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

Translator: Joseph Geni Reviewer: Morton Bast

Prevodilac: Andrea Jovanovic Lektor: Boško Eraković

So, well, I do applied math,

Dakle, bavim se primenjenom matematikom

and this is a peculiar problem

i svojstven problem

for anyone who does applied math, is that

za svakoga ko se bavi primenjenom matematikom,

we are like management consultants.

je taj da smo mi kao konsultanti u oblasti menedžmenta.

No one knows what the hell we do.

Niko ne zna šta dovraga radimo.

So I am going to give you some -- attempt today

Dakle, pokušaću danas

to try and explain to you what I do.

da vam objasnim šta radim.

So, dancing is one of the most human of activities.

Dakle, ples je jedna od najljudskijih aktivnosti.

We delight at ballet virtuosos and tap dancers

Uživamo u virtuozima baleta i plesačima stepa

you will see later on.

koje ćete videti kasnije.

Now, ballet requires an extraordinary level of expertise

E sad, balet zahteva izvanredan nivo stručnosti

and a high level of skill,

i visok nivo umeća,

and probably a level of initial suitability

i verovatno određeni nivo predodređenosti

that may well have a genetic component to it.

koji je vrlo verovatno sakriven u genima.

Now, sadly, neurological disorders such as Parkinson's disease

Nažalost, poremećaji nervnog sistema kao što je Parkinsonova bolest

gradually destroy this extraordinary ability,

postepeno uništavaju ovu izvanrednu sposobnost,

as it is doing to my friend Jan Stripling, who was

kao što to čini mom prijatelju Janu Striplingu,

a virtuoso ballet dancer in his time.

koji je bio virtuoz baleta u svoje vreme.

So great progress and treatment has been made over the years.

Važan napredak u lečenju je napravljen tokom godina.

However, there are 6.3 million people worldwide

I pored toga, 6,3 miliona ljudi širom sveta

who have the disease, and they have to live with

ima ovu bolest i mora da živi

incurable weakness, tremor, rigidity

sa neizlečivom slabošću, drhtavicom, ukočenošću

and the other symptoms that go along with the disease,

i ostalim simptomima koji prate ovu bolest,

so what we need are objective tools

pa ono što nam je potrebno jesu objektivni alati

to detect the disease before it's too late.

da prepoznamo bolest pre nego što je kasno.

We need to be able to measure progression objectively,

Moramo biti sposobni da objektivno odredimo napredovanje,

and ultimately, the only way we're going to know

i na kraju krajeva, jedini način da znamo

when we actually have a cure is when we have

da zapravo imamo lek je da posedujemo

an objective measure that can answer that for sure.

objektivne mere koje mogu sigurno odgovoriti na to.

But frustratingly, with Parkinson's disease

Ali frustrirajuće je to što kod Parkinsonove bolesti

and other movement disorders, there are no biomarkers,

i ostalih poremećaja kretanja, ne postoje nikakvi biomarkeri,

so there's no simple blood test that you can do,

ne postoji običan test krvi koji možete uraditi,

and the best that we have is like

i najbolje što imamo

this 20-minute neurologist test.

je ovaj test nervnog sistema od 20 minuta.

You have to go to the clinic to do it. It's very, very costly,

Morate uraditi taj test u klinici. Veoma, veoma je skup,

and that means that, outside the clinical trials,

i to znači da, van kliničkih ispitivanja nikad se ne sprovodi.

it's just never done. It's never done.

Nikad.

But what if patients could do this test at home?

Ali šta ako bi pacijenti mogli da urade test kod kuće?

Now, that would actually save on a difficult trip to the clinic,

Tako bi ih zapravo poštedeli teškog puta do klinike,

and what if patients could do that test themselves, right?

i šta kad bi sami mogli da urade test, zar ne?

No expensive staff time required.

Ne zahteva vreme skupog osoblja.

Takes about $300, by the way,

Košta, uzgred, 300 dolara,

in the neurologist's clinic to do it.

na neurološkoj klinici, da se uradi.

So what I want to propose to you as an unconventional way

Ono što želim da vam predložim kao nekonvencionalan način

in which we can try to achieve this,

putem kojeg želimo ovo da postignemo,

because, you see, in one sense, at least,

jer, vidite, na neki način barem,

we are all virtuosos like my friend Jan Stripling.

svi smo mi virtuozi kao moj prijatelj Jan Stripling.

So here we have a video of the vibrating vocal folds.

Ovde imamo video vibrirajućih glasnih žica.

Now, this is healthy and this is somebody making speech sounds,

Ovo je zdravo i ovo je neko ko stvara govorne zvukove

and we can think of ourselves as vocal ballet dancers,

i možemo zamisliti sebe kao vokalne baletane,

because we have to coordinate all of these vocal organs

jer moramo da koordiniramo svim ovim vokalnim organima

when we make sounds, and we all actually

kad stvaramo zvukove, i svi mi zapravo posedujemo gene za to.

have the genes for it. FoxP2, for example.

Na primer, "FoxP2" .

And like ballet, it takes an extraordinary level of training.

I kao i balet, to zahteva izuzetan nivo treninga.

I mean, just think how long it takes a child to learn to speak.

Mislim, zamislite samo koliko treba detetu da nauči da priča.

From the sound, we can actually track

Pomoću zvuka, možemo pratiti

the vocal fold position as it vibrates,

poziciju glasne žice kako vibrira,

and just as the limbs are affected in Parkinson's,

i kao što su udovi pogođeni kod Parkinsona,

so too are the vocal organs.

tako su i vokalni organi.

So on the bottom trace, you can see an example of

Na donjoj crti, možete videti primer

irregular vocal fold tremor.

nepravilnog drhtanja glasne žice.

We see all the same symptoms.

Vidimo sve iste simptome.

We see vocal tremor, weakness and rigidity.

Vidimo vokalno podrhtavanje, slabost i ukočenost.

The speech actually becomes quieter and more breathy

Govor zapravo postaje tiši i zadihaniji posle nekog vremena,

after a while, and that's one of the example symptoms of it.

i ovo jedan primer simptoma.

So these vocal effects can actually be quite subtle,

Ovi vokalni efekti mogu biti zaista poprilično suptilni,

in some cases, but with any digital microphone,

u nekim slučajevima, ali sa bilo kojim digitalnim mikrofonom,

and using precision voice analysis software

i koristeći precizne softvere za analizu glasa

in combination with the latest in machine learning,

u kombinaciji sa najnovijim mogućnostima mašinskog učenja,

which is very advanced by now,

koje je mnogo unapređeno danas,

we can now quantify exactly where somebody lies

možemo tačno odrediti gde se neko nalazi

on a continuum between health and disease

na kontinuumu između zdravlja i bolesti

using voice signals alone.

koristeći jedino glasovne signale.

So these voice-based tests, how do they stack up against

Kako ovi testovi na osnovu glasa stoje naspram

expert clinical tests? We'll, they're both non-invasive.

ekspertskih kliničkih testova?

Pa, oba su neinvazivna.

The neurologist's test is non-invasive. They both use existing infrastructure.

Neurološki test je neinvazivan. Oba koriste postojeću infrastrukturu.

You don't have to design a whole new set of hospitals to do it.

Ne morate dizajnirati potpuno nove bolnice da bi ga uradili.

And they're both accurate. Okay, but in addition,

I oba su tačna.

Dobro, ali osim toga,

voice-based tests are non-expert.

testovi na bazi glasa ne zahtevaju stručnjaka.

That means they can be self-administered.

To znači da se mogu samostalno koristiti.

They're high-speed, take about 30 seconds at most.

Brzi su, potrebno je najviše 30 sekundi.

They're ultra-low cost, and we all know what happens.

Veoma su jeftini i svi znamo šta se dešava.

When something becomes ultra-low cost,

Kad nešto postane jako jeftino,

it becomes massively scalable.

postaje masovno upotrebljavano.

So here are some amazing goals that I think we can deal with now.

Evo nekoliko neverovatnih ciljeva koje mislim da možemo rešiti sad.

We can reduce logistical difficulties with patients.

Možemo smanjiti logističke poteškoće sa pacijentima.

No need to go to the clinic for a routine checkup.

Nema potreba da se ide u bolnicu na rutinsku kontrolu.

We can do high-frequency monitoring to get objective data.

Možemo uraditi kontrolu visoke frekvencije da bismo dobili objektivne podatke.

We can perform low-cost mass recruitment for clinical trials,

Možemo izvršti jeftine masovne regrutacije za klinička ispitivanja,

and we can make population-scale screening

i možemo po prvi put uraditi testiranja na nivou populacije.

feasible for the first time.

We have the opportunity to start to search

Imamo mogućnost da započnemo potragu

for the early biomarkers of the disease before it's too late.

za ranim biomarkerima bolesti pre nego što bude kasno.

So, taking the first steps towards this today,

I tako, čineći prve korake ka ovome danas,

we're launching the Parkinson's Voice Initiative.

pokrećemo Parkinsonovu Glasnu Inicijativu.

With Aculab and PatientsLikeMe, we're aiming

Sa "Aculab" i "PatientsLikeMe",

to record a very large number of voices worldwide

ciljamo da snimimo veliki broj širom sveta

to collect enough data to start to tackle these four goals.

da bismo sakupili dovoljno podata i započeli ostvarivanje ova četiri cilja.

We have local numbers accessible to three quarters

Imamo lokalne brojeve dostupne

of a billion people on the planet.

za tri-četrvrtine milijarde ljudi na planeti.

Anyone healthy or with Parkinson's can call in, cheaply,

Svako ko je zdrav ili sa Parkinsonom može nazvati, jeftino,

and leave recordings, a few cents each,

i ostaviti snimke, nekoliko centi za svaki,

and I'm really happy to announce that we've already hit

i zaista sam srećan da objavim da smo već dostigli

six percent of our target just in eight hours.

6% naše ciljne grupe u roku od samo 8 sati.

Thank you. (Applause)

Hvala vam. (Aplauz)

(Applause)

(Aplauz)

Tom Rielly: So Max, by taking all these samples of,

Tom Rajli: Znači Maks, uzimajući sve ove uzorke od,

let's say, 10,000 people,

recimo, 10.000 ljudi,

you'll be able to tell who's healthy and who's not?

vi ćete moći da kažete ko je zdrav, a ko nije?

What are you going to get out of those samples?

Šta ćete dobiti iz svih tih uzoraka?

Max Little: Yeah. Yeah. So what will happen is that,

Maks Litl: Da. Da. Ono što će se desiti je,

during the call you have to indicate whether or not

za vreme poziva morate naznačiti da li imate bolest ili ne, znate.

you have the disease or not, you see. TR: Right.

ML: You see, some people may not do it. They may not get through it.

TR: U redu.

ML: Neki ljudi neće to uraditi. Oni možda neće proći kroz to.

But we'll get a very large sample of data that is collected

Ali mi ćemo dobiti veliki broj uzoraka koji su prikupljeni

from all different circumstances, and it's getting it

pod različitim okolnostima,

in different circumstances that matter because then

i uzimati ih u različitim okolnostima je važno

we are looking at ironing out the confounding factors,

jer zatim nastojimo da izdvojimo zbunjujuće faktore

and looking for the actual markers of the disease.

i tražimo stvarne markere bolesti.

TR: So you're 86 percent accurate right now?

TR: Znači vi ste sad 86% tačni?

ML: It's much better than that.

ML: Mnogo je bolje od toga.

Actually, my student Thanasis, I have to plug him,

Zapravo, moj student Tanasis, moram ga spomenuti,

because he's done some fantastic work,

jer je uradio fantastičan posao,

and now he has proved that it works over the mobile telephone network as well,

i dokazao je da to funkcioniše i preko mobilne telefonske mreže

which enables this project, and we're getting 99 percent accuracy.

što omogućava ovaj projekat, i postajemo 99% tačni.

TR: Ninety-nine. Well, that's an improvement.

TR: Devedeset devet. Pa, to je zaista napredak.

So what that means is that people will be able to —

Dakle, to znači da će ljudi biti u mogućnosti -

ML: (Laughs)

ML: (Smeh)

TR: People will be able to call in from their mobile phones

TR: Ljudi će moći da nazovu sa svojih mobilnih telefona

and do this test, and people with Parkinson's could call in,

i urade ovaj test, i ljudi sa Parkinsonom mogu nazvati,

record their voice, and then their doctor can check up

snimiti svoj glas i zatim njihov doktor može proveriti njihov napredak,

on their progress, see where they're doing in this course of the disease.

videti u kojoj fazi je bolest.

ML: Absolutely.

ML: Apsolutno.

TR: Thanks so much. Max Little, everybody.

TR: Hvala ti puno. Maks Litl.

ML: Thanks, Tom. (Applause)

ML: Hvala, Tom. (Aplauz)