TEDMED 2009
Eric Topol: The wireless future of medicine
Eric Topol：未来医疗的无线化
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EricTopol说，我们很快就可以通过智能手机来监控我们的生命体征并监测一些慢性疾病。在TEDMED上，他着重介绍了应用在未来医疗上的一些重要无线装置，这些装置可以帮助我们远离医院的病床。
Eric Topol - Cardiologist and geneticist
Eric Topol is a leading cardiologist who has embraced the study of genomics and the latest advances in technology to treat chronic disease. Full bio
Eric Topol is a leading cardiologist who has embraced the study of genomics and the latest advances in technology to treat chronic disease. Full bio
Double-click the English transcript below to play the video.
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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掌声
ABOUT THE SPEAKER
Eric Topol - Cardiologist and geneticistEric Topol is a leading cardiologist who has embraced the study of genomics and the latest advances in technology to treat chronic disease.
Why you should listen
As director of the Scripps Translational Science Institute in La Jolla, California, Eric Topol uses the study of genomics to propel game-changing medical research. The Institute combines clinical investigation with scientific theory, training physicians and scientists for research-based careers. He also serves on the board of the West Wireless Health Institute, discovering how wireless technology can change the future of health care.
In his early career, Topol was credited with leading the cardiovascular program at Cleveland Clinic to the topmost position in the US. He also was the first physician researcher to raise questions about the safety of Vioxx, has been elected to the Institute of Medicine of the National Academy of Sciences and was named Doctor of the Decade by the Institute for Scientific Information.
Eric Topol | Speaker | TED.com