What the !!@#$%^&*()_ing ~!@#$%^&*() Is Personalized Medicine?

Other than the catchphrase of the day in biomedical research. The dream of "personalized medicine" is the why for everything. Why sequence every human genome in the universe? Why, this information will herald in a brave new era of personalized medicine, of course. It's GenerationME ME ME!!!!111!!! meets medicine. Download the latest cure from my MY-Pod.

Most of the people talking about personalized medicine don't usually bother to explain what they have in mind, nor do they really seem to care whether that's clear. This leaves me confused about what all the fuss is about. Occaisonally I suffer from fits of sanity and it strikes me that maybe it's bad to be totally confused about the NEXTbigTHING about to hit your field.

So as always, I consult with all-knowing Goog-Oracle. Goog-Oracle spews forth some pretty trippy, but meaningless flow-charts, most wherein people are depicted by male/female icons from the restroom door. People with the gall to put their definitions into words come up with some pretty wishy-washy shit. Andy De of the excintingly entitled blog "Life Sciences and Healthcare Strategy", and self-proclaimed "visionary thought leader" has this to offer:

“Personalized Medicine means knowing what works, knowing why it works, knowing who it works for and applying the knowledge for patients”, is perhaps the most succinct articulation of P/M from the honorable Mr. Michael Leavitt, secretary of Health and Human Services (HHS). This implies delivering treatment to patients that is proactive, predictive, personalized and participatory unlike the status quo today."

What??? That doesn't sound very high-tech to me. It kind of sounds more like what I thought I was supposed to be getting from my family doctor all these years...apparently not:

"By way of the “trial and error” medicine (also sometimes referred to as “intuitive medicine”) practiced across the world today, the doctor makes a “most likely” diagnosis consistent with symptoms and them prescribes what he/she considers appropriate treatment comprising drugs, devices or surgery. If the treatment does not work and presents significant side effects or adverse events, the doctor most likely would alter dosage or prescribe an alternative medicine. This iterative cycle is repeated, until the diagnosis and treatment that actually presents the desired clinical outcome in the patient is reached. The paradigm has reached a point of diminishing returns as evidenced by the fact that most drugs prescribed in the U.S. today are effective in fewer than 60% of treated patients(2)!"

Wow. Holy shit! My doctor is a useless piece of garbage. We need to get these inept humans out of medicine and start replacing them with IBM(tm)adding machines computers as soon as possible! If personalized medicine = computerized/roboticized medicine, then give me some personalized medicine, double-time.

Chocolate-Funded Researchers Fudging the Data?

Unfortunately, corporations seem to have perfected the art of corrupting academic research to help up their street cred and push their products. It's fairly simple to do if you have a decent sized budget and can be accomplished in three easy steps:

1. Throw lots of soft money into funding research chairs, grants, conferences, lectures, consultancies, etc. for cash-strapped scientists at public institutions to investigate your product. Remember, "industry-funded research is 4 to 8 times more likely than independently funded research to result in findings favorable to the sponsor".
   
2. See what they produce and reward those who put out positive results with continued funding, while cutting support when you get results that don't help you sell products. It's survival of the fittest - but don't worry, the theory of evolution is public domain and can be freely exploited without necessitating royalty payments to the descendants of Charles Darwin.
3. After a few cycles of this "directed evolution of truth" the data should more or less be saying what you want. Polish things off by having your scientific pawns publish drastically over-hyped and over-stated interpretations of their data in a peer-reviewed journal, the higher the impact factor the better. Boisterously announce the publication of these findings with an even more over-hyped press release to major media outlets. Don't forget to to reward your peons with an all-expenses paid trip or at least a nice dinner party. Or maybe a chocolate bar.
   

I think the big pharmas were probably one of the first to use this method to beef up the street cred of their drugs, and more recently other industries like the winemakers have been getting into the action. Sure...a glass of red wine a day is the key to longevity because it contains flavonoids. Then again, if you're really after health, you could always skip out on the toxic alcohol content and just eat a grape or drink some juice.

Anyway, now it's chocolate-funded research, and things are just getting so ridiculous it's funny. This great article by blogger Mark Klempner describes how the Mars bar company is manipulating academia to demonstrate the supposed benefits of the "flavanols" in their products, while of course ignoring the massive negative effects of the sugars and fats they contain. I mean come on, we're talking about JUNK FOOD here. I would be embarrassed to be associated with a would-be serious academic institution such as the University of California at Davis, who support a Mars bar endowed chair in nutrition and have allowed their researchers to recieve at total of $10 million in research funding from the chocolate bar maker. Maybe they should be calling themselves something like "Department of Junk Food and Obesity Promotion, University of Mars Bar at Davis" instead. These guys even have a paper in PNAS that is commonly cited on chocolate industry propaganda websites. On these sites you can find quotes from people at the center of this conflict of interest, like Harold Schmitz, Mars Chief Scientific Officer and UC Davis visiting professor in nutrition: "Traditional cocoa processing often destroys the flavanols, but Mars technology helps to retain these naturally occurring nutrients from cocoa. This new research emphasizes the importance of understanding the potential public health applications of emerging cocoa science, which is a challenge we take very seriously at Mars." Priceless.

The saddest part is that it's usually not obvious, when you read a paper like this, see a poster or hear a talk, that the research has been funded for corporate gain. Instead you're just left wondering why you've wasted your time listening to a bunch of meaningless, over-stated, irrelevent and massaged data disguised to look like science.

Great piece though, and I think he's bang on. The Brave New World reference is interesting although disconcerting. (Naturally, Klempner manages to tie global waming into his article as well).