Dissecting the “Real Age” Phenomenon

Posted 23 August, 2007 in current trends, demos, problems, solutions

Recently a number of websites have been offering “real age” calculators which, upon asking a number of health/lifestyle questions, attempt to predict how long you will live. The difference between how long you are going to live and how long people live on average determines your “real age.” If, for example, you are a heavy smoker with a family history of heart disease, you might have been born 28 years ago, but your real age could be closer to 35. As a measure of its popularity, even Oprah and her ilk have been jumping on the real age bandwagon.

These real age calculators are not without their faults however.

1. No (or little) research is offered to substantiate their healthcare calculations
2. The numbers are frequently a little *too* clean (what are the chances that all bad things raise your real age by EXACTLY 1 year?)
3. No distinction is made between elements you can and cannot control
4. At the end of the survey, no action items are provided to allow the user to alter their Real Age. After all, unless you can glean some ACTIONABLE INTELLIGENCE from the results, these calculators are ultimately of little utility.

After seeing the calculator at http://www.poodwaddle.com/realage.htm, I spent a few hours reverse engineering it. healthtech’s real age calculator is an attempt to rectify the aforementioned deficits.

1. Based on XML: see the real age XML now: download and modify the XML as new scientific studies are released. add your own questions, etc.
2. Open Source: download the Real Age code and run it yourself
3. Better health summary at the end (action checklist)
4. Items are distinguished as controllable or not

RemedyMD’s tagline is “Better Data, Better Decisions, Better Outcomes,” and you might be tempted to think that better data leads automatically to better decisions, but that is not always the case. More often, it is the application of intelligent analytic algorithms (predictive informatics, if you will) which transforms the raw data into actionable information. A lot of EHR systems collect medical history, for example, but how many of them process that information to produce actionable knowledge?

What is your Real Age?!?

More Data != Better Data

Posted 18 July, 2007 in problems, solutions, tech choices

The World Wide Web is terrifically empowering because it carries a nearly infinite wealth of knowledge on innumerable entwined topics right into the leisure of your home. The caveat to this blessing is that intermixed in this wave of data is erroneous, incomplete and misleading material. Also, a deluge of information without context and experience can lead to inflated confidence and poor consequent decisions. This is particularly troubling in the healthcare domain, for after reading up on a variety of medical topics on wikipedia, it’s not uncommon to overvalue your medical competence. Doctors in Australia, for example, say they spend, on average, “1 day per week reassuring patients who have misdiagnosed themselves due to using the Internet to find health related information.”^*

The problem of Internet information is not only a shallow, encyclopedic rendering of complex topics^**, but also an ever-growing cesspit of misinformation from unscrupulous persons (see quackery.)

The internet is choked with unscientific “alternative” health sites which purport to hold insights into “what doctors don’t want you to know.” They prey on the uniformed, the naive and the desperate, to peddle dietary supplements, exotic foreign juices and daily colonics. All of which are, at best, expensive placebos, and at worse, dangerous and sinister. These fraudsters sidestep the FDA, double-blind tests, and the scientific method by verbal slight of hand and faulty logic such as, “If doctors were successful at curing people, they would be out of a job, so it’s in a doctor’s best interests to keep you sick.”

And then there is Web2.0 that, with all its promise, is also full of user-generated nonsense. “Blogs have become so dizzyingly infinite that they’ve undermined our sense of what is true and what is false, what is real and what is imaginary. These days, kids can’t tell the difference between credible [information] by objective professional[s] and what they read on [any blog]“^***

So, in summary, ten minutes of Goolging doesn’t make you a doctor, much of what you read online is false, massive doses of vitamin C doesn’t cure cancer and Kevin Trudeau is a con man.

So, how do we solve this problem? “All animals are created equal, but some are more equal than others,” was certainly bad policy for the pigs in Animal Farm, but when applied to Internet medical content, it’s unarguable that not all content is created equal. Perhaps some sort of non-profit certifying organization could help mark the reliable and credible sources of information? Democratic moderation isn’t the answer, because what is popular is not the same as what is correct. Expert systems are a step in the right direction. An EHR that allows you to chat/email with physicians is another good remedy. What do you propose?

* “A survey of 106 GPs, published last month in Australian Doctor magazine, found almost 40 per cent of doctors spent nearly a day a week on patients who had incorrectly diagnosed themselves or their children.”
see http://www.smh.com.au/news/technology/diagnosis-by-internet-wastes-time-say-gps/2007/07/13/1183833772789.html

** “A little Learning is a dang’rous Thing;
Drink deep, or taste not the Pierian Spring:
There shallow Draughts intoxicate the Brain,
And drinking largely sobers us again.”
An Essay on Criticism, Alexander Pope

*** Andrew Keen, The Cult of the Amateur: How today’s Internet is killing our culture

The PROBLEM with healthcare

Posted 21 June, 2007 in problems

Or rather some of the problems. Here’s one possible scenario:

Virginia is for lovers, or so they say, so you and your wife make a beeline to Virginia Beach for a relaxing weekend. No vacation is complete without good food, and diets be damned, you eat a fair amount of everything. Now you’re not feeling well. You’ve ingested something that turned in your stomach and suddenly you begin vomiting. A lot. You’re losing fluids fast. Hours pass and you’re becoming severely dehydrated and delirious. A quick ambulance ride later and you are admitted to the nearby Sentara Bayside Hospital’s emergency room. You’re not from the area, so Sentara is neither your hospital, nor is it in your hospital chain.

Time for paper work. Lots of forms: Insurance. Consent. Previous Medical History. Allergies. Of course, this is the worse time to be asking you to think about anything, let alone the details of your previous medical history. You mean to check the box beside penicillin allergy, but you are distracted by your wife, who is on the phone with her mother. You also missed an entire page where, under better conditions, you would have mentioned that you suffer from mild epilepsy.

Your stomach suddenly seizes and you throw up in the waiting area, which is just enough incentive for the triage nurse to quickly move you to a private room.

A nurse arrives and takes your vitals. Minutes later the physician shows up and, after a brief inspection, concludes that you have a bacterial stomach bug. He prescribes Benzylpenicillin (penicillin G) as the antibiotic. An injection later and you start to feel better. Then, without notice, the epileptic seizures caused by your allergic reaction begin…

This situation would have been much different if

1. Your hospital had an electronically accessible, universal format of your electronic medical records to which Sentara Bayside could be granted access
2. The medical record system had a Internet “patient portal” so you could have thoroughly reviewed your information before an emergency requires it