Disqus - Latest Comments for drewyates

Re: The Problem with “Health Information Technology” in Two Paragraph Quotes

drewyates — Thu, 21 May 2009 16:15:24 -0000

I think Hello Health is great. I just didn't want to be another bozo pinging for "partnerships" because I hate that. I know people really do like you, your blog, and your mission, and your web credibility is legitimate. But, dude, you have bus emblazoned "Hello Health". There is a crowd of people in front of it. Who are these people?

My ire is because while I see a lot of names slung around on Myca and Hello Health, and while I read so much about how great it is to have great software and a catchy brand ---I see zero programmers and zero designers named. And they do a good job! I like your website. And while Hello Health itself is a doctor's office (and so, obviously, I'd expect to see doctors named), Myca purports to be a software company. And they are. But who does the actual work of, you know, writing? Oh, that's for consultants. And employees. They execute our plans. And they do a good job. And that probably works just fine. And the product will be probably be good.

So maybe now one of these "freelance" guys will get "featured," but come on. Guys in suits: jingle jingle, thanks for renting your time, nerds, we're the Web 2.0 now. Yah, that's my tribe ---hackers--- and not yours ---doctors--- but doctors, you like those insurance contracts? HMOs? Hospital execs? Jingle jingle! They're coming for you, too! That's why doctors like the romance of Hello Health in the first place! Welcome to the payroll, boys.

And that's why I'm prickly.

Re: The Problem with “Health Information Technology” in Two Paragraph Quotes

drewyates — Thu, 21 May 2009 12:35:11 -0000

http://myca.com/team.html

Re: The Problem with “Health Information Technology” in Two Paragraph Quotes

drewyates — Thu, 21 May 2009 09:53:29 -0000

Yah, I'm excited about what Hello Health is doing. However, they seem to already have a big media following (in part, because they work with professional marketers). So, I figure if I ever have anything that they want, they'll come find me, and otherwise, I don't want to be "just another groupie" for tally by their "marketing guy".

Re: Wolfram Alpha destroys 23andMe’s Strategic Advantage? Huh?

drewyates — Tue, 19 May 2009 10:32:45 -0000

Yah, I don't get the hype. First, give Alpha a few years before expecting a more than a free Mathematica web prompt (which is cool itself, but unless you need to solve a complex equation, it's not relevant to most people). Second, Alpha has an API, and they'll probably sell access to their engine for your own data sets. That's also cool, but you'd still have to generate and administrate the data. Alpha would only be a data viewer and linker ---again, useful, but it's not "Magic." It's not going to magically "decode your DNA" using "AI" or any such rubbish. It will be hard work, clever design, and complex mathematics, and if it seems "magic" to you, that's only because you didn't care to learn how it worked.

Re: Should scientists study race and IQ?

drewyates — Thu, 19 Feb 2009 17:01:07 -0000

Lol, yes. Yes.

Re: GINA (Genetic Information Non-Discrimination Act) Loopholes?

drewyates — Mon, 16 Feb 2009 22:15:17 -0000

Good comment.

The goal of GINA is to concede a new class of criteria by which health insurers may discriminate which otherwise would have been implied. So, rather than a victory for patients, it is more of a cease-fire: GINA preserves the status quo.

However, the status quo already favors the insurers over the insured, and the progression of medical science continues to produce new opportunities for insurers to discriminate based on the accepted justification of "pre-existing condition." So, if the bias in favor of insurers isn't already unjust, given enough time, that question will be answered in court.

My claim regarding GINA is that it serves its purpose specifically, to prevent a new form of discrimination. I don't claim that the system is good or that it's getting better. My opinion is that GINA effectively reduces how fast the health care system seems to be getting worse within a context that's already poor. By that objective, GINA is successful, complete legislation.

Re: 23andMe in the Medical Space

drewyates — Sun, 15 Feb 2009 13:22:39 -0000

I'll respond to this more thoroughly later this week. I do have a Q/A about 23andMe from a few weeks ago:
http://www.thinkgene.com/if-somebody-came-to-yo...

The honest truth is that I'm still forming my opinions.

Re: Legal Details of a USA Certificate of Confidentiality in Medical Research

drewyates — Wed, 11 Feb 2009 11:14:28 -0000

This is congruent with the legal precedent that rights are "property". The alternative would be a reduction of personal freedoms.

Re: Coriell PMC Launches Web Portal

drewyates — Tue, 10 Feb 2009 19:04:19 -0000

You're right, "Don't know" should be the default radio button value, or the form element should be changed to a radio checkbox. Whoever designed their system did not define their "null" initial value well in their data model... I will pass this along. Thanks, Mike.

Re: Online Dating

drewyates — Tue, 10 Feb 2009 09:29:53 -0000

Yah, they almost certainly created their own "institution" for the purposes of laundering the scientific reputation of the dubious commercial ventures.

Re: “Genetic Engineering” will not “save” population trends

drewyates — Tue, 10 Feb 2009 09:26:36 -0000

Making genetic engineering "free" doesn't make it equally available to all people, though it may help amortize the costs. First and foremost is the decision when and how to participate. For example, birth control is "free," yet some populations continue to have unwanted pregnancies. Second, consider different levels of service. More comprehensive care may be more expensive than basic subsidized care, but further, genetic engineering of children is an extremely complex and emotionally engaging subject. Even if the exact same service was available to all people at no cost, some people will be more willing and more able to participate in the planning than others.

Re: Coriell is Medical Research: Responses to Common Concerns

drewyates — Wed, 04 Feb 2009 07:55:58 -0000

The FAQ, which is written for layperson participants, says:

"You WILL NOT receive results for all genetic variants. Genetic variants associated with medical conditions for which there is no treatment or intervention to reduce the risk of disease WILL NOT be reported back to participants. For example, variants elevating risk for incurable diseases such as Alzheimer's disease will not be reported. If a new therapy or lifestyle intervention is reported, the ICOB may update a condition to be "potentially medically actionable.""

I see no statement here that refutes my claim. Yes, the scientific justification isn't mentioned, but that's because this is a layperson's FAQ, not a brief regarding the design of the medical study.

As for "free" ... I'm really at a loss to intelligently address this other than repeat that participation in this medical research is at no cost to participants, and that it's not charity, it's research. What would the "study" study if participants didn't provide any data?

Re: Response to “That’s Just Boilerplate” comment

drewyates — Fri, 23 Jan 2009 00:10:58 -0000

The archetypal example of a diagnostic scientific success but clinical failure is Prostate Specific Antigen (PSA) testing, which, while considered one of the most effective tumor markers in human oncology, is not recommended or tenuously recommend by several prominent medical advisory boards because the treatments for prostate cancer are often more physiologically destructive than the disease itself. In short, "minor" prostate cancer is common, but generally, something else kills you before it advances enough to become a problem.

So, prostate cancer screening can have a net negative clinical outcome (particularly for elderly patients with less than ten years of expected lifespan) despite its successful use to diagnose prostate cancer.

Re: New Physician

drewyates — Thu, 22 Jan 2009 23:16:35 -0000

By the way, "Half Life" is a video game for you old people: http://orange.half-life2.com/hl2.html

"House" is a television show: http://www.fox.com/house/

Re: Response to “That’s Just Boilerplate” comment

drewyates — Wed, 21 Jan 2009 19:06:39 -0000

Curious and Anon... Ok, will respond in a new post ...

Re: There Is No Such Thing As Race

drewyates — Wed, 21 Jan 2009 17:49:30 -0000

Since there is some confusion, the except published as "Reading the 'Race' of your DNA" are my words. Gina Smith wrote "There is no such thing as race" in The Genomics Age" which you can read via the link marked "Spoiler" at the top. http://www.thinkgene.com/wp-content/uploads/200...

Re: Response to “That’s Just Boilerplate” comment

drewyates — Wed, 21 Jan 2009 04:52:52 -0000

I continue to be greatly amused to see statements issued by companies that violate their own legal contracts, however. Oh what, a product called "health compass" which claims that "your genes offer a road map to optimal health" is supposed to be interpreted... how? Oh right, as "informational purposes only." Right.

Re: DNA Dynasty

drewyates — Thu, 15 Jan 2009 13:41:22 -0000

Please do not send hired media shills to make false comments.

Re: Announcing The Navigenics and Think Gene Partnership!

drewyates — Mon, 12 Jan 2009 12:58:10 -0000

Haha, I may or may not have already done so...

Re: Dr. Dilbert

drewyates — Wed, 07 Jan 2009 20:42:20 -0000

You mean like: paying for it? Historically, that has been both an extremely effective way of rationing resources and encouraging the production of more of those resources.

Everybody has the right to a public defender, but that doesn't mean you can't hire your own lawyer. Medicine is no less a professional service and no more necessary than justice.

I note that you are a professor at Stanford, an institution that provides "best education science knows have to give." Yet, if every American got all that education, we would "blow away the national income several times over," not to mention that even a nationalized program such that all students must receive a Stanford education wouldn't make it so ---the resources simply do not exist.

Should Stanford be "integrated" into a national EMO (educational maintenance organization) because it's not "fair" that Stanford exists while others can barely read? Or should Stanford revert to an "more affordable" model because its innovations in education are not economically feasible to distribute to everybody?

Or... do we allow institutions to freely exist as they choose to exist within the bounds of civil society?

Do we blame the forever-increasing production of literature for illiteracy? No. So why blame the forever-increasing understanding of human biology for poor health?

Re: 23andMe to Create Institutional Review Board

drewyates — Tue, 23 Dec 2008 13:14:43 -0000

To trick you into commenting impulsively, of course.

Re: “Genetic Engineering” will not “save” population trends

drewyates — Mon, 22 Dec 2008 18:41:32 -0000

"Civilized" isn't a scientific term, but I specified "civilized" to keep my opinion to what I know: modern, urban, literate, specialized society. Start subtracting those traits and my thesis becomes less relevant.

I'm not going to name a specific nation because:
- it would provoke a potential opinion battle that's not relevant or interesting to my thesis and
- I don't have the concrete evidence to defend any such claim
- Naming a politically recognized state would be misleading since often many different social bodies that could be "nations" exist in a single state. For example, by "Americans," do you mean upper east side Manhattan? "Deliverance" rural south? The Bronx projects? A midwestern suburban housing development?

Re: “Genetic Engineering” will not “save” population trends

drewyates — Fri, 19 Dec 2008 06:24:55 -0000

Not in America. I can't speak about attitudes in Europe, but I assume that they're not radically different.

You'd certainly get in trouble if you stated "people are not created equal" on the television news in the USA. Also, "equal opportunity" is silly, too. Something as simple as where you are born and raised clearly nixes that idea. Are you telling me that you'd have the same life in Concordia, MO as in Toledo, OH, as in Palo Alto, CA as in Manhattan, NY? Again, that people do NOT have equal opportunity is one of those "so obvious" things about life that it seems one can't think about it directly.

Re: “Genetic Engineering” will not “save” population trends

drewyates — Fri, 19 Dec 2008 06:19:10 -0000

I don't know, this reads to me like the same "technology will save us" hopeful dodge. Extra-planetary colonization? Come on, bring it back down to Earth.

Re: Why the DTC companies will fail…or not?

drewyates — Thu, 18 Dec 2008 08:54:09 -0000

Maybe we could build this feature into New Helix as an interface between Coriell PMC and physician practices for our network physicians. That way, a physician could have specific access only to the relevant test results to the medical advice he was providing. Otherwise, it's arguable that if the physician didn't notice something in the report he wasn't looking for, he'd be liable. Also, it's a good "minimum necessary information" patent privacy precedent. Of course, if the patient and the physician wanted to share the complete report, they could, but maybe that would prompt some special waiver to avoid the liability you mentioned.