https://www-nature-com.cmezproxy.chmeds.ac.nz/collections/hiefjijeie
A new collection from Nature Medicine.
The specification of the companies involved in specific areas of digital health offers a good overview of the state of play, and the brief article highlighting the role of large tech firms and medical research is interesting.
“Axes of a Revolution …” is a nice introduction to the space that could be shared with those who have not been actively following the area.
The privacy article is a good introduction to how ethics need to be explored in big data.
The commentary on the hidden costs of model deployment is intriguing and a topic I’ve not seen covered. It does shy away from the ongoing costs of maintenance, and the potential costs associated with risks and adverse events.
The last is probably immediately relevant in light of the uncontrolled experiment that is occurring with Pinnacle Health of implementing a pharmacogenomic testing platform. At HINZ I had a not surprising, but nonetheless disappointing conversation with the person at the stand about this issue - e.g. who is response for the reanalysis and following of shifting importance of germ line genetic mutations based on new science and associations. The poor woman (I was in a disgruntled mood) bore the brunt of hearing a bunch of real and tentative scenarios in which germ-line mutations of unknown or even benign significance have been subsequently found to be pathological, or known variants but new drugs have shown poor outcomes. This is fundamental an issue of responsibility and an issue of having an comprehensive bioinformatics-clinical informatics pipeline that will monitor and alert providers when new information changes the importance of the germline change. The liability associated with this is what has made PGx really hard to implement in the US. In Pinnacle - I await the first patient who gets tested, has a CYP2D6 PM phenotype, then 10 years later gets started on codeine, while pregnant, and has a breast feeding narcotic overdose. Seeing who is held responsible for the ongoing alert and the national transfer of this information, much if new drugs, or new genetic associations arise …