[Fis] Why is FIS important?

Jerry LR Chandler jerry_lr_chandler at me.com
Wed Dec 11 02:25:53 CET 2019

Pedro, List:

> On Nov 17, 2019, at 2:34 PM, Pedro C. Marijuan <pcmarijuan.iacs at aragon.es> wrote:
> Now, Jerry, the excellent paper you mention by Topol says --in my modest opinion-- that in order to do something similar concerning human health, you need plenty, plenty of biological & medical fields involved, and a special "dataism" of first class to be able to digest the mountain of data. I am rather skeptical about the final results of this new big-data-health approach. In my opinion it can be terribly dehumanizing, and terribly unjust as it is addressed to the supposed "superhealth" of that infamous 0.01 of the 1% super-rich.

A belated response to the Topol paper and its implications in the context of the human value of FIS inquiry. 

From the perspective of both Public Health and my personal health/medical care, I strongly disagree with the responses.

Let me start by asserting simple propositions related the the QUALITY of medical care from a bio-medical perspective.

A board generalization: The quality of medical care depends on two principle generalizations:
1. A valid diagnosis of the “complaints” - that is the nature of the natural / psychological stars of the complaint.
2. Administer therapy that has the potential to reduce, minimize or eliminate the “complaints”.

The basic scientific premises: The ranges of patients, complaints, potential therapies, capacities to administer to the patients perceived needs is so extra-ordinary vast that we no way to even estimate the potential number of distinct pathways that potentially could be successful, let alone be curative.

From these premises, it appears to me that most physicians are skilled in making critical value judgments with access to only trivial fractions of the published data.  We (patients) hope for well educated guesses and endure the consequences.

Topol’s paper basically argues that the medical files on existing patient records can be curated into clinically useful information that can be used to augment the limited skills of a physician. 


The arguments that intelligently and well-curated databases will reduce the personal relationships with a physician or favor the wealthy are of relatively trivial importance when contrasted with the potentials for great advances in both diagnosis and therapy.  At least, that is how I see it from my professional and personal experiences over the past 40+ years as a public health professional.

For recent concrete examples of how these concepts are being implemented, see:

https://www.nature.com/articles/d41586-019-03754-3?utm_source=Nature+Briefing&utm_campaign=b2ab90bed3-briefing-dy-20191209_COPY_01&utm_medium=email&utm_term=0_c9dfd39373-b2ab90bed3-42205659 <https://www.nature.com/articles/d41586-019-03754-3?utm_source=Nature+Briefing&utm_campaign=b2ab90bed3-briefing-dy-20191209_COPY_01&utm_medium=email&utm_term=0_c9dfd39373-b2ab90bed3-42205659>

I wonder what list members are thinking about the long-range purposes and potential benefits of our FIS inquiries.

What are other applications of FIS advances? 
And, how do they rank with improved health care for citizens of the world?

In a simpler view, what is information good for, anyway?  
Topol argues that biomedical information is good for substantially improving our health care systems. 



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