The Future of Healthcare is Personalization
I remember when IBM unveiled their newest supercomputer, Watson. My younger self was fascinated. How cool would it be for computers to help doctors, nurses, and surgeons provide more specialized care depending on the patient’s needs?
And it is super cool, and I think it’s the future of healthcare and medicine.
But there’s still a lot of hurdles, despite recent advances in supercomputing power and technology.
In my debut book, Necessary Symbiosis: What Happens When Science and Government Work Together (and When They Don’t), I explore what personalized medicine can look like and how we’re moving closer to personalized medicine thanks to companies like 23andMe.
Below is an excerpt from my sixth chapter (formatted for Medium). Enjoy!
Before precision medicine was even a mere thought, the healthcare industry was population-based. Guidelines, protocols, treatments, and diagnoses were given based on data of a sample group of people that would — ideally — mimic the demographics of an entire population. But there are problems with that model. Not everyone fits in that sample group, and oftentimes science would exclude certain groups because of potential “interference.” While in many cases, that kind of interference could potentially skew the results of clinical trials, sometimes it was more systematic.(1)
That kind of bias isn’t just found in human trials, but even the early experimental research done on rats and mice, which skews the results and can cause severe side effects for those with female hormones, including transgender and intersex individuals. Many scientific studies performed on rats and mice were only done on male rats because scientists thought that female hormones would screw up the results. Female mice go through a faster version of the human menstrual cycle, a four-to-five-day cycle in mice instead the approximately 21–28 day cycle in humans. Scientists argued that the female mice responses wouldn’t be useful because of the speed of their hormone cycle.(2)
As a woman, I’m offended because those scientists are/were only on Earth because of a female human’s menstrual cycle. But Northeastern University’s Dr. Rebecca Shansky argues that male mice’s hormones fluctuate too, especially when they are kept in groups where they establish a dominance hierarchy. That means that the average dominant male mouse has five times more testosterone than the subordinate males. The most ironic finding of all? That kind of variation in the male mouse hormones is about the same as the female mouse hormones.(3)
Because of that bias against female hormones, many drugs that were tested on only male rats tend to work better in biologically male humans. Huh, what a surprise. So, what this means is that scientists ignored how female hormones could affect the drugs.
All of the potency, efficacy, and safety tests were done based off of male hormones.
That could explain why sometimes drugs are not as effective for those with female hormones. It can also explain some side effects.
Personalized healthcare can potentially take into account ignored interactions between female hormones and drugs. This will not only help the patients get more effective drugs, but it will help progress science toward a more equitable future.
And it’s not just drug-related studies. Psychology-related studies looked at how rats performed when scared. Dr. Shansky’s group realized that only the male rats would freeze, but the female rats would try to find a way to escape the situation by darting around.(4) Those kinds of findings, if only studied on the males, wouldn’t have been discovered.
Over the next weeks, I’ll be sharing excerpts and stories from my book, Necessary Symbiosis, in this article series. My book Necessary Symbiosis: What Happens When Science and Government Work Together (and When They Don’t) is available here: https://www.amazon.com/dp/B08PW4XP38. If you want to connect, find me on Twitter (@KarraVyshnavi), Instagram (@karravyshnavi, @necessarysymbiosis), and at www.vyshnavikarra.com.
(1) George Llopis, “Healthcare In The Age of Personalization,” Forbes, March 10, 2019.
(2) Laura Castañón, “Most biomedical research is done on male animals — that’s a public health problem,” MedicalXpress, May 31, 2019.
(3) Ibid.
(4) Ibid.
