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Former Intel CEO Rips Medical Research
Himuanam writes "Former Intel CEO Grove rips on the medical research community, contrasting their lack of progress with the tech industry's juggernaut of breakthroughs over the past half-century or so. 'On Sunday afternoon, Grove is unleashing a scathing critique of the nation's biomedical establishment. In a speech at the annual meeting of the Society for Neuroscience, he challenges big pharma companies, many of which haven't had an important new compound approved in ages, and academic researchers who are content with getting NIH grants and publishing research papers with little regard to whether their work leads to something that can alleviate disease, to change their ways.'"
He's a rich man who is getting sick and old, and he's mad because it has turned out to be hard to find out how to stop people from getting sick and old. He's upset, and I understand that, but he also missed most of the points that might be out there to get.
No question that medicine is a different culture than engineering. I've spent a lot of time in both, and I know. I also know that medicine is NOT particularly creative, and you don't really want it to be. You want your illness to be routine and fixable, and being routine means that nobody has to sweat particularly hard to figure it out. The sweat, and there's plenty, has to be done in research and development, and the difference in development effort between a new therapy for a disease and a new electronic entertainment device is remarkable.
He talks about how the two cultures deal with failure. In engineering, particularly in microelectronics, failure means that you spend money, time, and energy fixing something you broke. In medicine, failure means that you kill somebody. This used to happen a lot, and the modern biomedical research culture is highly biased against failure. It's not OK to die in a study any more, even if the condition we're studying is in and of itself fatal. Changing this would speed up the process of research, but who's volunteering to die for the cause? (And no, offshoring it is NOT the answer - foreign governments are wising up to this quickly, as are domestic ethics consultants.)
He derides modern statistical techniques, misunderstanding the difference between statistical failure and subgroup averaging, and he flatters himself a prophet when he recommends something that pharmaceutical researchers have been doing for thirty years: analyzing failure to see if you can find partial success somewhere.
He writes off in a sentence or two the hardest problem of all, which is figuring out what in the heck is really going on (preparatory to changing it). In engineering, the complexity is finite and human-directed, and the systems are designed with severable components to make the process of debugging and analysis easier. In medicine, the complexity is engineered by a billion years of evolution, not all of it productive or even useful, and very poorly understood. In an organism such as people, where 50,000 poorly-understood genes interact with factorial complexity, just figuring out which end to push on can be maddening. It's the reason that peer review was invented: if you're up a creek with a paddle-less enzyme, there are probably only a few hundred people in the world who can tell whether you're a genius or just confused. Peer review at its best is just like open source. At it's worst it's a lot like open source at it's worst, but the less said of that the better.
I would love to see more acceptance of modern information techniques and more flexibility in medical research. I would love to see better use of rapid prototyping and model systems, and we're heading that way. We've actually come a huge way in medicine just in the last decades, and the pace is accelerating. TFA is just a measure of the fact that, just like software, sometimes the better the system gets, the more you can see how imperfect it is.
For example, my wife has Crohn's disease. http://en.wikipedia.org/wiki/Crohns/
It's a pretty nasty disease of the small intenstine which affects something like half a million people in North America. The treatments start off typically with steroids (an old drug with lots of well-known nasty side effects), moving onto Imurin (a kidney anti-rejection drug that's been out for awhile, also with lost of nasty side effects) and Remicaid (the only really "new" treatment for it...still with nasty side effects though). Once those has been exhausted, they perform surgery to remove the infected parts, and then start all over again.
Here's the problem, it was discovered in 1932! In 75 years the best they can do is pump you full of nasty drugs that are toxic to the liver and kidneys until your body won't take it anymore, and then cut the infected sections out. They haven't figured out a proper cause for it yet! Some think it's an auto-immune disease, some think it's actually a persistant infection of the intestinal lining, some think it's genetic, some think there's a genetic predisposition and that diet or taking too many anti-biotics as a child will essentially "activate" it.
When you think about it, that's rather sad... We can't figure out what causes a disease we've knows about for 75 years and that affects half of million people. Of course, we have how many different drugs to help old men get it up? (And yet, strangely, they still haven't come up with one to help women want sex more. =) )
Yes, I realize that's a legit medical concern, but maybe we could work on other things besides another depression pill, or another drug for impotence, or another of whatever cash crop drug is currently popular with the medical industry. In the tech industry they don't leave things behind like that... We don't have 25GHz PC's with 32MB of RAM and 512KB graphics cards.
"Life's short and hard, like a body building elf." -- The Bloodhound Gang