I see Peter Thiel salivating already. #Palantir

(Not to mention all the data generated by his credulous approach to health apps… “Much of what is done in a hospital today will be done on the High Street, over the phone, or through the app in a decade’s time…”)

I have just had a knee replaced. Can we prioritise phone numbers that connect to humans, physiotherapy where the beds aren't broken & 24/7/365 hotlines for post operative support. Tech has is place in reducing admin but it won't replace systems with sufficiently resourced humans.

My experience as a cardiac patient has been that admin can be improved, the technology is actually pretty wonderful, and what’s lacking are people. My cardiac ward was never fully staffed and there was little continuity of care. I really wanted to see the same face for more than one day.

Absolutely. Same here.

Reducing staff is absolutely a top priority of this government. Their ideal model for healthcare for us peasants is an algorithm that despenser tablets.

Given the retention, training & immigration numbers. Can understand why Labour is concerned about NHS staff numbers however, medicine is not about medication its about healing. Sometimes that means care from humans with the ability to be motivate & encourage. The elderly? Those that live alone? MH?

Meanwhile if you actually want to measure your propensity to disease and do something about it (or demand politicians do), you’d be better off looking at your microbiome, your metabolites, or - more than anything - your wider environment - rather than your genes. www.sciencedaily.com/releases/201...

Had a visit to genetics because of weird inexplicable health issues and all that did was find out that I have the genetic markers for Beals syndrome. I do not have any of the symptoms of Beals. I still don't know why I am experiencing the issues I went to genetics for in the first place.

I had my gut microbiome analysed and learned an awful lot from it (without any medics), which I have already put into practice. In my case necessary, as medics still tell me (after 5 years) that they have no idea what #LongCovid is, let alone how to help/support me.

Can’t help wondering if the real draw of personalised medicine is not so much “you are predestined to get sick but we can help” as “you are in the market segment that can better tolerate this troublingly toxic pharmaceutical we’d like to sell”

More likely "you're going to cost us a lot of money in the future, so best we head that off by reducing our investment in you now, since we know you're going to be a burden". Like the DNR orders we got slapped with during early COVID without our consent.

Also means we deflect from the pressure to solve more expensive problems like poor housing.

Genomic testing might not change prevention advice, but it does change risk factors. Very useful for calculating insurance premiums.

Ho, hum 🙄

How handy for the pro-insurance crypto-fascist this government appears to be warming the bed for.

bsky.app/profile/davi...

I agree with you up to this point. It has been massively overhyped and helps ppl ignore other factors and public health measures. But there are *some* use cases where it means we can predict (to an extent) when someone either won't respond or will get toxicity so give them something else.

Someone sent me an interesting paper about IV gentamicin and possible genetic disposition to ototocity in newborns - but that was a highly targetted test being done at point of care (without delaying treatment) which is a v different scenario from blanket genomics. Interested in other example papers

Yes def targetted tests (not whole genome) can be useful for drug metabolising enzymes and transporters because these influence the plasma concentration of drug which in turn determines whether the effect is beneficial or toxic (or non-existent). eg bpspubs.onlinelibrary.wiley.com/doi/10.1111/...

However... these enzymes and transporters are also strongly influenced by many non-genetic factors - I co-authored a scoping review on this in relation to supposed inter-ethnic differences. doi.org/10.1002/prp2... And I don't think we really know the relative importance of these clinically.

That’s all fantastically helpful - thank you!

Thank you, very informative. There is little benefit in knowing genetic propensity. Targeted medicine OTOH saves lives. Streeting won't put more resource into that. His backers don't make money that way. One sleazy neoliberal Govt after another all putting Corporate interests above the public. 🤕

Or first in line for assisted dying as we don't want you to suffer..

I suppose he could have asked National Screening Committee first. All screening is harmful some has benefits some benefits can outweigh harms and if you’re lucky it could be a good use of scarce NHS resources.

Or, if they introduce health insurance model to UK: "sorry that condition is excluded from your insurance" ( because the data WILL get into the wrong hands.

Precisely

Lord knows I'm a solitary, introverted, shy misanthrope but even I know that medical treatment and health management need to be done face to face to establish rapport and ensure clear understanding (and avoid tech difficulties).

I would be interested to know who is going to have access to this data and who will hold the data? What other uses will it be put to that are not just for the individual that it belongs?

Well indeed.

Even if data were ‘knowledge’ (which they aren’t) in a clinically useful sense, I keep thinking of this: “All knowledge attains its ethical value and its human significance only by the human sense in which it is employed. Only a good man can be a great physician.” Hermann Nothnagel (1841 – 1905).