August 31, 2012

Looking for some autumn reading?

For someone like me it's easy to forget that personalised medicine isn't just about genomics.

Eric Topol's The  Creative Destruction of Medicine is a book for genomicists who want to know what's going on in health care innovation outside of genomics. It's also a book for everyone else working in a health-related field who wants to understand the changes that are happening in medicine right now outside of their specialisation.

The central thesis of the book is that there are several areas of innovation in medicine - genomics, wireless sensors, health IT, social networking, and novel ways of assessing drug efficacy - that could each have a large impact, but that together they could change medicine beyond recognition.

There are many parts of The Creative Destruction of Medicine that are excellent. The section on large clinical trials as an out-dated way of assessing drug efficacy and safety is one of them. Topol thinks that conditional approval would be a better alternative: Drugs that can reasonably be assumed to be safe are initially tested on a small group of patients under strictl regulation. The regulatory agency has the right to withdraw the conditional approval at any time, and only once a reasonably large dataset has been collected does the drug gain full approval.

Topol clearly loves his medical gadgets. I was amazed by some of the ones he describes, like a pocketable ultrasound device that allows imaging the heart in real time and that may soon replace that symbol of the medical profession, the stethoscope. My biggest complaint is that parts of the book are not entirely relevant to its central topic and have probably only been included because they are of interest to the author. For example, Topol is clearly passionate about the dangers posed by the ionising radiation that come with excessive use of medical imaging technology such as CT scans, but two chapters on this are too much.


If you wonder whether The Creative Destruction of Medicine is for you, here are the most important facts:

Areas covered: The convergence of wireless sensors, genomics, information systems, mobile connectivity, internet, social networking, and computing power. Basically anything that has to do with personalised medicine

Who it is for: Doctors and anyone else working in healthcare, including researchers. As someone working in genomics, I felt that the book did an excellent job of putting genomics into perspective

Who it is not for: This book is not a guide for patients to personalised medicine. Some of topics, such as the challenges of compatibility between different proprietary Health IT systems, will be less applicable to Europe than to the United States

How much it costs: The recommended retail price for the hardcover is $27.99, but online the book is available for $15.58. The Kindle edition is a bit more expensive and costs $15.73.

If you think you're going to buy this book, do so sooner rather than later: The rate of progress in medicine means that it'll be out-dated in a year.

Again, thanks to the Sanger Institute Library for ordering this book following my suggestion.

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