Eric Topol: The wireless future of medicine

50,323 views ・ 2010-02-23

TED


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翻译人员: dayu Vong 校对人员: Zhihua Dong
00:15
Does anybody know when the stethoscope was invented?
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有人知道听诊器是什么时候发明的吗?
00:20
Any guesses? 1816.
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大家试着猜一猜,有人说是1816年。
00:23
And what I can say is, in 2016,
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而我认为是在2016年。
00:26
doctors aren't going to be walking around with stethoscopes.
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那个时候医生就不需要拿着听诊器跑来跑去了
00:28
There's a whole lot better technology coming,
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更好的医疗技术已经呈现在我们面前
00:30
and that's part of the change in medicine.
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而这也是医疗革命的一部分。
00:33
What has changed our society
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已经改变我们人类社会的
00:36
has been wireless devices.
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是那些无线设备
00:38
But the future are digital medical wireless devices, OK?
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但我们的未来是数字化的医用无线设备,OK?
00:43
So, let me give you some examples of this
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因此,让我来通过一些例子
00:45
to kind of make this much more concrete.
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更具体地描述这个概念。
00:48
This is the first one. This is an electrocardiogram.
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这是第一个,这是一组心电图
00:51
And, as a cardiologist, to think that you could see in real time
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作为一名心脏病专家,
00:54
a patient, an individual, anywhere in the world
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无论在世界的哪一个角落,
00:57
on your smartphone,
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都能用智能手机及时诊断病人,观察他们的心电图,
00:59
watching your rhythm -- that's incredible,
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这是不可思议的。
01:01
and it's with us today.
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然而今天,这种不可思议已经成为现实
01:03
But that's just the beginning.
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但这仅仅是个开始
01:06
You check your email while you're sitting here.
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今天你可以坐在这里查收邮件
01:09
In the future you're going to be checking all your vital signs,
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不久的将来你就可以坐在这里查询你的生命体征
01:13
all your vital signs: your heart rhythm,
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你所有的生命体征,像心律、
01:15
your blood pressure, your oxygen, your temperature, etc.
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血压、体内的含氧量以及体温等等
01:19
This is already available today.
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其实这些今天都已经实现了
01:21
This is AirStrip Technologies.
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那就是AirStrip Technologies公司的技术。
01:23
It's now wired -- or I should say, wireless --
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现在它是有线的,
01:27
by taking the aggregate of these signals
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如果我将医院、重症监护室的数据信息进行汇总,
01:29
in the hospital, in the intensive care unit,
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输入到我的智能手机里发送给医生,
01:31
and putting it on a smartphone for physicians.
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这个意义上可以说是无线的。
01:34
If you're an expectant parent,
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如果你是一位准爸爸或者准妈妈
01:36
what about the ability to monitor, continuously,
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如果你可以随时持续获知胎儿的心率、你的宫缩确保临产时各项指标都正常
01:39
fetal heart rate, or intrauterine contractions,
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如果你可以随时持续获知胎儿的心率、你的宫缩确保临产时各项指标都正常
01:42
and not having to worry so much that things are
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如果你可以随时持续获知胎儿的心率、你的宫缩确保临产时各项指标都正常
01:45
fine as the pregnancy,
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如果你可以随时持续获知胎儿的心率、你的宫缩确保临产时各项指标都正常
01:47
and moving over into the time of delivery?
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并及时送往医院生产,将会怎样?
01:50
And then as we go further,
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进一步讲
01:53
today we have continuous glucose sensors.
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今天在我们的皮肤下
01:55
Right now, they are under the skin,
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可以安装葡萄糖检测器,
01:57
but in the future, they won't have to be implanted.
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但在不久的将来这些将无需植入体内。
02:01
And of course, the desired range -- trying to keep glucose
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当然,我们需要每隔5分钟查一下葡萄糖传感器,
02:03
between 75 and less than 200,
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确认我们的葡萄糖是否保持在75-200之间
02:07
checking it every five minutes in a continuous glucose sensor --
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确认我们的葡萄糖是否保持在75-200之间
02:10
you'll see how that can impact diabetes.
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大家可以看到这一变革将怎样影响糖尿病人的生活。
02:12
And what about sleep?
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那么我们的睡眠是否也可以如上所述呢?
02:14
We're going to zoom in on that a little bit.
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在这里,我们花一点时间稍作解释
02:16
We're supposed to spend a third of our life in sleep.
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我们的一生大约有三分之一的时间用于睡眠
02:18
What if, on your phone,
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假如在几个星期后,
02:20
which will be available in the next few weeks,
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你的手机可以显示你每一分钟的睡眠情况,
02:22
you had every minute of your sleep displayed?
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会怎么样?
02:25
And this is, of course, as you can see, the awake is the orange.
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大家请看,当你醒着的时候,这里的显示为橙色,
02:28
The REM sleep, rapid eye movement,
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当你处于快速眼动睡眠(REM=rapid eye movement sleep睡眠中眼睛迅速转动)
02:30
dream state, is in light green;
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状态时,显示为绿色
02:32
and light is gray, light sleep;
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当你处于轻度睡眠状态时,显示为灰色
02:34
and deep sleep, the best restorative sleep,
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当你处于深度睡眠(恢复体力的睡眠)状态时
02:36
is that dark green.
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呈现的是深绿色
02:38
How about counting every calorie?
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那么,如何计算你消耗和吸收的卡路里呢?
02:40
And this is ability, in real time, to actually take
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这里可以通过这个类似创可贴的东西
02:43
measurements of caloric intake
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来实时计算出你卡路里的摄入和支出
02:45
as well as expenditure, through a Band-Aid.
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来实时计算出你卡路里的摄入和支出
02:48
Now, what I've talked about are physiologic metrics.
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好,我刚才给大家讲述的是生理上的度量标准体系
02:51
But what I want to get to, the next frontier,
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但我接下来想很快地,
02:54
very quickly, and why the stethoscope
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为大家介绍的是另一项前沿科技。
02:56
is on its way out,
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为什么说听诊器快落伍了呢?
02:58
is because we can transcend listening to the valve sounds,
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因为通过GE引进的手持超声装置,
03:02
and the breath sounds, because now,
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我们的可听域超出了肠蠕动音、呼吸音的范围
03:04
introduced by G.E. is a handheld ultra-sound.
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我们的可听域超出了肠蠕动音、呼吸音的范围
03:07
Why is this important? Because this is so much more sensitive.
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为什么这是一项重要的技术?因为它更为灵敏。
03:10
Here is an example of an abdominal ultrasound,
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这里有三个范例,一个是关于腹部超声的
03:13
and also a cardiac echo, which can be sent wireless,
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第二个可以通过无线传输心脏超声
03:17
and then there's an example of fetal monitoring on your smartphone.
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第三个可以用你的智能手机进行胎儿监控
03:21
So, we're not just talking about physiologic metrics --
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在这里,我们所讨论的不仅仅是生理指标
03:24
the key measurements of vital signs,
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或者是关键的生命体征值
03:27
and all those things in physiology -- but also all the imaging
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以及生理学的其他指标,
03:30
that one could look at in your smartphone.
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还包括可以通过智能手机看到的所有成像结果。
03:32
Now, this is an example of another obsolete technology,
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现在,我给大家展示另一项即将过时的技术
03:36
soon to be buried: the Holter Monitor.
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霍尔行氏心电动态监控仪
03:38
Twenty-four hour recording, lots of wires.
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它可以24小时监控,大家可以看到有好多线连着
03:40
This is now a little tiny patch.
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现在改进为一个小贴片
03:42
You can put it on for two weeks
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你可以将这个放在身上长达2个星期
03:44
and send it in the mail.
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并且可以通过邮件传输
03:47
Now, how does this work? Well,
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那么这是如何实现的呢?
03:49
there is these smart Band-Aids or these sensors
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测试者可以把这些类似创可贴的小贴片和传感器
03:51
that one would put on, on a shoe or on the wrist.
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戴在手腕上或者放在鞋子里面
03:54
And this sends a signal
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这个装置就可以发送信号
03:57
and it creates a body area network to a gateway.
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从而建立通往网关的一个人体局域网
04:01
Gateway could be a smartphone or it could be a dedicated gateway,
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网关可以是你的智能手机或者是专用网关
04:04
as today many of these things are dedicated gateways,
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我们现在使用的网关大多是专用网关
04:06
because they are not so well integrated.
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因为他们还没有很好地兼容
04:08
That signal goes to the web, the cloud,
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信号被传到网络,经过云计算
04:11
and then it can be processed and sent anywhere:
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这样信号就可以被处理并传输到任何地方
04:13
to a caregiver, to a physician,
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比如说给护士、医生
04:15
back to the patient, etc.
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或者病人自己等等
04:17
So, that's basically very simplistic technology
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这基本是这一技术工作原理的简单介绍。
04:20
of how this works.
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这基本是这一技术工作原理的简单介绍。
04:22
Now, I have this device on.
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现在我的身上有一个类似的设备
04:24
I didn't want to take my shirt off to show you, but I can tell you it's on.
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我不想把衬衫脱掉给各位看,但是可以告诉大家我的确戴着它
04:27
This is a device that not only measures cardiac rhythm,
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这项设备不仅能够测量你的心律——
04:31
as you saw already,
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正如你已经看到的,
04:33
but it also goes well beyond that.
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它能做的事情远比这个要多。
04:36
This is me now. And you can see the ECG.
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我现在就站在这里,你可以看到我的心电图
04:39
Below that's the actual heart rate and the trend;
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它的下面是我的实际心率和心脏跳动的趋势
04:42
to the right of that is a bioconductant.
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右边是一个生理参量,
04:44
That's the fluid status,
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这是动态的
04:46
fluid status, that's really important
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这对于患有心力衰竭的病人非常重要
04:48
if you're monitoring somebody with heart failure.
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这对于患有心力衰竭的病人非常重要
04:50
And below that's temperature,
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再下面是体温
04:52
and respiration, and oxygen,
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呼吸强度以及体内含氧量
04:54
and then the position activity.
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这是我的位置活动
04:56
So, this is really striking, because this device
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这些的确是振奋人心的,因为这项设备
04:59
measures seven things
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能够监控心力衰竭患者7大项重要的生命体征
05:01
that are very much vital signs
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能够监控心力衰竭患者7大项重要的生命体征
05:04
for monitoring someone with heart failure. OK?
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能够监控心力衰竭患者7大项重要的生命体征
05:08
And why is this important? Well,
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为什么说很重要呢?大家看
05:10
this is the most expensive bed.
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这是世界上最贵的一种床
05:13
What if we could reduce the need for hospital beds?
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假如我们能减少人们对医院病床的需求,这将会产生什么影响?
05:16
Well, we can. First of all, heart failure
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遗憾的是,我们不能。首先,
05:18
is the number one reason
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在美国,入院的病人中,
05:21
for hospital admissions and readmissions in this country.
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心力衰竭患者所占的比例是最大的
05:24
The cost of heart failure is 37 billion dollars a year,
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心力衰竭患者每年的花费将近370个亿
05:29
which is 80 percent related to hospitalization.
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其中80%属于住院治疗的费用
05:32
And in the course of 30 days after a hospital stay
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经过住院治疗30天后
05:35
for a Medicare greater than 65 years or older,
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65岁以上患者中会有27%的人30天内再次入院
05:38
is -- 27 percent are readmitted in 30 days,
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65岁以上患者中会有27%的人30天内再次入院
05:41
and by six months, over 56 percent are readmitted.
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否则,6个月后将会有56%的患者再次入院
05:45
So, can we improve that? Well the idea is
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因此,我们能否改善一下这种情况呢?
05:47
we take this device that I'm wearing,
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我们的想法是,把我现在戴的这个装置,
05:49
and we put it on 600 patients with heart failure,
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戴在600名随机抽取的心力衰竭患者身上,
05:53
randomly assigned, versus 600 patients
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同时,我们对比另外
05:55
who don't have active monitoring,
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600名没有佩戴这种装置的心力衰竭患者
05:57
and see whether we can reduce heart failure readmissions,
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以便查证对比一下,这个装置是否可以降低患者再次入院的比例
06:00
and that's exciting. And we'll start that trial,
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结果将会是令人惊叹的。我们即将开始这个试验
06:02
and you'll hear more about how we're going to do that,
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大家将会听到更多关于我们如何进行这项试验的消息
06:04
but that's a type of wireless device trial
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这是一项能在未来几年将改变医疗现状的无线设备试验
06:07
that could change medicine in the years ahead.
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这是一项能在未来几年将改变医疗现状的无线设备试验
06:10
Why now? Why has this all of a sudden become
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什么是现在?为什么这会突然变成现实,
06:13
a reality, an exciting direction in the future of medicine?
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成为未来医疗界令人振奋的方向?
06:17
What we have is, in a way, a perfect positive storm.
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从某种程度上说,我们现在所经历的是一场积极变革
06:21
This sets up consumer-driven healthcare.
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它引起了以消费者为导向的医疗革命
06:23
That's where this is all starting.
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而这就是一切的根源
06:25
Let me just give you specifics about why this is
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如果你还没有意识到这一点,让我给大家举个例子来解释为什么这是一项重大举动
06:28
a big movement if you're not aware of it:
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如果你还没有意识到这一点,让我给大家举个例子来解释为什么这是一项重大举动
06:30
1.2 million Americans
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120万美国人
06:32
have gotten a Nike shoe, which is a body-area network
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都有一双耐克鞋,通过人体局域网链接了他们的Iphone、Ipod以及鞋子
06:35
that connects the shoe, the sole of the shoe to the iPhone, or an iPod.
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都有一双耐克鞋,通过人体局域网链接了他们的iPhone、iPod以及鞋子
06:39
And this Wired Magazine cover article
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这本《连线》的封面文章集合了很多这样的应用。
06:41
really captured a lot of this; it talked a lot about the Nike shoe
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它提到了耐克鞋如何迅速监控人们的生理运动和能量消耗
06:44
and how quickly that's been adopted to monitor exercise physiology
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它提到了耐克鞋如何迅速监控人们的生理运动
06:47
and energy expenditure.
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和能量消耗
06:49
Here are some things, the principles
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这些是需要我们牢记于心的指导原则
06:51
that are guiding principles to keep in mind:
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这些是需要我们牢记于心的指导原则
06:53
"A data-driven health revolution
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以数字技术为导向的医疗卫生革命,
06:55
promises to make us all
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将会让我们生活地更好、更快、更强
06:57
better, faster, and stronger. Living by numbers."
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将会让我们生活地更好、更快、更强
07:00
And this one, which is really telling,
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看一下这个,这的确很有说服力
07:02
this was from July, this cover article:
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这是7月的封面文章
07:05
"The personal metrics movement goes way beyond
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个人的监控远不止日常饮食和运动,
07:08
diet and exercise. It's about tracking every facet
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它涉及到生活的方方面面,
07:11
of life, from sleep to mood to pain,
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从睡眠到情绪到疼痛感,
07:13
24/7/365."
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贯穿一天24小时,一周7天,一年365天。
07:16
Well, I tried this device.
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因此,我尝试使用这种设备。
07:19
A lot of you have gotten that Phillips Direct Life.
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我知道你们中的很多人使用飞利浦的Direct Life
07:22
I didn't have one of those,
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我没有那个东西
07:24
but I got the Fitbit.
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不过我有个Fitbit
07:26
That looks like this.
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就是这个
07:28
It's like a wireless accelerometer, pedometer.
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它看起来就像是一个无线加速器或计步器
07:31
And I want to just give you the results of that testing,
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在这里,我只想给大家展示这个东西监控的结果
07:33
because I wanted to understand about the consumer movement.
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因为我想知道消费者的运动情况
07:36
I hope the, by the way, the Phillips Direct Life works better --
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我希望Phillips Direct Life会更好用一些
07:38
I hope so.
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希望如此
07:40
But this monitors food, it monitors activity and tracks weight.
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但这个还监控饮食,运动和体重
07:44
However you have to put in most of this stuff.
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然而,你需要输入大部分信息到这个设备中
07:46
The only thing it really tracks by itself is activity,
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它能够独立监控的只有运动
07:49
and even then, it's not complete.
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即便是这样,它还不是完整的。
07:51
So, you exercise and it picks up the exercise.
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因此,当你运动的时候,这个装置就会记录你运动的情况。
07:54
You put in your height and weight, it calculates BMI,
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你输入你的身高和体重,它就会计算出你的体质指数。
07:57
and of course it tells you how many calories you're expending
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当然,它还会告诉你在运动过程中你消耗了多少卡路里,
08:00
from the exercise, and how many you took in,
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吃东西吸收了多少卡路里,
08:03
if you go in and enter all the foods.
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不过,前提是你必须先输入有关食物的信息。
08:04
But it really wants you to enter all your activity.
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使用这个装置,你必须要输入所有有关你运动的信息。
08:07
And so I went to this,
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我一直使用这个,
08:10
and of course I was gratified that it picked up
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我很高兴Fitbit监控了我42分钟的运动
08:12
the 42 minutes of exercise, elliptical exercise I did,
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我所做的42分钟椭圆机运动
08:16
but then it wants more information.
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但是它还需要更多的信息
08:18
So, it says, "You want to log sexual activity.
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因此,它显示:“请录入性爱活动”
08:21
How long did you do it for?"
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你和你的爱人做爱多长时间
08:23
(Laughter)
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(笑声)
08:26
And it says, "How hard was it?"
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它又显示:“做爱的力度是怎样的?”
08:29
(Laughter)
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(笑声)
08:30
Furthermore it says, "Start time."
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然后它又显示:“开始的时间是?”
08:33
Now, this doesn't appear -- this just doesn't work,
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但现在它什么也不显示了...它停止工作了
08:35
I mean, this just doesn't work.
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我的意思是说,这样是不行的
08:37
So, now I want to move to sleep.
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好的,让我们转向下一个,睡眠
08:39
Who would ever have thought you could have your own EEG
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顺便问一下,有谁想过在自己家里的闹钟上
08:42
at your home, tagged to a very nice alarm clock, by the way?
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就可以看到自己的心电图?
08:45
This is the headband that goes with this alarm clock.
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这是和闹钟配套的头带
08:48
It monitors your brainwaves continuously, when you're sleeping.
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当你睡觉的时候,它能够监控你的脑电波
08:51
So, I did this thing for seven days
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为了准备TEDMed的演讲,我拿自己做试验,
08:53
getting ready for TEDMed.
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检测了我7天以来的睡眠状况。
08:55
This is an important part of our life, one-third you're supposed to be sleeping.
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睡眠是我们生命非常重要的一部分,我们三分之一的时间都用于睡觉。
08:58
Of course how many here
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请问在座的各位
09:00
have any problems with sleeping?
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有哪些睡眠存在问题?
09:04
It's usually 90 percent. So, you tell me you sleep better than expected.
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一般的比例高达90%,你们的情况比我想象得要好。
09:07
Okay, well this was a week of
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好的,请看,这是我一个星期的睡眠情况
09:10
my life in sleeping,
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好的,请看,这是我一个星期的睡眠情况
09:12
and you get a Z.Q. score. Instead of an I.Q. score,
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在这里我们用Z.Q.分数衡量睡眠质量,而不是I.Q.
09:15
you get a Z.Q. score when you wake up.
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当你起床的时候,就会有一个Z.Q.得分。
09:17
You say, "Oh, OK." And a Z.Q. score
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Z.Q.的标准会随着年龄不断调整。
09:19
is adjusted to age,
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Z.Q.的标准会随着年龄不断调整。
09:21
and you want to get as high as you possibly can.
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你希望能够得到你的年龄范围内最高的分数。
09:24
So this is the moment-by-moment,
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它会记录你分分秒秒的睡眠情况。
09:26
or minute-by-minute sleep.
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它会记录你分分秒秒的睡眠情况。
09:28
And you see that Z.Q. there was 80-odd.
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看一下,我的Z.Q.得分是80多
09:31
And the wake time is in orange.
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醒着的时候显示为橙色
09:34
And this can be a problem, as I learned.
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我发现了一个问题
09:37
Because it not only helps you with quantifying
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因为这不仅帮助你评估自己的睡眠质量
09:39
your sleep,
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也同时告诉其他人你是醒着的
09:41
but also tells others you're awake.
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也同时告诉其他人你是醒着的
09:44
So, when my wife came in and she
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所以,我的妻子一进房门
09:47
could tell you're awake.
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就可以看出其实我是醒着的
09:49
"Eric, I want to talk. I want to talk."
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“艾瑞克,我想聊天,我想聊天”
09:51
And I'm trying to play possum.
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而我还在装睡
09:53
This thing is very, very impressive.
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这件事情让我印象非常非常深刻
09:56
OK. So, that's the first night.
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好的,这是第一个晚上
09:59
And this one is now 67,
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这天晚上我得了67分
10:01
and that's not a good score.
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这不是很好的分数
10:03
And this tells you, of course, how much you had in REM sleep,
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这个还告诉你,你分别处于快速眼动睡眠、
10:05
in deep sleep, and all this sort of thing.
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深度睡眠或其他睡眠状态的时间
10:07
This was really fascinating because
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这的确很有趣
10:09
this gave that quantitation
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因为它为你睡眠的各个阶段进行定量分析
10:11
about all the different phases of sleep.
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因为它为你睡眠的各个阶段进行定量分析
10:13
So, it also then tells you how you do compared to your age group.
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而且,Z.Q.也可以帮助你与你同龄组的人进行比较
10:16
It's like a managed competition of sleep.
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这好像是一个睡眠竞争比赛
10:19
And really interesting stuff.
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非常有趣
10:23
Look at this thing and say, "Well, I didn't think I was a very good sleeper,
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我看到这个结果,然后想:“虽然我的睡眠质量不算好,
10:26
but actually I did better than average in 50 to 60 year olds." OK?
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但与50~60岁年龄组的平均水平相比还是很不错的。”
10:31
And the key thing was, what I didn't know,
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重要的是,我竟然不知道
10:33
was that I was a really good dreamer.
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我睡觉的时候经常做梦
10:35
OK. Now let's move from sleep to diseases.
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好的,让我们再从睡眠转向疾病
10:40
Eighty percent of Americans have chronic disease,
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80%的美国人都患有慢性疾病
10:43
or 80 percent of age greater than 65 have
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高于65岁的美国人中
10:46
two or more chronic disease,
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80%以上患有两种或多种慢性疾病
10:48
140 million Americans
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1.4亿美国人
10:50
have one or more chronic disease,
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有一种或多种慢性疾病
10:52
and 80 percent of our 1.5, whatever, trillion
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我们的1.5万亿医疗开销中
10:57
expenditures are related to chronic disease.
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80%与慢性疾病有关
10:59
Now, diabetes is one of the big ones.
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糖尿病就是其中人数最多的一种
11:01
Almost 24 million people have diabetes.
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在美国,几乎有2400万人患有糖尿病
11:04
And here is the latest map. It was published
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这是纽约时报上星期发表的最新疾病地图
11:06
just a little more than a week ago in the New York Times,
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这是纽约时报一周多前发表的最新疾病地图
11:09
and it isn't looking good.
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看起来情况不是很好
11:11
That is, for men, 29 percent
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在美国,60岁以上的男性中
11:14
in the country over 60 have Type II diabetes,
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29%患有II型糖尿病
11:17
and women, although it's less, it's terribly high.
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女性较男性人数虽少一些,但数目还是相当巨大
11:20
But of course we have a way to measure that now
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当然现在我们已经有方法可以连续监控它了
11:22
on a continuous basis,
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当然现在我们已经有方法可以连续监控它了
11:24
with a sensor that detects blood glucose,
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方法是用一个传感器来连续检测血糖浓度
11:26
and it's important because we could detect
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这很重要,因为通过检测
11:28
hyperglycemia that otherwise wouldn't be known,
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可以确定我们自己不知道的高血糖症或低血糖症
11:30
and also hypoglycemia.
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可以确定我们自己不知道的高血糖症或低血糖症
11:32
And you can see the red dots, in this particular patient's case,
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你可以看到,这个病例中的红点
11:35
were finger sticks, which would have missed both ends.
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是不连续数据,它遗漏了很多居于两端的数据
11:38
But by continuous monitoring,
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但是由于持续的监控
11:40
it captures all that vital information.
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我们可以获得所有的重要信息
11:42
The future of this though,
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这一技术的未来
11:44
is being able to move this to a Band-Aid type phenomenon,
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是要能把监控设备做得像创可贴一样简易
11:46
and that's not so far away.
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而且这也即将得以实现
11:49
So, let me just give you, very quickly,
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下面,让我来简略地介绍
11:51
10 top targets for wireless medicine.
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无线医疗的十大目标
11:53
All these things are possible --
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所有这些都是能够实现的
11:55
some of them are very close,
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有些已经非常接近了
11:57
or already, as you heard,
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或者如你所知
11:59
are available today, in some way or form.
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已经以某种形式或方式存在了
12:01
Alzheimer's disease:
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老年痴呆症
12:03
there's five million people affected, and you can check
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我们有500万人患有老年痴呆症,大家可以检查
12:05
vital signs, activity, balance.
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生命体征、活动以及身体各项均衡来进行监测
12:07
Asthma: large number, we could detect things like
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哮喘,患者众多,你也可以通过检测
12:10
pollen count, air quality, respiratory rate. Breast cancer,
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花粉、空气质量、呼吸率来有效控制。乳腺癌——
12:13
I'll show you an example of that real quickly.
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稍后我将给诸位展示一个例子
12:16
Chronic obstructive pulmonary disease.
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慢性阻塞性肺病
12:19
Depression, there's a great approach to that in mood disorders.
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忧郁症——我们现在有了监控情绪是否异常的好方法
12:22
Diabetes I've just mentioned. Heart failure we already talked about. Hypertension:
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糖尿病、心力衰竭我刚才已提到;然后就是高血压
12:25
74 million people could have continuous blood-pressure monitoring
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7400万的人可以通过持续监控来来很好的控制和预防高血压
12:28
to come up with much better management and prevention.
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7400万的人可以通过持续监控来来很好的控制和预防高血压
12:33
And obesity we already talked about, the ways to get to that.
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肥胖症和睡眠异常
12:36
And sleep disorders.
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也可以通过这样的方法来控制
12:38
This is effective around the world. The access to smartphones
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这在全球范围内都是非常有效的
12:41
and cell phones today is extraordinary.
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智能手机和移动手机现在已经遍地都是
12:44
And this article from The Economist summed it up beautifully
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这篇经济学人的文章很好地总结了
12:47
about the opportunities in health across the developing world:
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发展中国家健康卫生的机遇
12:49
"Mobile phones made a bigger difference to the lives of more people,
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“手机比其他先前的技术更大、更快地影响了更多人的生活”
12:52
more quickly, than any previous technology."
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“手机比其他先前的技术更大、更快地影响了更多人的生活”
12:55
And that's before we got going on the m-health world.
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而这正是在我们步入移动医疗卫生世界的基础
12:58
Aging: The problem is enormous,
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老龄化:问题非常严重
13:01
300,000 broken hips per year;
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每年都有300000老人髋部骨折
13:03
but the solutions are extraordinary,
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然而解决问题的办法是非常多的
13:06
and they include so many different things.
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并且每一个办法又包含了很多不同的内容
13:08
One of the ones I just wanted to mention:
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我想提到的一点就是:
13:10
The iShoe is another example of a sensor that
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iShoe就是一个很好的传感器的例子
13:13
improves proprioception among the elderly
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它通过一个传感器来提高老年人的本体感受
13:16
to prevent falling.
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从而降低摔倒的机率
13:17
One of many different techniques using wireless sensors.
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现在很多技术都是通过无线传感器实现的
13:20
So, we can change medicine across the continuum of care,
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因此我们可以在持续护理的过程中、
13:23
across the ages from premies or unborn children
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在不同的年龄组成中、
13:27
to seniors; the pharmaceutical arena changes;
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在变化的医药舞台上、
13:30
the full spectrum of disease -- I hope I've given you a sense of that --
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以及全疾病谱上,来改变医疗方法。我希望大家能意识到一件事——
13:33
across the globe.
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这个信念就是医疗改革的国际化
13:35
There are two things that can really accelerate this whole process.
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能推动这个进程的有两件事
13:38
One of them -- we're very fortunate -- is to develop a dedicated institute
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其中一件——我们很幸运——就是建立一个专门的机构
13:42
and that's work that started with the work that Scripps with Qualcomm ...
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高通公司和Scripps医疗公司已经开始了这个项目
13:48
and then the great fortune of meeting up with Gary and Mary West,
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我非常幸运的遇见了Gary和Mary West
13:51
to get behind this wireless health institute.
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他们正在着手建立一个无线化的健康机构
13:54
San Diego is an extraordinary place for this.
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圣地亚哥是一个非常适合做研究地方
13:56
There's over 650 wireless companies,
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那里有650个无线公司
13:59
100 of which or more are working in wireless health.
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其中100多个主攻无线医疗
14:02
It's the number one source of commerce, and interestingly
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这是该商业领域最大的资源,比较有趣的是
14:05
it dovetails beautifully with over 500 life science companies.
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他们还和500多个生命科学研究公司完美地结合在一起
14:08
The wireless institute,
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该无线研究所
14:11
the West Wireless Health Institute,
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西方无线医疗研究所
14:13
is really the outgrowth of two extraordinary people
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是两位杰出的人所创立的
14:17
who are here this evening:
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他们今晚也来到了会议现场
14:19
Gary and Mary West. And I'd like to give it up for them for getting behind this.
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Gary和MaryWest。让我们将掌声送给台下这两位
14:22
(Applause)
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掌声
14:26
Their fantastic philanthropic investment made this possible,
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他们的慈善投资让这个项目成为可能
14:29
and this is really a nonprofit education center
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这个研究所完全是非盈利性教育中心
14:32
which is just about to open. It looks like this,
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而这个研究院也即将开放。它看起来是这个样子的
14:35
this whole building dedicated.
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这栋建筑都是专用于研究所的研究的。
14:38
And what it's trying to do is accelerate this era:
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我们努力要做的就是推动这个时代向前发展
14:40
to take unmet medical needs, to work and innovate --
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以实现未满足的医疗需求,进行不断创新
14:43
and we just appointed the chief engineer, Mehran Mehregany,
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我们不久前刚刚任命了首席工程师,并在本周一宣布了结果
14:46
it was announced on Monday --
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他就是Mehran Mehregany
14:48
then to move up with development,
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我们需要不断与时俱进
14:50
clinical trial validation and then changing medical practice,
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发展临床试验,改善医疗实践
14:53
the most challenging thing of all,
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最具挑战性的一件事情是
14:56
requiring attention to reimbursement, healthcare policy, healthcare economics.
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这需要同时关注医疗赔偿、医疗卫生政策以及医疗经济学
14:59
The other big thing, besides having this fantastic
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除了有这个先进的研究院来推动这个领域的发展
15:02
institute to catalyze this process
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另一件重要的事情
15:05
is guidance,
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就是指引这个领域的发展方向
15:08
and that's of course relying on the fact that medicine goes digital.
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当然,这是建立在药物数字化基础之上的
15:11
If we understand biology from genomics and omics
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如果我们通过生理表现型,基因组学、生命组学以及
15:15
and wireless through physiologic phenotyping, that's big.
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无线来理解生物学,这将是很震撼的事情
15:19
Because what it does is allow a convergence like we've never had before.
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因为这将是我们从未达到过的知识的集合
15:22
Over 80 major diseases have been cracked at the genomic level,
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80%的主要疾病已经在基因组层次上被破解了
15:27
but this is quite extraordinary: More has been learned about
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这已经很了不起了
15:30
the underpinnings of disease in the last two and a half years
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在过去的两年半里,在疾病的理论基础方面,人们的认识急剧增加
15:32
than in the history of man.
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比人类历史中任何时候都多
15:34
And when you put that together with, for example,
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当你把这些新旧知识放在一起,比如说
15:36
now an app for the iPhone with your genotype
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用iPhone上的一个关于你基因类型的应用程序
15:39
to guide drug therapy ...
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作为你的药物治疗指南
15:41
but, the future -- we can now tell who's going to get Type II diabetes
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因此,不久的将来,我们就可以从所有的常见类型中
15:45
from all the common variants,
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判断出谁将会得II型糖尿病
15:47
and that's going to get filled in more
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而且将来我们会发现更多的
15:49
with low-frequency variants in the future.
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低频类型
15:51
We can tell who's going to get breast cancer
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我们可以通过多种遗传基因知道谁会患上乳腺癌
15:53
from the various genes.
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我们可以通过多种遗传基因知道谁会患上乳腺癌
15:55
We can also know who's likely to get atrial fibrillation.
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我们也能够知道谁会患心房纤维性颤动
15:58
And finally, another example: sudden cardiac death.
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此外,另一个实例就是心源性猝死
16:01
Each of these has a sensor.
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在这些的背后就是传感器
16:03
We can give glucose a sensor for diabetes to prevent it.
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我们可以给每个人一个葡萄糖传感器来预防糖尿病
16:07
We can prevent, or have the earliest detection possible,
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给病人使用超声设备
16:10
for breast cancer with an ultrasound device
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我们可以第一时间发现并预防乳腺癌
16:13
given to the patient.
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我们可以第一时间发现并预防乳腺癌
16:15
An iPatch, iRhythm, for atrial fibrillation.
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心房纤维性颤动则可以用iRhythm来监测
16:18
And vital-signs monitoring to prevent sudden cardiac death.
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也可以通过监控生命体征来预防心脏性猝死
16:22
We lose 700,000 people a year in the U.S. from sudden cardiac death.
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美国每年都会有700000人丧命于心脏性猝死
16:25
So, I hope I've convinced you of this,
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今天,我希望自己所说的内容,能让大家达成共识——
16:28
of the impact on hospital clinic resources is profound
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无线医疗设备对医院临床资源有着深远影响
16:32
and then the impact on diseases is equally impressive
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同时,对各种疾病的诊断的影响也是极其深远的
16:35
across all these different diseases and more.
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同时,对各种疾病的诊断的影响也是极其深远的
16:38
It's really taking individualized medicine to a new height
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我们将把个性化医疗推向一个新高度
16:42
and it's hyper-innovative,
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这将是一项创新性极强的事情
16:45
and I think it represents the black swan of medicine.
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我想这将成为医学界的一朵奇葩
16:49
Thanks for your attention.
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谢谢大家
16:52
(Applause)
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