Personalized Medicine and Education





This is a work in progress.

Introduction
The article (CORDIS, 2010) provides excellent information about progress in the individualization (personalization) of one aspect of medicine. In brief summary, each person (each patient) is unique. As researchers gain more information about this uniqueness and the properties of different treatments and combinations of treatments, they become more successful. Quoting from the article:


 * The ViroLab Virtual Laboratory, the core components of which are scheduled to be available online in 2010, uses the latest advances in machine learning, data mining, grid computing, modelling and simulation to turn the content of millions of scientific journal articles, disparate databases and patients’ own medical histories into knowledge that can effectively be used to treat disease.


 * Developed by a multidisciplinary team of European researchers working in the EU-funded ViroLab project, the virtual laboratory is already being used in seven hospitals to provide personalised treatment to HIV patients and is eliciting widespread interest as a potent decision-support tool for doctors.


 * “ViroLab finds new pathways for treatment by integrating different kinds of data, from genetic information and molecular interactions within the body, measured in nanoseconds, up to sociological interactions on the epidemiological level spanning years of disease progression,” explains Peter Sloot, a computational scientist at the University of Amsterdam and the coordinator of ViroLab.

In terms of education, we have long known the value of a student having an Individualized Education Plan (IEP) and also the value of individual tutoring or small group tutoring. In addition, we have long debated the value (or, the downside) of grouping students according to some criteria such as their current level of reading or math knowledge and skills. The argument in favor of this type of individualization is that the level of instruction is more appropriate to the level of the student, and this leads to a better education.

Medical Education Versus General Education
One possible starting point in discussing these two different disciplines is to look at medical education versus general education.

Medicine is a specialized area of study. Its content and practice is driven by a substantial amount of research. Moreover, it is driven by the fact that every person knows something about medicine and from time to time has a personal interest in accurate diagnosis and treatment.

For example, my wife and I do foster care for kittens and cats. We some times have feral cats or cats that have been poorly treated. As we work to domesticate these cats and get them ready for adoption into a permanent home, it is not uncommon for us to get scratched or bitten. Over time, we have learned quite a bit both about how to avoid such injuries and also how to treat such injuries. Prevention, diagnosis, treatment, and making use of a doctor if necessary.

Think about the same ideas, but in general education. During the early years of a child's life, the prevention of injuries and possible illness is the responsibility of parents and other caregivers. Many problems are handled by the parents and other caregivers. However, more serious medically-related problems are referred to a professional.

There are a very wide range of problems that get referred to general practitioners and medical specialists. Thus, for example, there are experts on vision and hearing. There are speech experts. And, there are many narrower specialists in medicine. A child with challenging physical and/or mental problems is often treated by a team of specialists, often over an extended period of time. (Think of this in terms of an IEP in education.)

If we go back to the early 1900s, the quality of medical education varied widely throughout the country. Also, the quality of medical treatment (and its availability) varied widely.

Do you detect a parallel with the quality and quantity of formal education at the time?) Since then, we have come a long way in medical education and the practice of medicine. We have also come a long way in the education of teachers, and in the design and implementation of schooling.

Medical education became better as "best practices" became commonly taught and as standards for both education and practice were implemented. Pay special attention to this statement about both the education and the practices. The educational system educates and trains physicians. They then enter into a career—the practice of medicine. They directly use what they have learned. In using their knowledge and skills they continually improve.

Moreover, they engage in a career of ongoing formal and informal education. They are faced by steady progress in their discipline. For a short history of medical education, and contributions made by Abraham Flexner about a hundred years ago, see http://theglitteringeye.com/?p=1707.

Moreover, physicians are faced by patients and caregivers of patients) who have learned and are learning about some of this progress. Access to the Web, for example, makes it much easier for people to learn about their own medical conditions and play a more active role in seeking and receiving appropriate medical care.

Some of this same situation exists in the education of students. Both students and their caregivers have access to information about the teaching and learning processes. Many parents intervene in the informal and formal education of their children. Many parents play an active role in the education of their children. In this, the level of education of the parents makes a significant difference. The home environment plays a significant role in the education of children.

The Professions Medicine and Education
In both medicine and education, there has been considerable research during the past hundred years. Both disciplines have had to deal with the advent of Information and Communication Technology (ICT).

It is in the contributions of research and development, and in ICT that we can see huge differences in the differing challenges of the medical and education professions. Lets begin with a simple example. Quoting from http://inventors.about.com/library/inventors/blaspirin.htm:




 * Hippocrates, who lived sometime between 460 B.C and 377 B.C. Hippocrates was left historical records of pain relief treatments, including the use of powder made from the bark and leaves of the willow tree to help heal headaches, pains and fevers.


 * By 1829, scientists discovered that it was the compound called salicin in willow plants which gave you the pain relief.

Eventually aspirin was mass produced and mass distributed. Eventually other medicines for pain and fever were discovered, and some of them mass produced and mass distributed without doctors' prescriptions.

Moving from these examples, think about the types of medical research and development that lead to medicines, machines (such as x-ray and various other types of scanners), methodologies (arthroscopic surgery, open heart surgery) that have become common place in the medical profession. We have equipment to do analysis of a blood sample, checking for many possible problems. Some of this may seem like magic to you.

So, in medicine we have developments that can be widely used by patients and we have developments that are widely used by physicians as they work with patients. We have in place a system of education and marketing (for patients, adult caregivers, physicians) and distribution that makes this happen.

Now, what about a parallel for education. One parallel lies in textbooks for students. A federal agency or corporation will pay for the development and research on a new curriculum. The curriculum is represented by books for students, teachers' editions for teachers, video supplements, aids to assessment, and other aids for students and their teachers. These can be mass produced and mass distributed. In addition, home libraries, school libraries, and now the Web have all made important contributions to improving education.

Somewhat is a similar vein, books, videos, educational toys, and other aids to teaching and learning can be developed for direct sale to parents, to help them to be more productively engaged in the education of their children.

But, in this endeavor, there are few magic pills, magic machines, and magic procedural interventions. The overall disciplines of medicine and education are different, and they face different challenges.

But, lets go further in this exploration.

Self Assessment and Self Treatment (Work in progress)
In medicine, people learn to self assess (self diagnose). Thermometer, blood pressure, blood sugar, ... What else is available and routinely used? What exists that might be added to this repertoire? See Self-Assessment Tools, New York University Langone Medical Center, at http://www.med.nyu.edu/patientcare/library/tools.html. For example, here is a list of healthy Living Calculators that are available:

Ideal Body Weight Using body mass index as a reference, this calculator determines your ideal body weight range. All you need to do is enter your height.

Body Mass Index This tool considers your height and weight to assess your weight status.

Waist-to-Hip Ratio Are you apple-shaped or pear-shaped? Find out here.

Waist-to-Hip Basal Metabolism This is the amount of calories your body burns when at rest, but awake, over the course of one day. What's your basal metabolism?

Calorie/Energy Needs How many calories do you need to eat each day to maintain your weight and fuel your physical activity? Enter a few of your stats into this calculator to find out.

Target Heart Rate When you stop to take your heart rate during a workout, what should it be? Depends on your age and how hard you're working out. Find out your range here.

Activity Calculator Enter your weight and how many calories you would like to burn. We'll tell you which activities to do and how long to do them to work off those calories.

Calories Burned Select the type and duration of activity you do and we'll tell you the calories you've burned.

Exercise Guide Enter your current weight and how much you would like to lose per week. Well tell you which activities will help you accomplish your weight loss goal and how much time you will need to spend doing them.

Ovulation Calculator Is it time to expand your family? This tool identifies your most fertile days during the month.

Pregnancy Due Date Make sure you buy the diapers in time! This tool calculates your expected delivery date (EDD).

Here is a list of Health Risk Assessors

Health Risk Assessors

Depression Determine your risk of depression by answering nine questions mental health professionals use to help make the diagnosis of this common condition.

Diabetes Find out if you are at increased risk for Type II Diabetes by answering a series of simple questions.

Osteoporosis Find out if you could benefit from further testing and treatment for osteoporosis.

Breast Cancer Determine your risk of developing breast cancer within the next five years based on your age and other known risk factors.

Coronary Heart Disease Determine your risk of developing significant coronary heart disease within the next ten years based on your age, blood pressure, cholesterol levels and other risk factors

Author or Authors
The initial version of this page was developed by David Moursund.