Max Little: A test for Parkinson's with a phone call

114,963 views ・ 2012-08-07

TED


Please double-click on the English subtitles below to play the video.

00:00
Translator: Joseph Geni Reviewer: Morton Bast
0
0
7000
Translator: Núria Núñez Reviewer: Fran Ontanaya
00:15
So, well, I do applied math,
1
15927
2103
Doncs bé, jo faig matemàtica aplicada
00:18
and this is a peculiar problem
2
18030
1524
i això és un problema peculiar
00:19
for anyone who does applied math, is that
3
19554
2173
per qui la fa:
00:21
we are like management consultants.
4
21727
1933
som com els consultors de gestió.
00:23
No one knows what the hell we do.
5
23660
1946
Ningú sap que coi fem.
00:25
So I am going to give you some -- attempt today
6
25606
2274
Per això mateix avui intentaré...
00:27
to try and explain to you what I do.
7
27880
2293
...explicar-vos què faig.
00:30
So, dancing is one of the most human of activities.
8
30173
3321
El ball és una de les activitats més humanes.
00:33
We delight at ballet virtuosos and tap dancers
9
33494
3682
Ens delecten els virtuosos del ballet i els ballarins de claqué
00:37
you will see later on.
10
37176
1148
que veurem més endavant.
00:38
Now, ballet requires an extraordinary level of expertise
11
38324
2690
Però el ballet exigeix un grau d'entrenament extraordinari,
00:41
and a high level of skill,
12
41014
2914
un alt nivell de destresa
00:43
and probably a level of initial suitability
13
43928
2531
i probablement una certa aptitud inicial
00:46
that may well have a genetic component to it.
14
46459
1847
que bé pot tenir un component genètic.
00:48
Now, sadly, neurological disorders such as Parkinson's disease
15
48306
3393
Malauradament, els trastorns neurològics com ara el Parkinson
00:51
gradually destroy this extraordinary ability,
16
51699
2087
destrueixen gradualment aquesta extraordinària habilitat,
00:53
as it is doing to my friend Jan Stripling, who was
17
53786
2323
com li està passant al meu amic Jan Stripling que, en la seva època,
00:56
a virtuoso ballet dancer in his time.
18
56109
2967
va ser un virtuós ballarí de ballet.
00:59
So great progress and treatment has been made over the years.
19
59076
3054
En els darrers anys s'ha progressat considerablement en el tractament.
01:02
However, there are 6.3 million people worldwide
20
62130
2944
Tanmateix, hi ha 6.3 milions de persones al món
01:05
who have the disease, and they have to live with
21
65074
3448
que pateixen aquesta malaltia i han de viure amb
01:08
incurable weakness, tremor, rigidity
22
68522
2568
una debilitat incurable, tremolors, rigidesa
01:11
and the other symptoms that go along with the disease,
23
71090
1857
i altres símptomes d'aquesta malaltia,
01:12
so what we need are objective tools
24
72947
2383
o sigui que el que necessitem són eines objectives
01:15
to detect the disease before it's too late.
25
75330
3057
per a detectar la malaltia abans no sigui massa tard.
01:18
We need to be able to measure progression objectively,
26
78387
2554
Necessitem poder mesurar el progrés de manera objectiva
01:20
and ultimately, the only way we're going to know
27
80941
3173
i, en definitiva, sols sabrem
01:24
when we actually have a cure is when we have
28
84114
2192
si realment existeix una cura quan tinguem
01:26
an objective measure that can answer that for sure.
29
86306
3398
una mètrica objectiva i certera.
01:29
But frustratingly, with Parkinson's disease
30
89704
2850
Però és frustrant que per al Parkinson
01:32
and other movement disorders, there are no biomarkers,
31
92554
2353
i altres trastorns del moviment no hi hagi marcadors biològics.
01:34
so there's no simple blood test that you can do,
32
94907
2229
Per això mateix, no serveixen les anàlisis de sang
01:37
and the best that we have is like
33
97136
1802
i la millor cosa que tenim és
01:38
this 20-minute neurologist test.
34
98938
2241
un examen neurològic de 20 minuts.
01:41
You have to go to the clinic to do it. It's very, very costly,
35
101179
2458
S'ha d'anar a una clínica a fer-se'l. És molt, molt car,
01:43
and that means that, outside the clinical trials,
36
103637
2757
i això significa que, tret dels assajos clínics,
01:46
it's just never done. It's never done.
37
106394
2728
mai es fa. Mai s'ha fet.
01:49
But what if patients could do this test at home?
38
109122
3077
Però, i si els pacients el poguessin fer a casa seva?
01:52
Now, that would actually save on a difficult trip to the clinic,
39
112199
2098
Això els estalviaria un viatge dificultós a la clínica.
01:54
and what if patients could do that test themselves, right?
40
114297
4254
I si els pacients es poguessin fer l'examen ells mateixos?
01:58
No expensive staff time required.
41
118551
1920
No caldria personal.
02:00
Takes about $300, by the way,
42
120471
1418
Per cert, costa poc més de 200 euros
02:01
in the neurologist's clinic to do it.
43
121889
1993
anar a fer el test a la clínica neurològica.
02:03
So what I want to propose to you as an unconventional way
44
123882
2681
Per això mateix, el que us vull proposar com una manera poc convencional
02:06
in which we can try to achieve this,
45
126563
1514
amb què podriem intentar aconseguir això,
02:08
because, you see, in one sense, at least,
46
128077
1808
perquè, en certa manera almenys,
02:09
we are all virtuosos like my friend Jan Stripling.
47
129885
3256
tothom és virtuós com el meu amic Jan Stripling.
02:13
So here we have a video of the vibrating vocal folds.
48
133141
3755
Aquest és un vídeo de la vibració de les cordes vocals.
02:16
Now, this is healthy and this is somebody making speech sounds,
49
136896
3229
Es tracta d'una persona sana que emet sons mentre parla
02:20
and we can think of ourselves as vocal ballet dancers,
50
140125
3464
i ens podem veure com ballarins de ballet vocal,
02:23
because we have to coordinate all of these vocal organs
51
143589
2214
perquè hem de coordinar tots aquests òrgans vocals
02:25
when we make sounds, and we all actually
52
145803
2295
quan emetem sons, i tothom té
02:28
have the genes for it. FoxP2, for example.
53
148098
2296
els gens per a fer-ho. El FoxP2, per exemple.
02:30
And like ballet, it takes an extraordinary level of training.
54
150394
2713
I com al ballet, és necessari un nivell extraordinari d'entrenament.
02:33
I mean, just think how long it takes a child to learn to speak.
55
153107
2585
És a dir, només penseu quant li costa a un nen aprendre a parlar.
02:35
From the sound, we can actually track
56
155692
2382
A partir del so, podem en realitat seguir
02:38
the vocal fold position as it vibrates,
57
158074
2281
la posició de les cordes vocals a mesura que vibren,
02:40
and just as the limbs are affected in Parkinson's,
58
160355
2543
i de la mateixa manera que les extremitats es veuen afectades pel Parkinson,
02:42
so too are the vocal organs.
59
162898
2781
el mateix passa amb els òrgans vocals.
02:45
So on the bottom trace, you can see an example of
60
165679
1880
A la pista de sota, podeu veure un exemple
02:47
irregular vocal fold tremor.
61
167559
1698
de tremolor irregular de les cordes vocals.
02:49
We see all the same symptoms.
62
169257
1168
Veiem els mateixos símptomes:
02:50
We see vocal tremor, weakness and rigidity.
63
170425
2930
tremolor vocal, debilitat i rigidesa.
02:53
The speech actually becomes quieter and more breathy
64
173355
2104
En realitat, el discurs esdevé més assossegat i escanyat
02:55
after a while, and that's one of the example symptoms of it.
65
175459
2233
i aquest és només un exemple dels símptomes.
02:57
So these vocal effects can actually be quite subtle,
66
177692
2847
Aquests efectes vocals poden ser bastant subtils,
03:00
in some cases, but with any digital microphone,
67
180539
3216
en alguns casos, no obstant, amb un micròfon digital,
03:03
and using precision voice analysis software
68
183755
2545
i emprant un software de precisió d'anàlisi de veu
03:06
in combination with the latest in machine learning,
69
186300
2409
junt a l'últim en aprenentatge automàtic,
03:08
which is very advanced by now,
70
188709
1578
que ha evolucionat molt hui en dia,
03:10
we can now quantify exactly where somebody lies
71
190287
2886
ara podem quantificar exactament on es troba una persona
03:13
on a continuum between health and disease
72
193173
2881
en un continuu entre la salut i la malaltia
03:16
using voice signals alone.
73
196054
2596
sols amb els senyals de la veu.
03:18
So these voice-based tests, how do they stack up against
74
198650
2314
I com es comparen aquests exàmens de veu amb els clínics especialitzats?
03:20
expert clinical tests? We'll, they're both non-invasive.
75
200964
2150
Bé, tots dos són no invasius.
03:23
The neurologist's test is non-invasive. They both use existing infrastructure.
76
203114
3982
El test neurològic no és invasiu. Ambdós usen infraestructura existent.
03:27
You don't have to design a whole new set of hospitals to do it.
77
207096
3004
No has de dissenyar un nou conjunt d'hospitals per fer-ho.
03:30
And they're both accurate. Okay, but in addition,
78
210100
2302
I ambdós són exactes. Bé, però a més,
03:32
voice-based tests are non-expert.
79
212402
3327
els exàmens de veu no són especialitzats.
03:35
That means they can be self-administered.
80
215729
1992
La qual cosa significa que poden ser autoadministrats.
03:37
They're high-speed, take about 30 seconds at most.
81
217721
2580
Es fan molt ràpidament, duren uns 30 segons com a màxim.
03:40
They're ultra-low cost, and we all know what happens.
82
220301
2294
Són de cost mínim i tothom sap que ocorre
03:42
When something becomes ultra-low cost,
83
222595
2440
quan una cosa té un cost tan baix:
03:45
it becomes massively scalable.
84
225035
2296
apareix a escala massiva.
03:47
So here are some amazing goals that I think we can deal with now.
85
227331
3675
Aquestes són algunes metes increïbles que podem abordar.
03:51
We can reduce logistical difficulties with patients.
86
231006
2426
Podem reduir les dificultats logístiques dels pacients.
03:53
No need to go to the clinic for a routine checkup.
87
233432
2312
No seria necessari anar a la clínica per a la rutinaria revisió.
03:55
We can do high-frequency monitoring to get objective data.
88
235744
2320
Amb la monitorització d'alta freqüència podríem obtindre dades objectives.
03:58
We can perform low-cost mass recruitment for clinical trials,
89
238064
4105
Podríem fer un reclutament massiu de baix cost per als assajos clínics
04:02
and we can make population-scale screening
90
242169
2115
i, per primera vegada, revisions factibles
04:04
feasible for the first time.
91
244284
1596
a escala general.
04:05
We have the opportunity to start to search
92
245880
2202
Tenim l'oportunitat de començar a buscar
04:08
for the early biomarkers of the disease before it's too late.
93
248082
3541
els primers biomarcadors de la malaltia abans que sigui massa tard.
04:11
So, taking the first steps towards this today,
94
251623
2758
Per això mateixa, en donar avui les primeres passes en aquest sentit
04:14
we're launching the Parkinson's Voice Initiative.
95
254381
2126
estem llançant la Iniciativa Vocal del Parkinson.
04:16
With Aculab and PatientsLikeMe, we're aiming
96
256507
2232
Amb Aculab i PatientsLikeMe, volem
04:18
to record a very large number of voices worldwide
97
258739
1928
registrar una gran quantitat de veus arreu del món
04:20
to collect enough data to start to tackle these four goals.
98
260667
3140
per recol·lectar suficients dades i començar a abordar aquests objectius.
04:23
We have local numbers accessible to three quarters
99
263807
1700
Tenim línies locals accessibles per a uns
04:25
of a billion people on the planet.
100
265507
1610
750 milions de persones al món.
04:27
Anyone healthy or with Parkinson's can call in, cheaply,
101
267117
3077
Qualsevol, amb o sense Parkinson, pot trucar a baix cost
04:30
and leave recordings, a few cents each,
102
270194
2139
i deixar grabacions per uns cèntims.
04:32
and I'm really happy to announce that we've already hit
103
272333
2190
I em complau anunciar que ja hem arribat
04:34
six percent of our target just in eight hours.
104
274523
3543
al 6% de la meta ens sols vuit hores.
04:38
Thank you. (Applause)
105
278066
3751
Gràcies. (Aplaudiments)
04:41
(Applause)
106
281817
6320
(Aplaudiments)
04:48
Tom Rielly: So Max, by taking all these samples of,
107
288137
3575
Tom Rielly: Aleshores Max, amb totes aquestes mostres de,
04:51
let's say, 10,000 people,
108
291712
2776
digam 10 000 persones,
04:54
you'll be able to tell who's healthy and who's not?
109
294488
2854
podem dir qui està sa i qui no?
04:57
What are you going to get out of those samples?
110
297342
1685
Què trauran d'aquestes mostres?
04:59
Max Little: Yeah. Yeah. So what will happen is that,
111
299027
1830
Max Litte: Sí, sí. El que passa és que
05:00
during the call you have to indicate whether or not
112
300857
1657
durant la trucada has d'indicar si tens o no
05:02
you have the disease or not, you see. TR: Right.
113
302514
1267
la malaltia. TR: És clar.
05:03
ML: You see, some people may not do it. They may not get through it.
114
303781
2507
ML: Ja veuen, algunes persones poden no passar-ho. Pot ser no ho acabin.
05:06
But we'll get a very large sample of data that is collected
115
306288
2717
Però obtindrem una mostra molt gran de dades recopilades
05:09
from all different circumstances, and it's getting it
116
309005
3408
en diferents circumstàncies, i fer-ho
05:12
in different circumstances that matter because then
117
312413
1905
en diferents circumstàncies és important perquè
05:14
we are looking at ironing out the confounding factors,
118
314318
3384
estem buscant llimar els factors de confusió
05:17
and looking for the actual markers of the disease.
119
317702
2161
en busca de marcadors reals de la malaltia.
05:19
TR: So you're 86 percent accurate right now?
120
319863
2497
TR: Tenen un 86% de precisió en aquest moment?
05:22
ML: It's much better than that.
121
322360
1194
ML: Molt més que això.
05:23
Actually, my student Thanasis, I have to plug him,
122
323554
1720
En realitat, el meu estudiant Thanasis, he de fer-li propaganda,
05:25
because he's done some fantastic work,
123
325274
1870
ha fet un treball fantàstic
05:27
and now he has proved that it works over the mobile telephone network as well,
124
327144
3770
i ara ha demostrat que funciona en la red de telefonia mòbil també,
05:30
which enables this project, and we're getting 99 percent accuracy.
125
330914
3390
la qual cosa agilita el projecte. Ara tenim un 99% de precisió.
05:34
TR: Ninety-nine. Well, that's an improvement.
126
334304
1576
TR: Noranta nou. Bé, és una millora.
05:35
So what that means is that people will be able to —
127
335880
2201
Aleshores les persones podran...
05:38
ML: (Laughs)
128
338081
1852
ML: (Rises)
05:39
TR: People will be able to call in from their mobile phones
129
339933
1906
TR: Les persones podran trucar des dels seus mòbils
05:41
and do this test, and people with Parkinson's could call in,
130
341839
3072
i fer el test. Les persones amb Parkinson podrien trucar,
05:44
record their voice, and then their doctor can check up
131
344911
2870
gravar la seva veu i després els metges podrien revisar
05:47
on their progress, see where they're doing in this course of the disease.
132
347781
2681
el progrés, veure on estan en el curs de la malaltia.
05:50
ML: Absolutely.
133
350462
970
ML: Per descomptat.
05:51
TR: Thanks so much. Max Little, everybody.
134
351432
1743
TR: Moltes gràcies. Max Little, senyors i senyores.
05:53
ML: Thanks, Tom. (Applause)
135
353175
5157
ML: Gràcies, Tom. (Aplaudiments)
About this website

This site will introduce you to YouTube videos that are useful for learning English. You will see English lessons taught by top-notch teachers from around the world. Double-click on the English subtitles displayed on each video page to play the video from there. The subtitles scroll in sync with the video playback. If you have any comments or requests, please contact us using this contact form.

https://forms.gle/WvT1wiN1qDtmnspy7