The passing of clean taxonomies.

Among the most productive constructs of the enlightenment are the modern taxonomies. These have been helpful in bringing order to the chaos of signs and symptoms and other clinical findings and were central tools in achieving our 20th century understanding of pathophysiology. They have also have an influential role to play in reimbursement for medical services. With the dawn of high-throughput molecular diagnostics many of us recognize that we are going to be able to be far more precise in our diagnostic and therefore therapeutic approach to diseases and their prevention.

Nonetheless, as we approach the systematization of medicine, we will be reminded often that nature may not hew to the simplified models that we are developing. This recent study in the New England Journal of Medicine, just does that by demonstrating directly that within a "single" tumor there exists a large multiplicity of tumor types, each with its own genomic characteristics and therefore particular therapeutic responsiveness (or lack of it). It can be argued that this is another instance of the tension between the "neats" and the "scruffies" but perhaps it is a foreshadowing of the decreased effectiveness of taxonomies as a cognitive tool for biomedical discovery and clinical care. If indeed, the underlying substructure of physiology is best represented by a probabilistic network model that can only be best grasped and managed through the use of computational tools, we have to seriously re-evaluate both our approach to disease definition and biomedical education.


City as organism

This video from Geneva, Switzerland is a beautiful instance of the repurposing of data. Shown are the data flows between cell phones across the city over night and day. This glimpse of the interactions over time also suggests new frontiers in real-time epidemiology. What if these (anonymized) data could be tagged with symptoms (e.g. cough, sneeze) could we track the spread of infections? Public health would then start to look a lot more like intensive care medicine, providing real-time monitoring of cities or nations (taking the "pulse" of the population, evaluating the activity and coherence of its "neural" activity). Will there be a new research and medical discipline that fuses the sciences of population ecology and population health? And should populations be empowered to forego such intensive study?

(Hat tip: Joshua Parker).


Ville Vivante from Interactive Things on Vimeo.

p.s. As a someone who grew up in Geneva, I was quite surprised to see a lot of activity at 2 AM. Is this the consequence of the Swiss work ethic?

Get paid to play

Earlier, I described the SHRINE distributed query system across 6 million patients with 10 billion facts. If you are a member of the Harvard Medical School faculty (with employment at one of the affiliated hospitals) you now have the opportunity to get money and glory (more the latter than the former) to spin clinical data into biomedical gold. Details on the context can be found here: http://catalyst.harvard.edu/services/pilotfunding/shrine.html

If you have questions, use this email contact.