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

Translator: Joseph Geni Reviewer: Morton Bast

翻译人员: Li Li 校对人员: Yuguo Zhang

So, well, I do applied math,

话说，我是学应用数学的

and this is a peculiar problem

对于每一个学应用数学的人来说

for anyone who does applied math, is that

有一个特殊的难题，就是

we are like management consultants.

我们和管理顾问都很像

No one knows what the hell we do.

没人知道我们是干嘛的

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

所以我今天会给你们一些实例

to try and explain to you what I do.

来解释我们是干什么的

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

嗯，跳舞是人类众多的活动之一

We delight at ballet virtuosos and tap dancers

我们会因芭蕾舞大师和踢踏舞蹈者而感到欣悦

you will see later on.

稍后你们就会知道了

Now, ballet requires an extraordinary level of expertise

如今芭蕾需要非凡的专业知识

and a high level of skill,

和杰出的专业技巧

and probably a level of initial suitability

甚至一定的初级适应性

that may well have a genetic component to it.

这可能就是所说的天赋

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

不过，可悲的是，神经系统疾病，例如帕金森症

gradually destroy this extraordinary ability,

慢慢地在摧毁这一卓越的才能

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

这正发生在我的朋友Jan Striling身上

a virtuoso ballet dancer in his time.

他曾是他那个时代的芭蕾舞大师

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

这些年他接受过很多治疗也有很大的进步

However, there are 6.3 million people worldwide

然而，世上有630万的人

who have the disease, and they have to live with

患有这种疾病，而且他们还得忍受

incurable weakness, tremor, rigidity

无法治愈的虚弱，震颤，僵化

and the other symptoms that go along with the disease,

等其他伴随而来的症状的折磨

so what we need are objective tools

所以我们需要客观的工具

to detect the disease before it's too late.

在病重之前将之检测出来

We need to be able to measure progression objectively,

我们需要客观地测量进展

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

最后，想要知道何时有治愈之方的唯一方法

when we actually have a cure is when we have

就是当我们

an objective measure that can answer that for sure.

拥有了能准确回答那些问题的客观测量法

But frustratingly, with Parkinson's disease

但令人泄气的是，帕金森症

and other movement disorders, there are no biomarkers,

和其他运动障碍疾病，都没有生物标志物

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

所以你没法做简单的血液检查

and the best that we have is like

我们能做到的最好的

this 20-minute neurologist test.

就是像这个20分钟的神经学测试

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

你必须得到诊所去，而且花费相当相当大

and that means that, outside the clinical trials,

这也意味着，在临床试验之外

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

从来没人做过这个测试，从来没有

But what if patients could do this test at home?

但如果病人能在家完成这个测试呢？

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

这也能为病人节省下那段去诊所的路程

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

如果病人能独立完成这个测试呢？

No expensive staff time required.

就不需要花大量的钱去雇佣员工

Takes about $300, by the way,

顺便提下，如果去神经科诊所做的话

in the neurologist's clinic to do it.

这个费用要300美金

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

所以我想向你们提出一个非常规的的方法

in which we can try to achieve this,

一个我们能尝试去达到目的的方法

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

因为你也知道，在某种意义上，至少

we are all virtuosos like my friend Jan Stripling.

我们都是像我朋友Jan Stripling一样的艺术大师

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

我这里有一个关于声襞颤动的视频

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

这个是健康状态下的某人在发声

and we can think of ourselves as vocal ballet dancers,

我们把自己想当作是声音的芭蕾舞者

because we have to coordinate all of these vocal organs

因为当我们发声时

when we make sounds, and we all actually

我们得去协调这些发声器官，确实

have the genes for it. FoxP2, for example.

这些是与生俱来的，例如Foxp2基因

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

而且和芭蕾一样，这也需要经过特殊地训练

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

可以想一想，小孩学说话得花多长时间

From the sound, we can actually track

从声音里，我们可以追寻到

the vocal fold position as it vibrates,

声襞颤动时的位置

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

正如帕金森能影响我们四肢

so too are the vocal organs.

它也能影响我们发声器官

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

你可以看到底部的颤动轨迹

irregular vocal fold tremor.

是一种不规则的声襞颤动

We see all the same symptoms.

我们看到了一样的症状

We see vocal tremor, weakness and rigidity.

声音颤动，虚弱，和僵化

The speech actually becomes quieter and more breathy

讲话会变得小声而且之后伴随更多气息音

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

这些都是症状的例子

So these vocal effects can actually be quite subtle,

事实上，这些声效大部分时候挺难以捉摸的

in some cases, but with any digital microphone,

但只要有任何一款数码麦克风

and using precision voice analysis software

搭上精密的声音分析软件

in combination with the latest in machine learning,

再组合用上最新的目前已非常先进的

which is very advanced by now,

机器研究

we can now quantify exactly where somebody lies

现在我们就能准确地定量

on a continuum between health and disease

他人处于健康和疾病这一直线上的位置

using voice signals alone.

这仅仅只需要语音信号而已

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

那么这些以语音为基础的测试，他们会怎样

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

与专业的临床测试展开较量呢？其实他们都是无创技术

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

神经学测试是无创性的，而且他们都使用现有的基础设备

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

你无需去设计一系列新的医院来完成测试

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

他们也都具有精确性。虽然这么说，但是

voice-based tests are non-expert.

基于语音的测试却不是专家级别的

That means they can be self-administered.

这意味着患者能自己搞定

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

而且速度也快，最多只要30秒

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

价格很低，我们也知道是怎么一回儿事

When something becomes ultra-low cost,

一旦价格低廉

it becomes massively scalable.

它也就能被大规模地扩展

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

我这儿有些现在能拿出来说的伟大的目标

We can reduce logistical difficulties with patients.

我们能减少和病人有关的后勤问题

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

没必要去诊所做例行的检查

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

我们能进行高频率的监测以获取客观数据

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

我们能为临床试验组织大量征召且耗费很低

and we can make population-scale screening

我们也能使人数的规模的展示

feasible for the first time.

在第一时间变得可行

We have the opportunity to start to search

我们也有机会开始寻找

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

这种疾病在病入膏肓前的早期生物标志物

So, taking the first steps towards this today,

所以，从今天开始朝这个方向迈出第一步

we're launching the Parkinson's Voice Initiative.

我们开始了Parkinson's Voice Initiative(帕金森主创声音测试)这个项目

With Aculab and PatientsLikeMe, we're aiming

和Aculab还有PatientsLikeMe一起合作，我们希望

to record a very large number of voices worldwide

记录下大量世界各地的声音

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

收集足够的数据来达到这四个目标

We have local numbers accessible to three quarters

我们的市话号码能接通地球上

of a billion people on the planet.

7亿5000万人的来电

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

任何健康或者患有帕金森疾病的人都能打进来，很便宜

and leave recordings, a few cents each,

留下录音，每次只要几分钱

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

我很高兴宣布我们仅在8小时内

six percent of our target just in eight hours.

就达到了我们目标的6%

Thank you. (Applause)

谢谢（掌声）

(Applause)

（掌声）

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

Tom Rielly: Max，靠着这些采样

let's say, 10,000 people,

不妨说，在一万人中

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

你能够辨别出谁是健康的，谁是患病的？

What are you going to get out of those samples?

你又想从这些采样中得出什么呢？

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

Max Little:对，是的。所以是这样的

during the call you have to indicate whether or not

在来电期间，你得告诉我们

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

你是否患有这种疾病。TR：嗯

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

ML:要知道，有些人可能不会打给我们，或者没接通

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

但我们还是会得到大量

from all different circumstances, and it's getting it

来自不同环境下的采样数据

in different circumstances that matter because then

而且重点是不同的环境，因为这样

we are looking at ironing out the confounding factors,

我们才能消除掉那些混淆的因素

and looking for the actual markers of the disease.

寻求这种疾病真正的标记

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

TR:所以你现在拥有86%的准确率了？

ML: It's much better than that.

ML:已经远远不止了

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

事实上，我的学生Thanasis，我得提一下他

because he's done some fantastic work,

因为他做出一些出色的成果

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

现在他已经证明了在移动电话网上也能进行这个项目

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

所以现在我们接近99%的准确率了

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

TR:九十九，好吧，这还挺了不起的

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

所以这也意味着人们能——

ML: (Laughs)

ML:（笑）

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

TR:人们能用手机打进你们的电话

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

然后做这项测试，帕金森病人也能打通电话

record their voice, and then their doctor can check up

然后记录下声音，之后他们的医生就能检查他们的进展

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

确定他们处于这种疾病的哪个阶段

ML: Absolutely.

ML:就是这样

TR: Thanks so much. Max Little, everybody.

TR:非常感谢，Max Little和所有人

ML: Thanks, Tom. (Applause)

ML:谢谢你Tom（掌声）