triggering 13

15 Sensor science and technology explosion 14

16 The (near) future! Non-invasive measurement methods " Ultrasound " Electromagnetic " Thermal " Saliva " Tears! Implantable multiparameter measurement " Nano particles " Carbon nanotubes " Graphene " Electrospun nanofibers " Quantum dots " 15

17 Diabetes remote management platform goals! Calculation, evolution, and display of instantaneous, historical, and forecast patient glycemic curve! Tracking and displaying lifestyle variables in real-time that influence risk of incident DM, as well as consequences of existing DM! Optimization of metabolic control variables using real time feedback-loop messaging and gaming elements! Calculation and display of alert points in the glycemic curve, and how glycemic control correlates with real-time tracked nutrition and physical activity 16

18 Platform output! Output integrated into contextual gaming and social network engines " Real time feedback lifestyle effect on glycemic curve! Real-time user (and, selectively, healthcare provider) output " Medication adherence score " Prescribed activity and metabolic response scores " Scores measuring real-time evolution of disease risks " Glycemic response curves and related scores " Real-time alerts and notifications 17

19 When?! Platform available now! Clinical and field trials in design stage or in progress 18

20 Where do we go from here?! Multiple ongoing clinical trials " Heart Failure " Diabetes " COPD " Parkinson s 19