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

Translator: Joseph Geni Reviewer: Morton Bast

譯者: Yuguo Zhang 審譯者: Wang-Ju Tsai

So, well, I do applied math,

嗯.我是做應用數學的

and this is a peculiar problem

而對於任何做應用數學的人來說,

for anyone who does applied math, is that

我們就像是

we are like management consultants.

管理的諮詢師

No one knows what the hell we do.

沒人知道我們到底幹什麼

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

因此呢我準備試試

to try and explain to you what I do.

向你解釋一下我幹什麼

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

舞蹈可以說是最具人類化的活動了

We delight at ballet virtuosos and tap dancers

我們都喜歡芭蕾舞蹈和踢踏舞

you will see later on.

你一會兒會看到的

Now, ballet requires an extraordinary level of expertise

芭蕾要求很高的專業技巧

and a high level of skill,

和很高的技術水準

and probably a level of initial suitability

甚至還需要一些天賦

that may well have a genetic component to it.

因此跟你的基因組成也有關

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

不過可惜的是,像帕金森癥這樣的神經系統疾病

gradually destroy this extraordinary ability,

會慢慢的毀滅這樣的能力

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

就像發生在我一位跳芭蕾舞的朋友,

a virtuoso ballet dancer in his time.

Jan Stripling的身上一樣

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

近年來在治療上已經有很多進步和應用了

However, there are 6.3 million people worldwide

但是呢,這世界上有630萬人有帕金森症

who have the disease, and they have to live with

他們每天都得面對

incurable weakness, tremor, rigidity

這無法治愈的虛弱,顫抖,僵硬

and the other symptoms that go along with the disease,

以及其他一些的癥狀

so what we need are objective tools

因此我們需要的是能夠在早期

to detect the disease before it's too late.

就探測到疾病的良好工具

We need to be able to measure progression objectively,

我們需要能夠客觀地測量進程,

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

並且最終,只有我們有能客觀地測量

when we actually have a cure is when we have

我們才能研究出

an objective measure that can answer that for sure.

能夠治愈帕金森症的方法

But frustratingly, with Parkinson's disease

但是遺憾的是,帕金森症和

and other movement disorders, there are no biomarkers,

其他生理障礙還是沒有一個生物標記

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

因此不可能做一個簡單的驗血就能查出來

and the best that we have is like

目前我們能做到的只是一個

this 20-minute neurologist test.

20分鐘的神經系統的測試

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

你必須去臨床醫院去做,而且十分的貴,

and that means that, outside the clinical trials,

這樣就意味著,除了在臨床試驗中,

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

我們是不會去做這個測試的

But what if patients could do this test at home?

不過要是病人在家裡能做的話會怎麼樣?

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

當然這樣一來他們不必去臨床醫院,對吧?

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

而且工作人員寶貴的

No expensive staff time required.

時間也會節省下來

Takes about $300, by the way,

順便提一下,做這個測試要花醫院

in the neurologist's clinic to do it.

大約300美金呢

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

因此我想告訴你一種非傳統的方法

in which we can try to achieve this,

從而達到這個目的

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

因為你可以看到,至少,一定程度上

we are all virtuosos like my friend Jan Stripling.

我們都是像我朋友Jan Stripling一樣的舞蹈家

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

我這有一個關於波動聲音的視頻

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

這個是健康的而這個是某人在說話的聲音

and we can think of ourselves as vocal ballet dancers,

我們可以把自己想像為聲音芭蕾舞者

because we have to coordinate all of these vocal organs

因為我們必須使所有聲音器官都協調起來

when we make sounds, and we all actually

當我們發聲的時候,我們都有

have the genes for it. FoxP2, for example.

固定的基因在配合.比如說FoxP2

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

跟芭蕾一樣,這需要很高的訓練水準

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

就想想一個小孩學會說話得多長時間吧

From the sound, we can actually track

從發出的聲音裏,我們實際上可以

the vocal fold position as it vibrates,

在它震動時找到聲音的位置

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

就跟肢體一樣,聲音器官

so too are the vocal organs.

在帕金森症中也會被影響

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

在這底下,你可以看到一個不尋常的

irregular vocal fold tremor.

聲音腫瘤

We see all the same symptoms.

我們看到的都是一樣的症狀

We see vocal tremor, weakness and rigidity.

我們看到腫瘤,虛弱以及僵硬

The speech actually becomes quieter and more breathy

說話變得越來越虛弱多氣

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

過一會,就成了其中一個症狀的表現

So these vocal effects can actually be quite subtle,

這些對聲音的影響可能會很細微,

in some cases, but with any digital microphone,

在有些情況下,使用精細聲音分析軟體

and using precision voice analysis software

以及目前發展很快的機器製造學中的知識

in combination with the latest in machine learning,

加上一個數位的麥克風

which is very advanced by now,

我們就可以準確地

we can now quantify exactly where somebody lies

辨認出人們在健康

on a continuum between health and disease

和疾病之間的狀態

using voice signals alone.

只用聲音信號就能鑒別

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

那麼這些聲音測試是怎麼跟專業

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

的臨床測試相對比呢?嗯,他們都是不具侵略性的

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

他們都使用目前存在的設備

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

你不需要重新設計一套新的設備去做這個測試

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

而且他們都是準確的.不過呢,

voice-based tests are non-expert.

聲音測試不是專家性的

That means they can be self-administered.

這就意味著這個測試可以由病人自己來做

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

他們很方便,最多30秒就能做完

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

而且費用極低,而且我們知道

When something becomes ultra-low cost,

有些東西一旦十分便宜,

it becomes massively scalable.

就可以被大規模生產

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

因此呢我認為我們可以實現一些十分驚人的目標

We can reduce logistical difficulties with patients.

我們可以減少運輸病人的困難

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

他們不再需要去臨床做常規檢查

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

我們可以做高頻率的測控去得到客觀的數據

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

我們還可以為臨床檢查進行大批的低廉的雇傭

and we can make population-scale screening

這樣我們就可以使得大規模的檢查

feasible for the first time.

有史以來第一次變得可行

We have the opportunity to start to search

我們可以及時檢查

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

初期疾病的標誌

So, taking the first steps towards this today,

因此呢,我們建立了在帕金森聲音

we're launching the Parkinson's Voice Initiative.

初始計畫上,邁出了第一步

With Aculab and PatientsLikeMe, we're aiming

通過Aculab和像我一樣的病人,我們準備

to record a very large number of voices worldwide

在全球記錄大量的聲音

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

去收集足夠的數據來實現這四個目標

We have local numbers accessible to three quarters

我們有這地球上7.5億人的

of a billion people on the planet.

當地電話號碼

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

任何健康或者有帕金森症的人都可以打電話來,

and leave recordings, a few cents each,

並且留下一段錄音,一次只花幾美分

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

而且我很高興地說我們

six percent of our target just in eight hours.

已經在8個小時內得到了600萬個錄音

Thank you. (Applause)

謝謝.(鼓掌)

(Applause)

(鼓掌)

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

Tom Rielly: Max, 通過收集這些,比如說10000人

let's say, 10,000 people,

的樣本,

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

你就可以看出誰健康誰不是?

What are you going to get out of those samples?

你能從這些樣本中看出什麼？

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

Max Little: 是的,是的.在通話期間你必須

during the call you have to indicate whether or not

說明你到底有沒有

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

帕金森綜合症. TR: 好

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

ML: 不過有些人可能就不會這麼做

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

不過我們可以得到一大批從不同境況下

from all different circumstances, and it's getting it

得到的數據,這樣的話這些數據都有用

in different circumstances that matter because then

因為我們就可以找出

we are looking at ironing out the confounding factors,

混淆的因子

and looking for the actual markers of the disease.

這樣找到真正疾病的標誌

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

TR: 那目前為止你有百分之86的正確率?

ML: It's much better than that.

ML: 比百分之86還好很多

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

實際上,我的一個學生Thanasis, 我必須把他提出來

because he's done some fantastic work,

因為他做了一些極棒的工作

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

現在他已經證明了在移動電話網上也可以測試

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

這樣一來我們這個計畫基本就有百分之99的正確率

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

TR: 99. 嗯,這改進還挺高的

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

那麼這就意味著人們可以----

ML: (Laughs)

ML: (笑)

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

TR: 人們就可以從他們手機打來電話

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

來做這個測試,患有帕金森症的人

record their voice, and then their doctor can check up

可以記錄他們的聲音,然後醫生可以監控

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

他們的進程,以及他們在做些什麼

ML: Absolutely.

ML: 沒錯,就是這樣

TR: Thanks so much. Max Little, everybody.

TR: 非常感謝, Max Little, 在場的每隔人

ML: Thanks, Tom. (Applause)

ML: 謝謝, Tom.(鼓掌)