TEDGlobal 2012
Max Little: A test for Parkinson's with a phone call
Max Little: un examen per al Parkinson amb una trucada telefònica
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El mal de Parkinson afecta a 6.3 milions de persones arreu del món. Causa debilitat, tremolors, però no hi ha una forma objectiva de detectar-lo des d'un principi. De moment. L'especialista en matemàtica aplicada i TED Fellow Max Little està provant en estudis clínics una ferramenta senzilla i econòmica capaç de detectar el Parkinson, amb una precisió del 99% amb una trucada telefònica de 30 segons.
Max Little - Applied mathematician
Max Little is a mathematician whose research includes a breakthrough technique to monitor – and potentially screen for – Parkinson's disease through simple voice recordings. Full bio
Max Little is a mathematician whose research includes a breakthrough technique to monitor – and potentially screen for – Parkinson's disease through simple voice recordings. Full bio
Double-click the English transcript below to play the video.
00:16
So, well, I do applied math,
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Doncs bé, jo faig matemàtica aplicada
00:18
and this is a peculiar problem
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i això és un problema peculiar
00:20
for anyone who does applied math, is that
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per qui la fa:
00:22
we are like management consultants.
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som com els consultors de gestió.
00:24
No one knows what the hell we do.
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Ningú sap que coi fem.
00:26
So I am going to give you some -- attempt today
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Per això mateix avui intentaré...
00:28
to try and explain to you what I do.
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...explicar-vos què faig.
00:30
So, dancing is one of the most human of activities.
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El ball és una de les activitats més humanes.
00:34
We delight at ballet virtuosos and tap dancers
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Ens delecten els virtuosos del ballet i els ballarins de claqué
00:37
you will see later on.
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que veurem més endavant.
00:38
Now, ballet requires an extraordinary level of expertise
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Però el ballet exigeix un grau d'entrenament extraordinari,
00:41
and a high level of skill,
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un alt nivell de destresa
00:44
and probably a level of initial suitability
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i probablement una certa aptitud inicial
00:47
that may well have a genetic component to it.
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que bé pot tenir un component genètic.
00:48
Now, sadly, neurological disorders such as Parkinson's disease
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Malauradament, els trastorns neurològics com ara el Parkinson
00:52
gradually destroy this extraordinary ability,
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destrueixen gradualment aquesta extraordinària habilitat,
00:54
as it is doing to my friend Jan Stripling, who was
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com li està passant al meu amic Jan Stripling que, en la seva època,
00:56
a virtuoso ballet dancer in his time.
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va ser un virtuós ballarí de ballet.
00:59
So great progress and treatment has been made over the years.
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En els darrers anys s'ha progressat considerablement en el tractament.
01:02
However, there are 6.3 million people worldwide
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Tanmateix, hi ha 6.3 milions de persones al món
01:05
who have the disease, and they have to live with
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que pateixen aquesta malaltia i han de viure amb
01:09
incurable weakness, tremor, rigidity
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una debilitat incurable, tremolors, rigidesa
01:11
and the other symptoms that go along with the disease,
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i altres símptomes d'aquesta malaltia,
01:13
so what we need are objective tools
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o sigui que el que necessitem són eines objectives
01:15
to detect the disease before it's too late.
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per a detectar la malaltia abans no sigui massa tard.
01:19
We need to be able to measure progression objectively,
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Necessitem poder mesurar el progrés de manera objectiva
01:21
and ultimately, the only way we're going to know
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i, en definitiva, sols sabrem
01:24
when we actually have a cure is when we have
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si realment existeix una cura quan tinguem
01:26
an objective measure that can answer that for sure.
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una mètrica objectiva i certera.
01:30
But frustratingly, with Parkinson's disease
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Però és frustrant que per al Parkinson
01:33
and other movement disorders, there are no biomarkers,
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i altres trastorns del moviment no hi hagi marcadors biològics.
01:35
so there's no simple blood test that you can do,
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Per això mateix, no serveixen les anàlisis de sang
01:37
and the best that we have is like
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i la millor cosa que tenim és
01:39
this 20-minute neurologist test.
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un examen neurològic de 20 minuts.
01:41
You have to go to the clinic to do it. It's very, very costly,
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S'ha d'anar a una clínica a fer-se'l. És molt, molt car,
01:44
and that means that, outside the clinical trials,
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i això significa que, tret dels assajos clínics,
01:47
it's just never done. It's never done.
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mai es fa. Mai s'ha fet.
01:49
But what if patients could do this test at home?
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Però, i si els pacients el poguessin fer a casa seva?
01:52
Now, that would actually save on a difficult trip to the clinic,
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Això els estalviaria un viatge dificultós a la clínica.
01:54
and what if patients could do that test themselves, right?
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I si els pacients es poguessin fer l'examen ells mateixos?
01:59
No expensive staff time required.
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No caldria personal.
02:01
Takes about $300, by the way,
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Per cert, costa poc més de 200 euros
02:02
in the neurologist's clinic to do it.
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anar a fer el test a la clínica neurològica.
02:04
So what I want to propose to you as an unconventional way
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Per això mateix, el que us vull proposar com una manera poc convencional
02:07
in which we can try to achieve this,
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amb què podriem intentar aconseguir això,
02:08
because, you see, in one sense, at least,
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perquè, en certa manera almenys,
02:10
we are all virtuosos like my friend Jan Stripling.
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tothom és virtuós com el meu amic Jan Stripling.
02:13
So here we have a video of the vibrating vocal folds.
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Aquest és un vídeo de la vibració de les cordes vocals.
02:17
Now, this is healthy and this is somebody making speech sounds,
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Es tracta d'una persona sana que emet sons mentre parla
02:20
and we can think of ourselves as vocal ballet dancers,
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i ens podem veure com ballarins de ballet vocal,
02:24
because we have to coordinate all of these vocal organs
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perquè hem de coordinar tots aquests òrgans vocals
02:26
when we make sounds, and we all actually
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quan emetem sons, i tothom té
02:28
have the genes for it. FoxP2, for example.
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els gens per a fer-ho. El FoxP2, per exemple.
02:31
And like ballet, it takes an extraordinary level of training.
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I com al ballet, és necessari un nivell extraordinari d'entrenament.
02:33
I mean, just think how long it takes a child to learn to speak.
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És a dir, només penseu quant li costa a un nen aprendre a parlar.
02:36
From the sound, we can actually track
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A partir del so, podem en realitat seguir
02:38
the vocal fold position as it vibrates,
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la posició de les cordes vocals a mesura que vibren,
02:40
and just as the limbs are affected in Parkinson's,
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i de la mateixa manera que les extremitats es veuen afectades pel Parkinson,
02:43
so too are the vocal organs.
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el mateix passa amb els òrgans vocals.
02:46
So on the bottom trace, you can see an example of
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A la pista de sota, podeu veure un exemple
02:48
irregular vocal fold tremor.
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de tremolor irregular de les cordes vocals.
02:49
We see all the same symptoms.
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Veiem els mateixos símptomes:
02:51
We see vocal tremor, weakness and rigidity.
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tremolor vocal, debilitat i rigidesa.
02:53
The speech actually becomes quieter and more breathy
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En realitat, el discurs esdevé més assossegat i escanyat
02:56
after a while, and that's one of the example symptoms of it.
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i aquest és només un exemple dels símptomes.
02:58
So these vocal effects can actually be quite subtle,
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Aquests efectes vocals poden ser bastant subtils,
03:01
in some cases, but with any digital microphone,
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en alguns casos, no obstant, amb un micròfon digital,
03:04
and using precision voice analysis software
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i emprant un software de precisió d'anàlisi de veu
03:06
in combination with the latest in machine learning,
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junt a l'últim en aprenentatge automàtic,
03:09
which is very advanced by now,
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que ha evolucionat molt hui en dia,
03:10
we can now quantify exactly where somebody lies
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ara podem quantificar exactament on es troba una persona
03:13
on a continuum between health and disease
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en un continuu entre la salut i la malaltia
03:16
using voice signals alone.
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sols amb els senyals de la veu.
03:19
So these voice-based tests, how do they stack up against
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I com es comparen aquests exàmens de veu amb els clínics especialitzats?
03:21
expert clinical tests? We'll, they're both non-invasive.
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Bé, tots dos són no invasius.
03:23
The neurologist's test is non-invasive. They both use existing infrastructure.
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El test neurològic no és invasiu. Ambdós usen infraestructura existent.
03:27
You don't have to design a whole new set of hospitals to do it.
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No has de dissenyar un nou conjunt d'hospitals per fer-ho.
03:30
And they're both accurate. Okay, but in addition,
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I ambdós són exactes. Bé, però a més,
03:33
voice-based tests are non-expert.
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els exàmens de veu no són especialitzats.
03:36
That means they can be self-administered.
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La qual cosa significa que poden ser autoadministrats.
03:38
They're high-speed, take about 30 seconds at most.
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Es fan molt ràpidament, duren uns 30 segons com a màxim.
03:40
They're ultra-low cost, and we all know what happens.
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Són de cost mínim i tothom sap que ocorre
03:43
When something becomes ultra-low cost,
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quan una cosa té un cost tan baix:
03:45
it becomes massively scalable.
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apareix a escala massiva.
03:47
So here are some amazing goals that I think we can deal with now.
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Aquestes són algunes metes increïbles que podem abordar.
03:51
We can reduce logistical difficulties with patients.
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Podem reduir les dificultats logístiques dels pacients.
03:54
No need to go to the clinic for a routine checkup.
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No seria necessari anar a la clínica per a la rutinaria revisió.
03:56
We can do high-frequency monitoring to get objective data.
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Amb la monitorització d'alta freqüència podríem obtindre dades objectives.
03:58
We can perform low-cost mass recruitment for clinical trials,
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Podríem fer un reclutament massiu de baix cost per als assajos clínics
04:02
and we can make population-scale screening
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i, per primera vegada, revisions factibles
04:04
feasible for the first time.
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a escala general.
04:06
We have the opportunity to start to search
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Tenim l'oportunitat de començar a buscar
04:08
for the early biomarkers of the disease before it's too late.
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els primers biomarcadors de la malaltia abans que sigui massa tard.
04:12
So, taking the first steps towards this today,
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Per això mateixa, en donar avui les primeres passes en aquest sentit
04:15
we're launching the Parkinson's Voice Initiative.
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estem llançant la Iniciativa Vocal del Parkinson.
04:17
With Aculab and PatientsLikeMe, we're aiming
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Amb Aculab i PatientsLikeMe, volem
04:19
to record a very large number of voices worldwide
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registrar una gran quantitat de veus arreu del món
04:21
to collect enough data to start to tackle these four goals.
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per recol·lectar suficients dades i començar a abordar aquests objectius.
04:24
We have local numbers accessible to three quarters
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Tenim línies locals accessibles per a uns
04:26
of a billion people on the planet.
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750 milions de persones al món.
04:27
Anyone healthy or with Parkinson's can call in, cheaply,
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Qualsevol, amb o sense Parkinson, pot trucar a baix cost
04:30
and leave recordings, a few cents each,
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i deixar grabacions per uns cèntims.
04:32
and I'm really happy to announce that we've already hit
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I em complau anunciar que ja hem arribat
04:35
six percent of our target just in eight hours.
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al 6% de la meta ens sols vuit hores.
04:38
Thank you. (Applause)
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Gràcies. (Aplaudiments)
04:42
(Applause)
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(Aplaudiments)
04:48
Tom Rielly: So Max, by taking all these samples of,
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Tom Rielly: Aleshores Max, amb totes aquestes mostres de,
04:52
let's say, 10,000 people,
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digam 10 000 persones,
04:55
you'll be able to tell who's healthy and who's not?
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podem dir qui està sa i qui no?
04:57
What are you going to get out of those samples?
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Què trauran d'aquestes mostres?
04:59
Max Little: Yeah. Yeah. So what will happen is that,
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Max Litte: Sí, sí. El que passa és que
05:01
during the call you have to indicate whether or not
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durant la trucada has d'indicar si tens o no
05:03
you have the disease or not, you see. TR: Right.
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la malaltia. TR: És clar.
05:04
ML: You see, some people may not do it. They may not get through it.
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ML: Ja veuen, algunes persones poden no passar-ho. Pot ser no ho acabin.
05:06
But we'll get a very large sample of data that is collected
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Però obtindrem una mostra molt gran de dades recopilades
05:09
from all different circumstances, and it's getting it
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en diferents circumstàncies, i fer-ho
05:13
in different circumstances that matter because then
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en diferents circumstàncies és important perquè
05:14
we are looking at ironing out the confounding factors,
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estem buscant llimar els factors de confusió
05:18
and looking for the actual markers of the disease.
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en busca de marcadors reals de la malaltia.
05:20
TR: So you're 86 percent accurate right now?
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TR: Tenen un 86% de precisió en aquest moment?
05:23
ML: It's much better than that.
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ML: Molt més que això.
05:24
Actually, my student Thanasis, I have to plug him,
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En realitat, el meu estudiant Thanasis, he de fer-li propaganda,
05:25
because he's done some fantastic work,
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ha fet un treball fantàstic
05:27
and now he has proved that it works over the mobile telephone network as well,
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i ara ha demostrat que funciona en la red de telefonia mòbil també,
05:31
which enables this project, and we're getting 99 percent accuracy.
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la qual cosa agilita el projecte. Ara tenim un 99% de precisió.
05:34
TR: Ninety-nine. Well, that's an improvement.
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TR: Noranta nou. Bé, és una millora.
05:36
So what that means is that people will be able to —
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Aleshores les persones podran...
05:38
ML: (Laughs)
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ML: (Rises)
05:40
TR: People will be able to call in from their mobile phones
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TR: Les persones podran trucar des dels seus mòbils
05:42
and do this test, and people with Parkinson's could call in,
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i fer el test. Les persones amb Parkinson podrien trucar,
05:45
record their voice, and then their doctor can check up
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gravar la seva veu i després els metges podrien revisar
05:48
on their progress, see where they're doing in this course of the disease.
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el progrés, veure on estan en el curs de la malaltia.
05:51
ML: Absolutely.
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ML: Per descomptat.
05:52
TR: Thanks so much. Max Little, everybody.
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TR: Moltes gràcies. Max Little, senyors i senyores.
05:53
ML: Thanks, Tom. (Applause)
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ML: Gràcies, Tom. (Aplaudiments)
ABOUT THE SPEAKER
Max Little - Applied mathematicianMax Little is a mathematician whose research includes a breakthrough technique to monitor – and potentially screen for – Parkinson's disease through simple voice recordings.
Why you should listen
Max Little is an applied mathematician whose goal is to "see connections between subjects, not boundaries … to see how things are related, not how they are different." He has a background in applied mathematics, statistics, signal processing and computational engineering, and his work has been applied across disciplines like biomedicine, extreme rainfall analysis and forecasting, biophysical signal processing, and hydrogeomorphology and open channel flow measurement. Little is best known for his work on the Parkinson's Voice Initiative, in which he and his team developed a cheap and simple tool that uses precise voice analysis software to detect Parkinson's with 99 percent accuracy. Little is a TEDGlobal 2012 Fellow and a Wellcome Trust-MIT Postdoctoral Research Fellow.
Max Little | Speaker | TED.com