Talithia Williams: Own your body's data

翻译人员: Wei Wu 校对人员: Melody Tang

As a kid I always loved information

我从小就很喜欢

that I could get from data

从数据中取得信息

and the stories that could be told with numbers.

和从数字中发现不为人知的故事

I remember, growing up, I'd be frustrated at

我现在还记得从小父母就常用数字骗我

how my own parents would lie to me using numbers.

给我带来的不开心

"Talithia, if I've told you once I've told you a thousand times."

“塔莉西亚，这话再说一遍 我就已经说了一千次了”

No dad, you've only told me 17 times

不，爸爸，你只说过17次

and twice it wasn't my fault. (Laughter)

其中两次还不是我的错（笑声）

I think that is one of the reasons I got a Ph.D. in statistics.

我想这是为什么我去念了统计学博士的原因之一

I always wanted to know,

我总是想知道 人们在数字背后隐藏了什么秘密

what are people trying to hide with numbers?

As a statistician,

作为统计学家 我总是要求人们给我看数据

I want people to show me the data

so I can decide for myself.

然后我自己来做出判断

Donald and I were pregnant with our third child

当我怀着我的第三个孩子的时候

and we were at about 41 and a half weeks,

我已经41周半了

what some of you may refer to as being overdue.

在座有些人可能会觉得我已经超预产期了

Statisticians, we call that

在统计学上

being within the 95 percent confidence interval.

我们说这还在95%置信区间

(Laughter)

（笑声）

And at this point in the process

在这段时间

we had to come in every couple of days

我们需要每隔两天 去做一次胎儿压力检查

to do a stress test on the baby,

and this is just routine,

这是例行公事

it tests whether or not the baby is feeling any type of undue stress.

用来检测胎儿是否 感受到了过大的压力

And you are rarely, if ever, seen by your actual doctor,

通常你很少会碰到你自己的大夫

just whoever happens to be working at the hospital that day.

谁在那天值班就是谁看诊

So we go in for a stress test and after 20 minutes

所以在我们去做了压力测试

20分钟之后，医生出来跟我们说

the doctor comes out and he says,

"Your baby is under stress, we need to induce you."

“你的孩子压力过大，我们需要引产。”

Now, as a statistician, what's my response?

现在，作为统计学家，你猜我会怎么说？

Show me the data!

“给我看数据！”

So then he proceeds to tell us

于是他就告诉我

the baby's heart rate trace went from 18 minutes,

胎儿过去18分钟的心率数据是正常的

the baby's heart rate was in the normal zone

and for two minutes it was in what appeared to be

最后两分钟的心率看起来更像是

my heart rate zone and I said,

我自己的心率范围，于是我说

"Is it possible that maybe this was my heart rate?

“有没有可能那是我的心率？

I was moving around a little bit,

我刚才下来走了走

it's hard to lay still on your back,

让一个41周的孕妇

41 weeks pregnant for 20 minutes.

平躺20分钟不动是有点难的

Maybe it was shifting around."

可能胎儿也因此动了动。”

He said, "Well, we don't want to take any chances."

他说，“嗯，我们不想出任何差错。”

I said okay.

我说，“好。如果我现在是36周， 也是这个数据

I said, "What if I was at 36 weeks

with this same data?

Would your decision be to induce?"

你也会建议我引产吗？”

"Well, no, I would wait until you were at least

“嗯，不会，我会等到你至少38周

38 weeks, but you are almost 42,

不过你先已经快42周了 没有理由还让胎儿在里面

there is no reason to leave that baby inside,

let's get you a room."

让我来帮你准备产房。”

I said, "Well, why don't we just do it again?

我说，“那么，

让我们再做一次检查吧？

We can collect more data.

我们可以拿到更多的数据

I can try to be really still for 20 minutes.

我可以尝试坚持平躺20分钟不动

We can average the two and see

我们可以把两次结果取平均值

what that means. (Laughter)

再看看结果如何？“（笑声）

And he goes,

他听了之后说

"Ma'am, I just don't want you to have a miscarriage."

“女士，我只是不希望你流产。”

That makes three of us.

我们当然都不希望如此

And then he says,

"Your chances of having a miscarriage double

他继续说

“当你过了预产期还没有生产的时候，

when you go past your due date. Let's get you a room."

你发生流产的可能性就提高了一倍。 我们开始吧。”

Wow. So now as a statistician, what's my response?

哇。这时，作为统计学家 我是什么反应呢？

Show me the data!

给我看数据！

Dude, you're talking chances,

老兄，你跟我谈概率

I do chances all day long, tell me all about chances.

我天天都跟概率打交道，要跟我谈概率

Let's talk chances. (Laughter)

我们就来谈概率吧 （笑声）

Let's talk chances.

我们来谈概率

So I say, "Okay, great.

所以我说，“好， 我流产的概率是从30%提高到了60%吗？

Do I go from a 30-percent chance to a 60-percent chance?

Where are we here with this miscarriage thing?

我流产的可能性是什么？

And he goes, "Not quite, but it doubles,

他说，“没有那么高，不过概率确实会翻倍

and we really just want what's best for the baby."

我们真的是为了胎儿好。”

Undaunted, I try a different angle.

我没有放弃，换了一个角度提问。

I said, "Okay, out of 1,000 full-term pregnant women,

我说，“好吧，每1000个足月的准妈妈，

how many of them are going to miscarry

大概有多少位妈妈会在

just before their due date?

预产期快到的时候流产？”

And then he looks at me and looks at Donald,

他看了看我，又看了看我丈夫

and he goes, about one in 1,000.

说，“大概1000个中有1个。”

I said, "Okay, so of those 1,000 women, how many

我问，“好，那么1000个准妈妈中，

are going to miscarry just after their due date?"

多少个会在预产期过了之后流产？”

"About two." (Laughter)

“大概2个。”（笑声）

I said, "Okay, so you are telling me that my chances

我说，“好的，所以你刚才跟我说的是

go from a 0.1-percent chance

我流产的概率从0.1%

to a 0.2-percent chance."

提高到了0.2%.”

Okay, so at this point the data is not convincing us

好，到目前为止所有这些数据都没有说服我们

that we need to be induced,

让我们接受引产

and so then we proceed to have a conversation

于是接下来我们又开始新一轮讨论 有关引产手术会增加

about how inductions lead to a higher rate

of Cesarean sections, and if at all possible we'd like to avoid that.

剖腹产的可能性， 而这个是我们希望能够避免的

And then I said,

然后我说

"And I really don't think my due date is accurate."

“其实我真的不知道我的预产期是否是准确的。”

(Laughter)

（笑声）

And so this really stunned him

这句话真的惊到他了

and he looked sort of puzzled

他看起来非常的困惑

and I said, "You may not know this,

我接着说，“你可能不知道

but pregnancy due dates are calculated

但是预产期的计算是 基于28天的生理周期

assuming that you have a standard 28-day cycle,

and my cycle ranges —

而我的月经周期不规律 从27天到38天不等

sometimes it's 27, sometimes it's up to 38 —

and I have been collecting the data to prove it.

而且我有自己的周期记录来证明这一点

(Laughter)

（笑声）

And so we ended up leaving the hospital that day without being induced.

所以，那天最后的结果是， 我们没有引产，回家了

We actually had to sign a waiver to walk out of the hospital.

事实上我们必须签一个免责声明 才能够从医院回家

And I'm not advocating that you not listen to your doctors,

我不是在怂恿你不去听你的医生的话

because even with our first child,

因为我们的第一个孩子 也是在第38周的时候引产的

we were induced at 38 weeks; cervical fluid was low.

因為子宮頸黏液偏低

I'm not anti-medical intervention.

我并不是那种反对医疗介入的人

But why were confident to leave that day?

但是为什么那天我会满怀自信的离开医院

Well, we had data that told a different story.

那是因为我有数据，支持我的观点

We had been collecting data for six years.

我们已经收集了6年相关的数据

I had this temperature data,

我收集了体温数据

and it told a different story.

这个数据透露出来不同的信息

In fact, we could probably pretty accurately estimate conception.

事实上，我们有可能 非常精确的预测怀孕

Yeah, that's a story you want to tell

或许你会愿意在你孩子的婚礼上 分享这个故事（笑声）

at your kid's wedding reception. (Laughter)

I remember like it was yesterday.

我还记得那天，就像昨天才发生一样

My temperature was a sizzling 97.8 degrees

当我与你父亲深情对望的时候

as I stared into your father's eyes. (Laughter)

我的体温飙到了97.8华氏度 （笑声）

Oh, yeah. Twenty-two more years, we're telling that story.

是的。二十多年过去了 我们一直在说这个故事

But we were confident to leave because we had been collecting data.

那天我们之所以很自信的离开医院 因为我们一直在收集数据

Now, what does that data look like?

这些数据看起来如何？

Here's a standard chart

这是一个女性

在一次完整的生理周期过程中

of a woman's waking body temperature

早晨体表温度的变化图

during the course of a cycle.

So from the beginning of the menstrual cycle

从每次月经周期的开始 到下一次月经周期的开始

till the beginning of the next.

You'll see that the temperature is not random.

你会看到这个温度曲线是有规律的

Clearly there is a low pattern

很明显的在生理周期的开始 温度是比较低的

at the beginning of her cycle

and then you see this jump and then a higher

然后你会看到温度突然上升 直到她生理周期的结束

set of temperatures at the end of her cycle.

So what's happening here?

为什么会这样？ 这些数据告诉你什么？

What is that data telling you?

Well, ladies, at the beginning of our cycle,

女士们，在我们周期的开始

the hormone estrogen is dominant and that estrogen

你体内主要是雌性激素起主导作用

causes a suppression of your body temperature.

这种激素会抑制你的体温

And at ovulation, your body releases an egg

排卵期开始之后，你的身体产生一个卵子

and progesterone takes over, pro-gestation.

这个时候孕酮开始起主导作用，准备怀孕

And so your body heats up in anticipation

所以你的身体开始升温

of housing this new little fertilized egg.

为新的受精卵做好准备工作

So why this temperature jump?

为什么温度突然升高？

Well, think about when a bird sits on her eggs.

想想鸟类妈妈孵蛋

Why is she sitting on them?

为什么鸟妈妈要坐在蛋上呢？

She wants to keep them warm,

因为她希望保持蛋的温度

protect them and keep them warm.

保护它们并让它们保持温暖

Ladies, this is exactly what our bodies do every month,

女士们，我们的身体每个月都在做同样的事情

they heat up in anticipation

它提高我们的体温

of keeping a new little life warm.

为接纳新生命做准备

And if nothing happens, if you are not pregnant,

如果什么事情都没有发生，没有怀孕

then estrogen takes back over and that cycle starts all over again.

那么雌性激素的水平又会上来 这个循环又重新开始

But if you do get pregnant, sometimes you

而当你真的受孕了

actually see another shift in your temperatures

那么你会看到另一种体温变化曲线

and it stays elevated for those whole nine months.

温度会一直保持在较高的水平直到分娩

That's why you see those pregnant women just sweating and hot,

这就是为什么有些孕妇 很容易出汗，觉得热

because their temperatures are high.

因为她们的体温就是变高了

Here's a chart that we had about three or four years ago.

这是我们三四年前记录的数据

We were really very excited about this chart.

我们看到这个曲线的时候真的很兴奋

You'll see the low temperature level

你看到刚开始的时候体温是偏低的

and then a shift and for about five days,

然后开始变高，持续4到5天

that's about the time it takes for the egg to travel

这大概是一个卵细胞从输卵管

down the fallopian tube and implant,

移动到子宫开始着床的时间

and then you see those temperatures start to go up a little bit.

然后你看到温度的数值 又开始往上提高了一点点

And in fact, we had a second temperature shift,

事实上，当时我们看到了第二个温度的变化

confirmed with a pregnancy test that were indeed pregnant

通过早早孕测试 证实了我确实怀孕了

with our first child, very exciting.

那是我们的第一个孩子 我们非常兴奋

Until a couple of days later

但是在几天之后

I saw some spotting and then I noticed heavy blood flow,

我开始有点状出血 接着我注意到出血量大量增加

and we had in fact had an early stage miscarriage.

事实上我是怀孕初期流产

Had I not been taking my temperature

如果我没有一直保持记录这些数据

I really would have just thought my period was late that month,

我非常有可能把这个事情理解为 我那次的月经延后而已

but we actually had data to show

但是我们通过这些数据知道了

that we had miscarried this baby,

我实际上经历了一次流产

and even though this data revealed a really

即使这些数据透露出来的故事

unfortunate event in our lives,

对于我们而言是不幸的

it was information that we could then take to our doctor.

当我们去找医生的时候 这些信息依然非常有价值

So if there was a fertility issue or some problem,

所以当我们去咨询受孕有关的问题时

I had data to show:

我有数据可以提供（给大夫）:

Look, we got pregnant, our temperature shifted,

看，我之前怀孕了，我的体温变高了

we somehow lost this baby.

但是不知为何流产了

What is it that we can do to help prevent this problem?

我们怎么做可以避免此类事情发生？

And it's not just about temperatures

这种方法不仅仅适用于体温

and it's not just about fertility;

也不仅仅适用于怀孕过程

we can use data about our bodies to tell us a lot of things.

我们可以根据我们身体的数据发现 很多很多的事情

For instance, did you know that taking your temperature can tell you a lot

举个例子，你是否知道 通过你的温度能够推断

about the condition of your thyroid?

你的甲状腺功能的状态？

So, your thyroid works a lot like the thermostat in your house.

你的甲状腺在你身体中的作用， 可以类比为一座房子的恒温器

There is an optimal temperature that you want in your house;

你希望你的房子的温度 能够保持在一个理想的水平

you set your thermostat.

你可以调节你的恒温器

When it gets too cold in the house, your thermostat kicks in

如果你的房子温度太低了 你的恒温器就会开始工作

and says, "Hey, we need to blow some heat around."

“嘿，我们需要加加热”

Or if it gets too hot, your thermostat

如果你的房子太热了，恒温器就会发出命令

registers, "Turn the A.C. on. Cool us off."

“把空调打开，降低温度。”

That's exactly how your thyroid works in your body.

你的甲状腺在你身体的作用正是如此

Your thyroid tries to keep an optimal temperature

你的甲状腺尝试为你的身体 维持一个理想温度

for your body.

If it gets too cold, your thyroid says, "Hey, we need to heat up."

你冷了，你的甲状腺会说 “嘿，我们需要升温。”

If it gets too hot, your thyroid cools you down.

如果体温高了，它负责降温

But what happens when your thyroid is not functioning well?

但是如果甲状腺功能出了问题 会如何呢？

When it doesn't function, then it shows up

当甲状腺出问题的时候

in your body temperatures,

你的体温就会表现出来

they tend to be lower than normal or very erratic.

体温会比正常体温低 或是其它更奇怪的表现

And so by collecting this data

所以通过收集这些数据 你可以知道你的甲状腺的一些信息

you can find out information about your thyroid.

Now, what is it, if you had a thyroid problem and you went to the doctor,

现在，如果你觉得甲状腺出问题了， 你去找医生

your doctor would actually test the amount of

医生一般会给你抽血化验

thyroid stimulating hormone in your blood.

看下促甲状腺激素的水平

Fine. But the problem with that test is

这没问题。问题是这个化验

it doesn't tell you how active the hormone is in your body.

没有办法告诉你和医生这个激素的实际效果

So you might have a lot of hormone present,

有可能你化验出来的激素水平相当高

but it might not be actively working to regulate

但是这些激素并没有能够有效的 调节你的体温

your body temperature.

So just by collecting your temperature every day,

所以只需要每天收集和记录自己的体温

you get information about the condition of your thyroid.

你就能够知道你的甲状腺的状态

So, what if you don't want to take your temperature every day?

那么，如果你不想每天测量体温, 那该怎么办呢？

I advocate that you do,

我建议你测量

but there are tons of other things you could take.

不过也有非常多的数据你可以去收集

You could take your blood pressure, you could take your weight —

你可以量血压， 可以称体重 —

yeah, who's excited about

嗯，在座有没有人 喜欢每天都称体重 （笑声）

taking their weight every day? (Laughter)

Early on in our marriage, Donald had a stuffy nose

我跟我丈夫刚结婚的时候，他有鼻塞

and he had been taking a slew of medications

他当时吃很多药

to try to relieve his stuffy nose, to no avail.

想要缓解他的鼻塞，不过效果不好

And so, that night he comes and he wakes me up and he says,

有一天夜里 他把我推醒，跟我说

"Honey, I can't breath out of my nose."

“老婆，我没法用鼻子呼吸。”

And I roll over and I look, and I said, "Well, can you breath out of your mouth?"

我翻身过去，看了看他，问 “那你能用嘴呼吸吗？”

(Laughter)

（笑声）

And he goes, "Yes, but I can't breath out of my nose!"

他说，（喘气声）“可以，

但是我不能用鼻子呼吸！”

作为一个好妻子

And so like any good wife, I rush him

to the emergency room

我带他冲到医院急救室

at 2 o'clock in the morning.

当时是半夜两点

And the whole time I'm driving and I'm thinking,

我开车的时候一直在想

you can't die on me now.

丈夫你千万不能死在路上啊

We just got married,

我们才结婚

people will think I killed you! (Laughter)

别人会觉得是我杀了你的 （笑声）

And so, we get to the emergency room, and the nurse sees us,

最终我们到了急救中心 护士看了看

and he can't breath out of his nose, and so

我丈夫还是不能用鼻子呼吸

she brings us to the back and the doctor says,

所以护士带我们去见了医生

"What seems to be the problem?" and he goes, "I can't breath out of my nose."

医生问，“什么问题？” 我丈夫说，“我不能用鼻子呼吸。”

And he said, "You can't breath out of your nose?

医生问，“你不能用鼻子呼吸了？”

No, but he can breath out of his mouth. (Laughter)

是，但是他可以用嘴呼吸。（笑声）

He takes a step back and he looks at both of us

他退后观察了我们两个人

and he says "Sir, I think I know the problem.

然后说，“先生，我大概知道了

You're having a heart attack.

你是心脏病发作

I'm going to order an EKG and a CAT scan

我这就为你准备心电图检测 和CT扫描。”

for you immediately."

And we are thinking,

我们的反应是 不，不，不是心脏病。他能呼吸

no, no, no. It's not a heart attack. He can breathe,

just out of his mouth. No, no, no, no, no.

只是得用嘴而已。不，不，不，不

And so we go back and forth with this doctor

然后我们就跟大夫反复讨论

because we think this is the incorrect diagnosis,

因为我们认为这个诊断不正确

and he's like, "No really, it'll be fine, just calm down."

他的反应是， “没关系的，没事的，别激动。”

And I'm thinking, how do you calm down? But I don't think he's having a heart attack.

我的反应是，“怎么能冷静下来？” 但是我真的不认为是心脏病发作

And so fortunately for us, this doctor was at the end of the shift.

非常幸运的是， 这个医生快下班了

So this new doctor comes in, he sees us clearly

另一个医生进来了

看到一个狂躁的我，和我那个

distraught, with a husband who can't breath

out of his nose. (Laughter)

不能用鼻子呼吸的丈夫。（笑声）

And he starts asking us questions.

新医生开始问我们问题

He says, "Well, do you two exercise?"

他问，“嗯，你俩来之前做了什么运动么？”

We ride our bikes, we go to the gym occasionally.

我们经常骑脚踏车，

偶尔去健身房

(Laughter)

（笑声）

We move around.

我们会走动走动

And he says, "What were you doing just before you came here?"

他问，“你们来之前， 在做什么？”

I'm thinking, I was sleeping, honestly.

我在想，我在睡觉，真的

But okay, what was Donald doing just before?

但是，我丈夫之前在干嘛？

So Donald goes into this slew of medications he was taking.

我丈夫开始报出自己正在吃的 各种药的名字

He lists, "I took this decongestant and then I took this nasal spray,"

他说，“我吃了这个鼻子减充血剂 然后喷了这个喷鼻剂，”

and then all of a sudden a lightbulb goes off and he says,

然后突然之间新医生发现了答案

"Oh! You should never mix this decongestant with this nasal spray.

“哦！你不能这么干，这两个不能同时用

Clogs you up every time. Here, take this one instead."

百分百鼻塞。来，给你开另外一种药。”

He gives us a prescription.

他给我们开了个处方

We're looking at each other, and I looked at the doctor,

我跟丈夫面面相觑，然后我看着医生

and I said, "Why is it that it seems like you

说，“为什么看起来

were able to accurately diagnose his condition,

你能够准确的诊断出来问题

but this previous doctor wanted to order

但是之前那个医生却想要

an EKG and a CAT scan?"

做心电图和CT扫描？”

And he looks at us and says,

他看了我们一眼说

"Well, when a 350-pound man walks in the emergency room and says he can't breath,

“是的，当一个350磅的胖子 跑到急救室说自己不能呼吸

you assume he's having a heart attack

你得假设他有心脏病发作

and you ask questions later."

来不及先问诊了。”

Now, emergency room doctors are trained to make decisions quickly,

急诊科大夫所受的训练是快速诊断

but not always accurately.

但他们的诊断不都是正确的

And so had we had some information

所以如果我们有一些自己心脏的数据 和医生分享

about our heart health to share with him,

maybe we would have gotten a better diagnosis the first time.

或许第一个医生就能够 给我们更好的诊断

I want you to consider the following chart,

我希望给各位展示一下这张图

of systolic blood pressure measurements

图上测量的是血压

from October 2010 to July 2012.

时间范围从2010年10月到2012年7月

You'll see that these measurements start

你会发现测量的值一开始落在了

in the prehypertension/hypertension zone,

高血压和高血压前期的区间,

but over about the course of a year and a half

但是在一年半之后

they move into the normal zone.

血压回落到了正常的范围

This is about the heart rate of a healthy 16-year-old.

现在这个心率看起来像是一个16岁的小伙子的

What story is this data telling you?

这个故事告诉你们什么？

Obviously it's the data from someone

很显然这表现的是一个人

who's made a drastic transformation,

发生了天翻地覆的变化

and fortunately for us, that person happens to be here today.

非常幸运的，这个人今天也来到了现场

So that 350-pound guy that walked into the emergency room with me

当年走进急救室的那个人 我那350磅的丈夫

is now an even sexier and healthier

现在变得更加性感和健康

225-pound guy, and that's his blood pressure trace.

现在只有225磅 前面的血压图就是他的记录

So over the course of that year and a half

在一年半之间

Donald's eating changed

我丈夫的饮食 和我们的运动习惯都做了改变

and our exercise regimen changed,

and his heart rate responded,

因为这些改变 他的心率有了改善

his blood pressure responded to that change

他的血压也有了很大的改善

that he made in his body.

So what's the take-home message

我希望在座各位从今天的演讲 得到什么信息呢？

that I want you to leave with today?

By taking ownership of your data just like we've done,

通过像我们一样拥有你自己的身体数据

just by taking this daily measurements about yourself,

通过每天测量一下自己的身体

you become the expert on your body.

你能够成为你自己身体的专家

You become the authority.

你能够成为权威

It's not hard to do.

一点不难

You don't have to have a Ph.D. in statistics

你不需要去读个统计学博士

to be an expert in yourself.

就可以做到

You don't have to have a medical degree

你不需要拿到医学博士资格

to be your body's expert.

才能成为自己身体的专家

Medical doctors, they're experts on the population,

医生们的专业经验是针对大众群体的

but you are the expert on yourself.

你的经验是针对你个人的

And so when two of you come together,

所以当你跟医生聚在一起 两个专家聚在一起

when two experts come together,

the two of you are able to make a better decision

两个人能够一起做出更好的诊断

than just your doctor alone.

比医生一个人诊断要好很多

Now that you understand the power of information

现在如果你能够理解信息的重要性

that you can get through personal data collection,

能够从个人身体信息中获得的信息的重要性

I'd like you all to stand and raise your right hand.

我希望你们站起来 举起你的的右手

(Laughter)

（笑声）

Yes, get it up.

没错，举起来

I challenge you to take ownership of your data.

我向你发出挑战：

去拥有你自己的数据

And today, I hereby confer upon you

今天，我在此向在座各位

a TEDx associate's degree in elementary statistics

授予一个基础统计学的TEDx认证

with a concentration in time-dependent data analysis

关于时间序列相关的数据分析方面

with all the rights and privileges appertaining thereto.

你们现在有了相关的权利和能力

And so the next time you are in your doctor's office,

所以，当你们下一次去找你的医生

as newly inducted statisticians,

你们作为一个新入行的统计学家

what should always be your response?

你们一贯的反应应该是什么？

Audience: Show me the data! Talithia Williams: I can't hear you!

听众：给我看数据 演讲者：我听不到

Audience: Show me the data!

听众：给我看数据！

TW: One more time!

演讲者：再大声一点

Audience: Show me the data!

听众：给我看数据！

TW: Show me the data.

演讲者：给我看数据

Thank you.

感谢大家

(Applause)

(掌声)