Why Computers Work and Health Care Doesn't

[Waverunner]

I started reading sciencedaily a few years ago and I would encourage everyone to do so. Great medical findings are made on a nearly daily basis. These findings affect the understanding and therefore the treatment of nearly all diseases we know, including CFS. Soon I became very enthralled and optimistic, that healthcare and the treatment for CFS could change in a very positive way. However, about one year later, reality had me back again. I realized that these many great findings didn't start the day I began reading sciencedaily, but there were tons of other great findings, that were made in the years before. So one question came up. This question is probably the most important question for everyone who suffers from a disease:

How can it be, that we have all these great findings but still no treatments?

The answer becomes clear when you look at the computer industry. We also have great scientific findings in this field, they also arrive on a daily basis. The big difference is, that these findings get transformed into practice within a very short period of time, even weeks or months. The company decides, if the finding should be implemented in its new product and the consumer decides if he likes it or not. If it is beneficial, the consumer will buy it and the finding will have its place for further development, if the consumer doesn't like it, the product will vanish from the market.

Flawed Healthcare!
Please read the following article to understand why things are different in the healthcare field.

http://www.lewrockwell.com/walker/walker29.html

Computers work. We complain about them, but that's because most of the time they work so fast that we don't even notice them in the background. And they get cheaper by the second. They get cheaper so fast that we can see the prices of memory and processor speed falling even without adjusting for inflation.
Health care, on the other hand, gets more expensive all the time, even for techniques that were invented decades ago. Computers get twice as fast every two years, but technology for carbon-based organisms improves at a snail's pace. Why? Biology isn't all that complex. After all, our cells only have the equivalent of about 2.8 gigabytes of (very slow) DNA memory storage. The viruses that kill us often get by with 12 kilobytes. Your cellphone has more memory than most pathogens, and cellphone design mutates more over the course of a year than the flu.

Read rest of the article here

 

[xchocoholic]

Interesting article but I believe the reason for the lack of progress is more complicated. For one, if patients
are cured, then the health care industry would go broke. And by giving unsuspecting patients drugs that cause
other problems down the road, they keep the money pouring in. Just look at all the lawsuits.

I'm not sure if sciencedaily includes non traditional medical info in their articles. Or if they're for or against
non traditional studies. But I see our future in functional or integrative medicine that embraces both traditional
info and holistic.

Fwiw. I'm an ex computer programmer / analyst and would've hated all the red tape and hoops. Tc .. X

 

[alex3619]

Computers are synthetic. Once you can build one, you can build another. People are all different by some percentage.

Second, the amount of data in a human being is MUCH more than what is claimed. DNA as data comparison?
Not likely. First of all there is in addition both mitochondrial DNA and also structural inheritance. DNA does not occur in a vacuum. The structure of the organelles, including mitochondria, are inherited too.

Third, DNA is not about the blueprint for a living being. Its about the rules to create a blueprint. Think of it as highly compressed data - you need a decompression algorithm to find the real blueprint. The complexity of interaction between the pieces is so high that nothing else on Earth compares - large living organisms, particularly ones with large brains, are very very complex.

Because of complexity and ethical considerations, and the fact that many of the rules that are necessary to make a living being are still not understood (unlike computers) the cost of advances is high. So is the time delay. Then there is all the testing and monitoring. Then there are legal considerations. Your motherboard dies? Install a new one, cheap. Your parent dies? Your child? Your sibling or partner? Not so cheap to compensate for, and not replaceable.

Biomedicine has gone after the easy solutions. One problem, one fix, or to put it another way, one biochemical defect, one drug. Complex problems, from type 2 diabetes onward, are orders of magnitude harder. Drug companies have failed to make advances there, but then they are looking for quick and easy fixes. After a century of research we still do not understand diabetes type 2, or type 1 (though I think a solution might be close there). Complexity is the enemy of reductionist science, but reductionist science is the principle behind most biomedical research.

Research into complex problems has to be publically funded. Yet we still have this quaint and obsolete notion that such research will be paid for by private enterprise. Once publically funded research unravels the mystery private pharmaceutical research will step up and deliver solutions. Until then they wait - they are not going to invest trillions of dollars into research programs with no benefit in sight.

Think of it this way. Pharmaceutical companies are not really about science. They are about biochemical engineering. They create solutions once the problem is understood. They do not do the basic research to understand the problem if its too complex.

Oh, and I agree that Science Daily is very cool.

Bye, Alex

 

[Waverunner]

Hi Alex,

you make very valid points. The problem I see however is, that while the computer industry goes step by step, the healthcare system goes one step every 10 years and not because it's too complex but because there are tons of regulations and entry barriers. It's impossible to introduce a new drug without having hundreds of millions of dollars to make it through the approval process. There are hundreds of experimental compounds, agonists, antagonists and blockers etc. available, that don't get transformed into drugs but could be great treatments. It should be my choice as patient, to choose what medication I would like. I can drink battery acid but I'm not allowed to buy the medication I want. As the article stated, there is nothing that makes the FDA superior to any other public or private institution when assessing medication. The patient should decide what medication he wants to take and the patient should also decide if he wants to believe what the Mayo Clinic, the FDA or whatever institution recommends. As long as we have these monopolies, low competition and the absolute lack of incentives to actually put new findings into drugs, the healthcare system will move on as slowly, as it did during the last half century.

 

[Tito]

I often heard the comment, "well, we've been able to go to the moon but we cannot cure cancer. How come?"
The thing is that building a rocket is an engineering challenge (applied research) while finding a cure for cancer is a scientific challenge (fundamental reseach).
When we go to the moon, we know where the moon is, the distance, the gravity, the trajectory, etc. We 'just' have to build the machine. When we talk about cancer, we don't know very much about the fundamental underlyings of the illness.
We should in fact compare 'going to the moon when humans still considered Earth as flat' and 'finding a cure for cancer today'. Then you would have the 2 things on the same foot.
Additionally, one field is an exact science (the IT world in an application of exact sciences) when medicine is not.

 

[Snow Leopard]

I'm not sure IT is an exact science (ever heard of a computer crash?), but the key point is that computers are magnitudes of orders lower in complexity than a mammal, or even a bacterial cell.

 

[Waverunner]

Well, it is harder to cure cancer than going to the moon but in my eyes the principal is the same. The big problem with cancer is that while you can define the goal (cure cancer) you cannot define the way on how to get there. Why can't we define the way on how to get there? In my eyes because we have much too less applied research. If it takes 10-15 years till fundamental research gets transformed into clinical practice, then how long does it take to reach even small waypoints? Everyone knows that monopolies are never efficient at doing anything, so why does anyone think that it's different for healthcare?

A very simple example: Telomerase inhibitors for cancer. Nearly 85% of all tumors need telomerase to become invincible. Blocking telomerase therefore could be a great target for treating cancers. We know this since 1994! Where are the drugs? When I read this article from 2011, on Science Daily, I could blow up
( http://www.sciencedaily.com/releases/2011/03/110323135623.htm ). We have great telomerase inhibitors since 2000 (e.g. oligonucleotides) but as long as humans are not allowed to test them, we will not be able to say if they work or what we need to improve. Even if a telomerase inhibitor will be used in the clinical practice soon, the next generation of telomerase inhibitors, with slightly improved properties, will show up 10 years later. If it takes 10-15 years till we implement latest findings into treatment, millions of people will die. We need a century for something, that we only would have needed 10 years for, in a free market system. Everything the medical field does is to bring out studies, that end with "need more studies...could...would...may" and doesn't put them into clinical practice because government makes it impossible to do so for a scientists who is not a billionaire. As long as humans are not allowed to test the thousands of compounds we have ready to use for every disease, we will not find out if they actually work. If NASA would only create studies about rocket engines and tests them every 10-15 years, we still wouldn't be on the moon.

 

[Tito]

I'm not sure IT is an exact science (ever heard of a computer crash?), but the key point is that computers are magnitudes of orders lower in complexity than a mammal, or even a bacterial cell.

I did not express myself very clearly, sorry. What I meant was that computers are the direct application of a tiny part of physics, in the sense that it deals with electros. And physics is an exact science. You are right, a lot is known about physics when very little is known in biology. DNA was discovered 50 years ago and Earth as a spherical model was thought about ... well, 6 centuries BC. The learning curve is indeed a curve and is therefore not linear, so the beginning is very slow. Personally I think we are at the very very begining in terms of understanding biology. There are millions of bacterias, etc. It is very complex.

 

[Tito]

Waverunner,
You are right, but on the other side, you are talking about substances to be tested on human beings. If you test a new rocket in a field and it crashes. Well, no big deal. Testing a substance on a man and he dies. Well, that's another story. It might even have the opposite effect, ie. to completely scare people off and completely stop ANY research. The difficulty is also that a substance might work in vitro, but not on a mouse/human.
To me, part of today's problem is that research is mainly left to pharmaceutical companies. Of course, their interest is to sell as many drugs as possible. So they will never do any research to fully cure a disease with one tablet, nor will they do any research on prevention of diseases. Prevention is often the cheapest and the most ethically pleasing technique to 'cure' people. Governments have deserted the field and in my view it is a big mistake. They were the only ones who were in a position to do some good prevention research. Of course it does not mean they would have done a good job, but at least there would have been a chance.
For example, for ME if there is a word we've never heard, it is the word 'prevention'.

 

[xchocoholic]

While I enjoyed reading this article, the author missed the real reason the tech industry continues to
amaze us with their innovative thinking and the healthcare industry continues to fail to make any real progress. In chronic heath conditions that is. The life saving techniques are truely amazing.

It's all about the money. While the tech industry makes a profit by creating a better product, healthcare is based
on keeping patients sick.

I agree on how complex the body is compared to computers but no one in the computer industry would've
written the lame definition for me/cfs either. It's obvious that there are subtypes but this has yet to be addressed.

Tc .. X

 

[alex3619]

Telemerase inhibitors have potential for cancer, but also huge risk. They could accelerate ageing and actually cause cancer and chromosomal defects. This is becase they are needed for cell survival. However, if such enzymes were packaged with a cancer targeting delivery system, only the cancer would be targeted. This would bypass many of the issues.

I am almost certain the pharmaceutical industries would adopt cures for chronic diseases if they knew of them. I am also almost certain they will not spend very much on pure research. They want obvious payoffs, soon. What a cure might do to the economic decisions of a pharma company or group might be to delay its release until after major patents have expired. That might be as long as twenty years. It would not however stop it. To develop such a cure they need drug targets. To find drug targets you need to isolate key molecules. To identify key molecules you need masses of research with no obvious benefits prior to getting useful results. Drug companies are not in the business of pure research. They simply wont do it.

So how would you spot a cure lurking in the shadows? Watch for a company making massively decreased resaerch into drugs for a particular disease without decreasing research in others.

Bye, Alex

 

[xchocoholic]

The fact that "they" know 97% of celiacs are undiagnosed and that the tests are unreliable
and they willingly tell the media that it takes 11 years for a celiac to even get diagnosed to me
clearly indcates an unwillingness to help patients.

I'm certain this is because the medical industry, including drug companies make huge profits off procedures and medications
on undiagnosed celiacs. Just ask a group of celiacs how much money they spent on tests and drugs
prior to getting their diagnosis. Many of the ones I met we close to death before finally being
diagnosed.

That was just one example ..

Not looking for other root causes isred flag. How many of us have been tested or properly
treated for parasites ? H pylori ? Nutritional deficiencies ? The list goes on.

Ignoring the side effects of many drugs keeps their profits up too. Nsaids cause gut damage
but they're still on the market.

Trying to pin down which chemcals are out of place and putting abandaid on it isn't working. In
mny cases it's not possible to even determine which chemicals are off either because it's not possible
to measure these or the labs used are inadequate.

This is where computers differ from our bodies. We can totally control what goes in and comes out of computers but we can't do that with bodies. Besides genes, there are peptides, aminos, enzymes,
nutrients and chemical byproducts occuring. When these get out of sync our bodies try to compensate.
But for how long ?


I have to laugh at how many times I've had doctors insist my labs were ok but it's because they didn't know what to look for. For ex, my glucose levels were always good when taken via the one stick approach. My glucose levels remain in the normal range. But I have hyperinsulinemia detected via the gtt + insulin.

 

[alex3619]

Hi xchocoholic, what you are describing as a bandage approach not working is spot on for complex problems. These companies have based their advances on simple targets. Someone finds the cause. They mess around with limited drug targets till they find a drug that works, and then they test it.

Complex diseases are something else. What is the cause of type 2 diabetes? We don't know. We have a huge list of risk factors, all of which seem important. Testing a cure is like taking a major gamble before you even start - we don't know that the target molecule is important enough to lead to a cure.

Disease testing is another issue entirely, to do with patents. There is usually a lot of ways to do a test, its easy for competitors to come up with alternatives. So I doubt they are spending enough money. This makes complete sense.

One of our problems is we presume that drug companies do all the range of research necessary. They don't. They just do the final bits and test them to make sure that more obvious problems don't arise. They still miss the less obvious issues - and sometimes, like with Vioxx, even miss the super obvious. Government should be filling in the gaps. but the presumption that demand will lead to supply misses the complexity of the situation, and the massive economic disincentives for drug companies to do more than they do.

One of the real issues for many complex diseases is they might not have a cause. They may have a complex interplay of factors which finally lead to a problem. With such disease processes it might be much harder to find targets. In the end I suspect this will require drug and nutrient cocktails to effect.

For example, in ME I suspect we will need at least an immune modulator and an antioxidant protocol. If we get lucky and find a single cause, that may change, but I am not holding my breath. Look at methylation or peroxynitrite models. They are complicated beasts. Yet I suspect they are only small pieces of a larger puzzle. Given that ME is closely tied to insulin resistance, and the issues of complexity in diabetes also arise. Its not going to be easy to isolate a single factor to treat unless such a factor exists and we get really lucky.

Let me make a prediction. Rituximab and a serious antioxidant protocol will be more powerful than Ritixumab alone. Its not a certainty, but it looks likely to me.

Bye, Alex

 

[Tito]

There is a lot of truth in your post. There is the hypothesis that diseases are uni-factorial and that once that factor is gone, the body reverses to its original state. The reality is very different. Most disease have multiple causes and even when you manage to get rid of the causes, there is no guarantee that people will be symtom-free. Take polio, even when the virus is gone, people remain paralysed.

 

[user9876]

While I enjoyed reading this article, the author missed the real reason the tech industry continues to
amaze us with their innovative thinking and the healthcare industry continues to fail to make any real progress. In chronic heath conditions that is. The life saving techniques are truely amazing.

It's all about the money. While the tech industry makes a profit by creating a better product, healthcare is based
on keeping patients sick.

I agree on how complex the body is compared to computers but no one in the computer industry would've
written the lame definition for me/cfs either. It's obvious that there are subtypes but this has yet to be addressed.

Tc .. X

Different industries are in different states. The IT industry until recently was in a high growth phase as new products and devices have been adopted by consumers and companies. This has changed over the last few years making the IT industry basically a commodity industry driven by a refresh cycle and fasion for consumer products. Perhaps the even of mobile communications and smart phones has slowed this cycle. I believe there is less R&D and inovation than in the past. (Note I would argue that google is a advertising agency that likes technology).

I know little about the pharma industry but the rate of drug discovery has dropped dramatically. Like the IT industry there was a growth phase where relatively simple drugs could be discovered, tested and produced. Once such drugs were produced it gets much harder. As Alex suggests the body is complex and it is very hard to find complex drugs.

Earlier someone talked about regulation and development costs. I believe phama companies spend more on marketing than R&D. I would also say R&D is very expensive in the IT industry. The costs of designing, developing and building a fab for new chips is in billions. Which is why companies like HP pulled out of that market. Software is cheaper to develop but testing is a huge cost (as clinical trials are for drugs). I believe about half of Microsoft's staff are involved in software testing.

 

[Waverunner]

Alex, you always make very valid points but in my eyes we already have lots of research. You say, that if we had more research, we would get better drugs and could cure chronic diseases. I disagree slightly. Why? Because the human body is too complex. It's like trying to build a retina smartphone in the year 2000. You can do all the research you want but if the technology is not available you won't be able to do it. You should start with a monochrome mobile phone first and then, on the basis of it, you develop better and better mobile phones. Otherwise you would need billions of dollars for upfront development, while you never can be sure that a retina display is even possible, with the technology you have.

Critics will now bring up their two main arguments:

1. This approach is not valid for medicine because medicine is no gradual science. An antibiotic is an antibiotic and it makes no sense to make it thinner, faster or whatever because what it should do, is kill bacteria.
2. A gradual approach is not possible because people might die if drugs are not tested properly over many years.

I will try to disprove both arguments with the example of antibiotics.

http://www.sciencedaily.com/releases/2011/11/111117144009.htm
ScienceDaily (Nov. 23, 2011) — Although scientists have known for centuries that many bacteria produce hydrogen sulfide (H2S) it was thought to be simply a toxic by-product of cellular activity. Now, researchers at NYU School of Medicine have discovered H2S in fact plays a major role in protecting bacteria from the effects of numerous different antibiotics...These findings suggest a conceptually new approach, an adjuvant therapy that targets bacterial gas defenses and thus increases the efficacy of many clinically used antibiotics."

--> We have the research but where are the adjuvant therapies? Is it too dangerous to lower H2S? No it isn't but if it takes 10 years to make this approach available because of FDA regulation and doctors who are not interested in change, there won't be any adjuvant therapies soon.


http://www.sciencedaily.com/releases/2012/02/120222132938.htm
ScienceDaily (Feb. 22, 2012) — Scientists are reporting use of a new technology for sifting through the world's largest remaining pool of potential antibiotics to discover two new antibiotics that work against deadly resistant microbes, including the "super bugs" known as MRSA... they identified two new possible antibiotics called fasamycin A and fasamycin B that killed MRSA and vancomycin-resistant Enterococcus faecalis, which also is becoming more resistant to known antibiotics.

--> How long will it take, till these two AB's will be available to the public? 10 more years? 15? Maybe we should ask the people who just died of an resistant bacterial infection if they think, that we need a decade of testing, before FDA should give approval to both. What is the risk for the patients? Surviving?


http://www.sciencedaily.com/releases/2012/03/120327215953.htm
ScienceDaily (Mar. 27, 2012) — Combining common antibiotics with additional compounds could make previously resistant bacteria more susceptible to the same antibiotics. 'Resuscitation' of existing antibiotics has the potential to make infections caused by multidrug-resistant bacteria easier to control, reducing antibiotic usage and levels of antimicrobial resistance, say scientists who recently presented their work at the Society for General Microbiology's Spring Conference in Dublin..."Hopefully this work will allow antibiotics to be incorporated into treatment regimes and administered in more effective ways," said Dr Martins.

--> The quote as where I had to laugh. It seems that Dr. Martin already knows what the problem is. It's not that we need more research, it's that research doesn't get transformed into clinical practice.

These were only three new studies. I don't want to know how many thousands of studies fall under the table, just because there are too high barriers to actually make profit of them. The patient cannot decide what treatments he gets and the doctor only has access to what the FDA has allowed. And as I said, the dead people will not sue the FDA and the living people seem not able to understand, that a monopoly on drug approval is not very efficient.

 

[xchocoholic]

Thanks for the interesting thread but I'm too tired to follow it right now. "I'll be back ... " ... X

 

[alex3619]

Hi waverunner, I do not disagree with either of your two main points in post 16. I explicitly agree that approval for drugs when fatality is an almost inevitable outcome should be hastened. A lot. I also agree that there should be more research into obvious things that get ignored.

However, in two examples you made my main point for me. In the case of H2S we simply didn't know what it was doing, and we cannot be sure we fully understand it even now. Biology is still in its infancy, the body is complex, but he brain is orders of magnitude more complex than the body. Understanding these is going to take a lot more research and a lot more time.A lot of that is basic research, not drug development. Big pharma doesnt do much basic research.

The reason for such extreme caution, well everyone knows about thalidamide (an unfairly maligned drug in my view, it was more the drug practices including manufacturing and marketing that failed, not the drug). So I want to talk about antiarhythmia drugs for heart conditions. Arhythmia is associated with sudden death etc. These drugs stop that. They do it well. They were touted as success and prescribed to millions. The result? Megadeath. These drugs killed people because what was not studied was the really important question: long term survival rates. I think these drugs are still used, but with more recent understanding I think our use of them has changed dramatically. A lot of drugs are good at what they do, but if you die faster what is the point?

The example of antibiotic combinations makes two additional points. The first is that they are trying stopgap measures to get a marginal improvemnt in effectiveness. It wont last, it just buys us more time. The second point is that these are old drugs. Either patent has expired, or is about to. Pathogens will quickly develop resistance to these drugs. I think we have to completely rethink the idea of antibiotics. They are useful but not a long term solution. Other solutions exist like blood filters that remove pathogens from the blood stream. These are currently in development.

Money for resaerch into old drugs has to come from the public purse, whether that be patients, their families, charities or government. No drug company will pay to have that research, and if they tried they would get themselves into a lot of trouble with shareholders and possible business regulations. Its not something they can do in a big way, though they are often willing to subsidize drug cost I think, or maybe even provide free drugs for such tests (I personally know of one example of that). They wont pay for the research though.

Look at LDN for treating disorders like ours. It works for a percentage of patietns. Its an old drug. Pharma wont pay for this resaerch, I think it is mostly being done in academia. I use LDN, and it works for me to an extent, I would really like to see more research. I cannot expect pharma to do it though.

If we want complex diseases solved, or wish to repurpose old drugs, then we cannot expect big pharma to pay for it. There is almost no profit incentive, only a yawning financial loss.

I do think that we should consider legal action against regulators that ban or fail to approve drugs in obviously dying patients. When you are dying risk is minimal. Whats the worse outcome, you die anyway? If we, as a global healthcare using community, were to play this right we might even be able to get big pharma on our side in this.

Non-approval for other drugs is another issue. In patients not facing imminent death then not only risk but liablity become major issues. However the FDA initiative to fast track drugs for disease in which there are few or no treatments is a step in the right direction. Or at least not a step backward. Hopefully we will have Ampligen officially approved next year, but I wont put money on it.

Bye, Alex

 

[Waverunner]

Hi Alex, research as well as clinical practice is important and I agree with you, that more research is always good. So much money gets wasted all over the world, may it be wars or financial crises or whatever. It would be only fair to use the money for those people, who are the least able to help themselves, because they are ill. I still cannot believe that we haven't gone one step towards the solution of CFS. Maybe Rituximab turns out to be the first step but as long as there are no further studies, I'm pretty depressed about the fact, that although we have thousands of drugs, PWCs are still left with nothing.

Have a nice day.

 

[beaverfury]

What baffles me is..... WHY DO PEOPLE GET BETTER ?

I know a few that have made complete or partial recoveries. Is there any value in researchers grabbing these people, sticking them in a beaker, and poking them ? ( I'm not a science person :thumbdown: and ive probably gone off topic )