Matthew Finch

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Stories By Matthew Finch

  • The differing views on e-cigarettes across the Atlantic

    Over the past couple of years, as more in-depth research has been conducted, the NHS has endorsed the use of e-cigarettes alongside their stop smoking services. With the top scientists in the UK estimating that e-cigarettes are 95% safer than smoking tobacco, it's not hard to see why Britain's health service is taking its chances with this potentially revolutionary technology, but our cousins across the Atlantic are more cautious in their approach. In 2014, the Food and Drug Administration announced its plan to include e-cigarettes in its regulation of tobacco products, reflecting America's suspicions of the product and the government's desire to promote it as a danger on the same level as its tobacco counterpart. This plan was finalised in 2016. E-cigarettes are just over a decade old, having first appeared on the market in 2004. This obviously poses some difficulties for scientists to discern the danger of the product, as nothing similar has been seen before. In terms of fulfilling its basic premise, though, it is a successful product. Instead of inhaling the smoke from burning tobacco, the smoker breathes in the vapour from a heated liquid that contains nicotine and other additives, such as flavours. This prevents the smoker from being exposed to the 4000+ chemicals in tobacco smoke, at least 50 of which are carcinogenic. The only issue at stake is the unknown effect(s) of exposure to e-liquid vapour. However, government bodies and the medical industry in the UK believe that the advantages of using e-cigarettes far outweigh the disadvantage of not knowing its long-term dangers, if indeed there are any. Numerous studies are continuously being conducted that expose the dangers of tobacco smoking and the value that every cigarette smoked has on your life. For example, this one by BMJ, which found that every tobacco cigarette smoked reduces the smoker's life by an estimated 11 minutes. The average smoker in the UK smokes 11 cigarettes a day, so that's 2 hours of life per day they are losing, and one month a year. The gist of the UK's argument is that even just swapping half of your total cigarettes smoked for an e-cigarette could save you months and, over time, years of your life. In terms of its use to quit smoking altogether, the NHS is emphatic in its advice to use e-cigarettes alongside support from the NHS stop smoking service, because the desire for a cigarette is a psychological thing as well as chemical. But the reason the NHS recommend using e-cigarettes is not just based on scientific research. Charity 'Action on Smoking and Health' conducted a survey of the UK's 2.8 million e-cigarette users. 67% of the ex-tobacco smokers from that group said that e-cigarettes helped them stop smoking entirely. So far, both the theory and the practice of vaping has proven hugely successful in the UK. America's government bodies, however, don't have 'sufficient evidence' to convince them of the benefit of e-cigarettes. The FDA's incorporation of the e-cigarette market into its Tobacco Act of 2009 means that every e-cigarette product will need to be presented to the FDA for approval, and every new product, such as new flavours, will need to be authorised by the FDA. Such a process could cost millions of dollars and will almost certainly stall the production and distribution of e-cigarettes in the US. Essentially, the US fears that e-cigarettes are actually a means for people - especially young people - to get into smoking rather than to quit. Both theories, however, don't have enough evidence to convince anyone either way. The FDA reports that 'long-term studies are not yet available' to determine whether e-cigarettes cause people to transition to 'combusted products' (i.e. tobacco) or are used as a means to quit smoking. But it's not just the FDA who have these suspicions. Health charities in America express their concern over the toxicity of the liquid in e-cigarettes, though they admit that most come from 'accidental ingestion' of the liquid. And then there's the pressure applied from tobacco company giants, such as Phillip Morris, maker of the internationally favoured Marlboro cigarettes and owner of 50% of the US's tobacco market. Morris overtly supported the FDA's Tobacco Act as it means he alone will fly through the FDA approvals, and with a tobacco giant as rich and stealthy as that, e-cigarettes will barely get a look in. It took hundreds of years to unearth the magnitude of the dangers of tobacco, so understandably people are worried about the unknown long-term effects of smoking e-cigarettes. But according to reports from the Center for Disease Control and Prevention, cigarette smoking is responsible for 480,000 deaths per year in the US. It seems about time that the US put its extensive resources to use and put health before wealth.

    By Matthew Finch Read More
  • DeepMind and chatbot - the expanding role of technology in the NHS

    NHS at the crossroads At a time when the incoming Trump administration is already laying the groundwork for a full repeal of Obama's signature medical insurance policy, it is natural that attention should turn to our own health system. Like Obamacare, the NHS is loved in some quarters but maligned in others. Whatever your judgement of the NHS, the facts are stark: it faces an ever-increasing burden caused by greater demands on staff and these demands are partly the result of an increasingly unhealthy population - a quarter of British adults are clinically obese, making Britain the 'fat man of Europe'. At the same time, these demands are exacerbated by the effects of winter. Winter sees the pressure on the NHS rise: around 40% more deaths are recorded in these months alone and the number is increasing. The consequence is that NHS staff are strained and over the last decade, winter mortality has increased by 75%. According to recent figures, 84% of GPs view their workload as excessive such that it affects their ability to provide a consistently high standard of care. The NHS is therefore at something of a crossroads. If it is to survive it must streamline its process and embrace technology. The future of healthcare? The NHS has begun to display a willingness to exploit technology, specifically in easing diagnosis and hastening the process through which medical professionals access patient records. Last year, the Royal Free London NHS Trust signed a deal with DeepMind, Google's artificial intelligence (AI) subsidiary. This deal, to last five years, will cover the development of a so-called 'mobile clinical app' called Streams which will assist doctors in monitoring kidneys and interpreting test results. The app will alert doctors automatically if a patient's condition is likely to deteriorate, thereby streamlining the diagnostic process. Estimates are that the app will save some half a million hours a year and as a result lend relief to an overworked and underfunded NHS, as well as eradicating the potential for human error. It is hoped that similar technological initiatives will guarantee the NHS's continued relevance in an increasingly digital age. DeepMind's Streams patient care service is just their first partnership with NHS Trusts. In July, DeepMind signed an agreement with Moorfields Eye Hospital in east London to develop an AI which could assess eye scans and 'recognise' the early stages of degenerative eye conditions. The system would also collate thousands of detailed eye scans and thus ease access to patient records. According to Prof. Peng Tee Khaw, the head of Moorfields' ophthalmology research centre, the AI has placed at his fingertips "the experience of 10,000 lifetimes." Although the initial cost of the scheme is high, the benefits are far-reaching. Speedy diagnosis can often slow the progress of degenerative conditions or even prevent them altogether: for instance, around 98% of cases of serious visual loss can be halted if the condition is spotted early enough. In these cases, prevention really is better than cure, and technology has a vital role to play in making this a reality. The rise of the medical app DeepMind is not the only company to benefit from the NHS's willingness to embrace technology. Babylon Health is set to trial its 'chatbot' app at the end of January. This app is intended for use by the public as a self-diagnosis tool. It is hoped that the app will ease the strain on the NHS's 111 non-emergency hotline by acting as a first port of call in understanding a potential medical condition. The app's AI is designed to process users' responses to targeted medical questions and then, using its access to a vast array of trusted information, suggest a response. Although there may be a degree of scepticism regarding the accuracy of an electronic programme, it is in fact little different to the existing 111 service whose handlers are not medical professionals and who usually suggest scripted solutions. The app is designed to rapidly assess non-critical conditions and "process billions of symptom combinations" instantaneously. Babylon's app does not only facilitate diagnosis. One of its chief aims is to improve accessibility to medical services generally. It allows users to book an audio or visual (via video call) appointment in seconds; arrange to have their prescriptions sent to their home or office; and assist GPs in collating users' medical history and current conditions by providing an analysis of calorie consumption, sleep quality, weight, blood pressure and pulse rate. In other words, it is a suite which allows the user more autonomy in matters of personal health. The NHS's desire to embrace technology is heartening, as is its desire to give individuals a greater say in managing personal health. The NHS is facing many challenges: the UK's population is getting older and unhealthier, internal inefficiencies, and doctors are some of the most overworked and stressed out in Europe. But the UK is also becoming more digitally aware. In sponsoring the use of pioneering technologies, the NHS is itself innovating by utilising our increasingly digital world to improve national health.

    By Matthew Finch Read More