Wednesday, 3 October 2018

Social addiction to biometrics

Salvador Casado

Mirrors are polished surfaces that reflect the image projected on them.  It is a technology that the ancient Egyptians and Greeks already knew and that has evolved over time. Today the majority of the population carries a pocket mirror that also allows immortalizing the images that come to it in the form of an auto-photo. In addition, modern mirrors reflect multiple variables and information of their owner. They measure his steps and the distance he travels, his activity pattern, his movements, his level of communication. They can measure the sleep/wakefulness rhythm and give a report on the quality of sleep and if we connect some specific gadget they can measure blood pressure, blood sugar and even do an electrocardiogram.

People love to know what their weight is, what their blood pressure is, what their biochemical and analytical parameters are. We love check-ups, medical imaging tests and anything that provides information about ourselves. We are a curious species. That's why biometrics has always been big business. Technological companies know this. For example, Apple's new intelligent smart watch make a reduced electrocardiogram of one derivation in a minute. It is a technology that already existed, very easy to use. Years ago I tested the application of AliveCor and effectively with two electrodes connected by bluetooth to the mobile phone gets to make a strip in derivation II capable of detecting sinus rhythm or atrial fibrillation. I don't know if the popular watch will detect P waves or it will only do a QRS analysis but what I can say is that there will be a legion of people hyper worried about the supposed irregularities that with time will appear on their recording devices.

Providing diagnostic devices to the population often results in some level of overuse. Hypochondriacs and those who care most about their health will not be able to avoid intensive use. In my experience this tends to end up overwhelming the person who does it. We have to remember that to be able to prescribe and indicate a certain treatment requires many years of preparation and experience. The same thing happens with the indication of diagnostic tests. To measure the blod presure once in a while doesn't hurt anyone but doing it several times a day, every day, being healthy is a barbarity. 

A lot of health education is needed. Facilitating access to diagnostic tests can have side effects. They are called false positives and excessive concern for one's own health. Health professionals know that both are dangerous and cause suffering. In a market society where economic profit is the king it will be difficult to explain that more is not always better in the world of health where things are often more complex than they seem.

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