lunes, 14 de enero de 2013

Tecnología de la salud en 2030. Informe NIC.



Publica la National Intelligence Council un informe sobre las tendencias del mundo en 2030, el estudio esta disponible en la red.www.dni.gov/nic/globaltrends

En dicho informe de 116 páginas el apartado relativo a la salud que figura en la página 98 y siguientes ,nos habla del papel de la medicina predictiva en ese escenario de 2030.

Reproduzco este apartado.

José Miguel Rodríguez-Pardo.

.............................................................................


Disease management technologies in development
promise significant healthy longevity gains throughout
the world while human augmentation technologies
will likely transform everyday life, particularly for the
elderly and mobility-impaired populations.
The greatest gains in healthy longevity are likely
to occur in those developing countries that will
experience a huge growth in the size of their middle
class populations. Although the current health-care
systems of such countries may be poor, developing
countries are expected to make substantial progress in
the longevity potential of their populations by 2030.
Indeed, many leading centers of innovation in disease
management are likely to be in the East
DISEASE MANAGEMENT
Disease management is the effective control and
treatment of communicable and noncommunicable
illnesses. Today, physicians struggle to differentiate
between many illnesses with similar symptoms.
Obtaining results from detection tests can take
several days, leading to delays in diagnosis, which
can be life threatening. Consequently, diagnostic
and pathogen-detection devices will be key enabling
technologies for disease management; the future
accuracy of molecular diagnostics has the power
to transform medicine. The targets of molecular
diagnostics include genetic information on disease
presence or predisposition, and the ability to monitor
the physical manifestation of a disease. One enabling
technology, DNA sequencing, is advancing rapidly with
some techniques currently capable of reading a human
genome for about $1,000.
Molecular diagnostic devices will revolutionize
medicine by providing a rapid means of testing for
both genetic and pathogenic diseases during surgeries.
Readily available genetic testing will hasten disease
diagnosis and help physicians decide on the optimal
treatment for each patient. Such personalized medicine
will reduce the health-care costs associated with
physicians’ prescribing ineffective drugs. In addition,
the declining cost of such testing will facilitate
the cataloguing of many more individuals’ genetic
profiles, which will lead to a greater understanding
of the genetic basis of many diseases. Theranostics,
the combination of a diagnostic and a therapeutic
approach in one treatment, may become an important
discipline for disease management, reducing hospital
costs by accelerating patients’ recovery times and
complications caused by invasive surgery. Advances
in synthetic biology will likely result in production
facilities making novel treatments and diagnostics
agents. Advances in regenerative medicine almost
certainly will parallel these developments in diagnostic
and treatment protocols. For example, replacement
organs, such as kidneys and livers, could be developed
by 2030.
The new disease management technologies will
increase the longevity and quality of life for the world’s
aging population, tipping the demographic profile
of many countries toward an older (but healthy)
population. However, improvements in disease
management technologies could be out of reach of
poor people in countries that do not have health
coverage for all.
Cost is the major barrier preventing molecular
diagnostic technologies from becoming routinely
available in physician’s surgeries, although costs
for genetic sequencing are rapidly decreasing. The
cost per individual diagnostic test is more important
than the cost of the diagnostic equipment itself. A
move away from expensive biological reagents to
silicon-based molecular diagnostics procedures should
reduce the costs of genetic tests further. The drawback
of today’s genetic profiling is that the number of
known disease-related genes is insufficient to provide
mass screening. Synergistic technologies such as
computer processing power and big data storage and
analysis will be important for managing the huge
amounts of data gathered by genome sequencing.
However, with computing technology still advancing
at a high rate computer power should not be a
rate-limiting factor. Acquiring governments’ approval
for diagnostic tests will delay their implementation.
HUMAN AUGMENTATION
Spanning a wide gamut of technologies, ranging from
implants and prosthetics to powered exoskeletons,
human augmentation enhances innate human abilities,
or replaces missing or defective functions such as
damaged limbs. Prosthetic limbs have now reached the
stage where they offer equivalent or slightly improved
functionality to human limbs. Brain-machine interfaces
in the form of brain-implants are demonstrating that
directly bridging the gap between brain and machine
is possible. Military organizations are experimenting
with a wide range of augmentation technologies,
including exoskeletons that allow personnel to carry
increased loads and psychostimulants that allow
personnel to operate for longer periods.
Human augmentation could allow civilian and military
people to work more effectively, and in environments
that were previously inaccessible. Elderly people
may benefit from powered exoskeletons that assist
wearers with simple walking and lifting activities,
improving the health and quality of life for aging
populations. Successful prosthetics probably will be
directly integrated with the user’s body. Brain-machine
interfaces could provide “superhuman” abilities,
enhancing strength and speed, as well as providing
functions not previously available.
As replacement limb technology advances, people may
choose to enhance their physical selves as they do with
cosmetic surgery today. Future retinal eye implants
could enable night vision, and neuro-enhancements
could provide superior memory recall or speed of
thought. Neuro-pharmaceuticals will allow people
to maintain concentration for longer periods of
time or enhance their learning abilities. Augmented
reality systems can provide enhanced experiences
of real-world situations. Combined with advances in
robotics, avatars could provide feedback in the form of
sensors providing touch and smell as well as aural and
visual information to the operator
Owing to the high cost of human augmentation,
it probably will be available in 15-20 years only to
those who are able to pay for it. Such a situation
may lead to a two-tiered society of an enhanced and
non-enhanced persons and may require regulation.
In addition, the technology must be sufficiently
robust to prevent hacking and interference of human
augmentation. Advances in synergistic and enabling
technologies are necessary for improved practicality
of human augmentation technologies. For example,
improvements in battery life will dramatically improve
the practicality of exoskeleton use. Progress in
understanding human memory and brain functions
will be critical to future brain-machine interfaces,
while advances in flexible biocompatible electronics
will enable better integration with the recipient
of augmentations and recreate or enhance sensory
experiences. Moral and ethical challenges to human
augmentation are inevitable