F.D.A. Will Allow 23andMe to Sell Genetic Tests for Disease Risk to Consumers

NYT, 6 April 2017
Author: Gina Kolata
“For the first time, the Food and Drug Administration said it would allow a company to sell genetic tests for disease risk directly to consumers, providing people with information about the likelihood that they could develop various conditions, including Parkinson’s and Alzheimer’s. The move on Thursday is a turnaround for the agency, which had imposed a moratorium in 2013 on disease tests sold by 23andMe. The decision is expected to open the floodgates for more direct-to-consumer tests for disease risks, drawing a road map for other companies to do the same thing.”
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Mind the Gap: Ethical Failures in the Treatment of Chronic Fatigue Syndrome

J Med Ethics Blog, 6 december 2016
Authors: Charlotte Blease, Keith Geraghty
“That might sound like an inflammatory comment – especially for a medical journal, yet perhaps the biggest concealed fact in medicine is that hierarchies of diseases exist among patients and healthcare professionals. A caste system of illness influences how patients perceive their health complaints, whilst health professionals also hold biases that influence how they treat and rank patients in the medical pecking order.”
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How can doctors use technology to help them diagnose?

The Conversation, 24 October 2016
Author: David Tuffley
“In Japan’s first reported case of artificial intelligence (AI) saving someone’s life. A woman with a rare type of leukaemia was correctly diagnosed by the AI. Even more remarkable, it took just ten minutes to compare the woman’s genetic information with 20 million clinical oncology studies to arrive at the life-saving diagnosis. Does this mean robots are going to replace our doctors? Not quite, but increasing volumes of medical data, more powerful computers and smarter algorithms could see a future medical science in which human doctors are helped by AI.”
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Coote v Kelly; Northam v Kelly [2016] NSWSC 1447

Decision date: 13 October 2016
“Malcolm Coote, the deceased, died on 23 May 2012 from metastatic acral lentiginous melanoma (ALM). The melanoma was first diagnosed on 16 March 2011 following a biopsy taken by a Dr Rosalind Hiddins who had been consulted by Mr Coote since January 2011 for what various doctors believed to be a plantar wart on his left foot.”
Find case here.

Doctors beat online symptom checkers in diagnosis contest

Reuters, 11 October 2016
Author: Kathryn Doyle
“Doctors are much better than symptom-checker programs at reaching a correct diagnosis, though the humans are not perfect and might benefit from using algorithms to supplement their skills, a small study suggests. In a head-to-head comparison, human doctors with access to the same information about medical history and symptoms as was put into a symptom checker got the diagnosis right 72 percent of the time, compared to 34 percent for the apps.”
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Harried doctors can make diagnostic errors: They need time to think

The Conversation, 23 August 2016
Authors: Vineet Chopra and Sanjay Saint
“When a person goes to the doctor, there’s usually one thing they want: a diagnosis. Once a diagnosis is made, a path toward wellness can begin. When physicians learn to make diagnoses in medical school, they are trained to initiate a mental calculus, analyzing symptoms and considering the possible conditions and illnesses that may cause them. With time and experience, mental shortcuts overshadow this time-consuming process and mistakes may result.”
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Worldwide Thyroid-Cancer Epidemic? The Increasing Impact of Overdiagnosis

N Engl J Med 2016; 375:614-617
Authors: Salvatore Vaccarella, Silvia Franceschi, Freddie Bray, Christopher P. Wild, Martyn Plummer, Luigino Dal Maso
“Studies comparing thyroid-cancer incidence during different periods and across countries can help in estimating overdiagnosis — that is, diagnosis of thyroid tumors that would not, if left alone, result in symptoms or death. Here, we provide a measure of thyroid-cancer overdiagnosis over the past two decades in selected high-income countries, based on recently developed methods and high-quality cancer-registry data.”
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A definition and ethical evaluation of overdiagnosis

J Med Ethics doi:10.1136/medethics-2015-102928
Authors: Stacy M Carter, Chris Degeling, Jenny Doust, Alexandra Barratt
“Overdiagnosis is an emerging problem in health policy and practice: we address its definition and ethical implications. We argue that the definition of overdiagnosis should be expressed at the level of populations.”
Find abstract here.

The Age of Genomics

Australian Science, July/August 2016
Author: Ainsley Newson
“This edition of Australasian Science focuses on the ethical, legal and social issues associated with advances in genomic science. Faster and more accurate sequencing of human genomes; smaller and smarter wearable technologies; an increasingly connected world; direct access to health testing; improvements in data storage. These are just some recent innovations now influencing Australian health care and society, and this issue of Australasian Science focuses on their associated social, ethical and legal issues.”
Find editorial here and links to articles on online genetic testing, indigenous genomics, biobanking, stem cell commercialisation, and personal genomics.