The Decision Tree: Thomas Goetz’s upcoming book on predictive/personalized medicine

In the past months Thomas Goetz begun writing a book on the radical changes already ongoing but mostly upcoming in healthcare due to affordable new technologies and quantitative approaches in personalized genomics and medicine.

The book is to be called The Decision Tree (explanation below) accompanied by a new website. Thomas is the perfect man for this job, he is the deputy editor of Wired magazine (=he is well informed and connected), a good journalist who took his job (writing on science, health and medicine) so seriously that he went back to school to get a degree in Public Health. Back in the days his very early coverage on 23andMe (actually published before the official launch of the service) was actually the only serious insight on 23andMe.

With this book Thomas will have a chance to become the Chris Anderson or Malcolm Gladwell of personalized medicine and public health.

“The premise is that we are at a new phase of health and medical care, where more decisions are being made by individuals on their own behalf, rather than by physicians, and that, furthermore, these decisions are being informed by new tools based on statistics, data, and predictions. This is a good thing – it will let us, the general public, live better, happier, and even longer lives. But it will require us to be stewards of our health in ways we may not be prepared for. We will act on the basis of risk factors and predictive scores, rather than on conventional wisdom and doctors recommendations. We will act in collaboration with others, drawing on collective experience with health and disease, rather than in the isolation and ignorance that can come with “privacy” concerns. And we will act early, well before symptoms appear, opting to tap the science of genomics and proteomics in order to mitigate our risks down the road.

Together, these tools will create a new opportunity and a new responsibility for people to act – to make health decisions well before they become patients. This can be characterized as a decision tree, a series of informed choices we will make to minimize uncertainty and optimize our outcomes. Indeed, we will use decision trees to navigate most of our health decisions, sometimes in overt ways – new decision support tools will both inform us and guide us, and they’ll be steeped in statistics, prediction, and the power of collective experience.”

19 thoughts on “The Decision Tree: Thomas Goetz’s upcoming book on predictive/personalized medicine

  1. Challenging decisions! I went to the AMA conference about 10 years ago that was supposed to explain genetics/genomics to primary care physicians. The family practitioner sitting next to me listened to the talks about how we could detect risk for things like colon cancer and potentially improve lifestyle choices and medical screening patterns to make people healthier. The sample patient described was a man in his early 20’s. The FP turned to me and said “but he won’t even listen to me tell him about his risk of something that will happen when he’s 40, much less 60. And his highest risks right now relate to sex and motorcycles.” That’s all still very true and still the biggest barrier to genetic screening being seen as useful to the general public. All our high-powered knowledge is still primarily useful only to families who carry single-gene disorders. But someday maybe it really will matter? As a geneticist, I hope we’re able to learn to make meaningful decisions. As a patient, I’m dubious.

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