Wake wake ukhohlwa ukuthatha imithi yakho? Noma, ingabe uke wayeka inkambo yama-antibiotic ekuqaleni ngoba usuvele uzizwa ungcono? Uma kunjalo, awunabo. Ngamaphesenti angama-50 abantu abangathathi izidakamizwa njengoba kunqunyiwe, ukubambelela kwemithi kuye kwaba yinselele enkulu ohlelweni lwezempilo lwe-US.
Umzamo omkhulu uye wangena ezindleleni ezintsha zokuthuthukisa ukuhambisana kwethu, ngezixazululo eziningana zedijithali nephansi ezisekhona emakethe.
Amabhokisi okugulisa amaphilisi, imiyalezo, namabhodlela aphethwe i-Chip asetshenziswa njengamasu okuba ngcono ukunamathela kwemithi. Kodwa-ke, lezi zindlela ezintsha azikaze zinikeze ubufakazi obuqinisayo, obuqinisekisiwe bokuthi umuntu uye wagwinya ngempela imithi yabo.
Ukufika kwe "ipilisi ehlakaniphile" ehlanganiswe nenzwa manje inikeza indlela yenveli yokulandelwa kwezidakamizwa zokulandelela. Le teknoloji entsha yezempilo ithola ukunakwa okuningi kwesayensi nabezindaba, kanye nokuphendula okuvela emphakathini. Ingabe iphilisi engathumela ulwazi kusuka egazini (noma umzila wokugaya) isise impilo yethu ngendlela entsha? Futhi, ingabe kukhona ukucabangela okuzungezile lawa maphilisi edijithali amasha okufanele ahlolwe ngaphambi kokuthola lobu buchwepheshe obusha?
I-FDA ivumela iPilisi yokuqala yeDijidli
Ngo-November 2017, i-US Food and Drug Administration (i-FDA) yase-United States ivume umuthi wokuqala onesimiso sokulandelela ukulayishwa kwe-digital.
Iphilisi evunyelwe yenziwa yi-Otsuka Pharmaceutical Co. Kusukela ngoJulayi 2012, u-Otsuka ubelokhu esebenza neCalifornia inkampani iProteus Digital Health ukuze afake isidakamizwa se-antipsychotic esivele ikhona i-Abilify (igama lomshicileli we-aripiprazole) ngesisindo esingenakwenzeka (IEM) senzwa. Umkhiqizo omusha, i-Abilify MyCite, ungathola uma imithi isithathwe.
I-sensor eyenziwe enethusi, i-magnesium, ne-silicon-iklanyelwe ukuthumela isignali kagesi kumamukeli wangaphandle uma iphilisi ixubana nesisu somswakama.
I-receiver (njengamanje i-patch) igqoke insimu yesibhamu esobunxele. I-patch ixhumana nohlelo lokusebenza lwe-smartphone nge-Bluetooth futhi inikeza ulwazi ngosuku nesikhathi umuthi uthathwe. Lolu lwazi lungathunyelwa eqenjini labantu abakhethiwe (kuze kube yi-ezine) ngokususelwa kwimvume yomsebenzisi. Iphilisi le-digital elilindelwe kakhulu kulindeleke ukuthi liphume ngo-2018 futhi kungenzeka lilandelwe neminye imikhiqizo ku-niche yezidakamizwa ze-digital.
Ubuchwepheshe obusungulwe yiProteus buye lwasetshenziswa kwezinye izindawo zemithi, futhi. Isisindo esingenakusiza (esizimele kunoma imuphi umuthi) sithole imvume ye-FDA kakade ngo-2012. Selokhu isetshenziselwa ukwakha izidakamizwa ezinikezwa inzwa yomshuwalense ongalawuleki nohlobo lwesifo sikashukela 2. Amalungiselelo okukala ukunamathela kubantu abane-Alzheimer's disease, isibindi C kanye nalabo abasanda kuphuma esibhedlela nabo babhaliwe. Ngakho-ke, i-MyCite ye-Abilify yiyona kuphela ilungu lomndeni wakwaProteus wamaphilisi edijithali.
Eqinisweni, ukukhethwa kwe-FDA kwephilisi yabo yokutholwa ye-digital yokuqala kuye kwamangala abanye ochwepheshe.
I-Abilify iyisidakamizwa esisetshenziselwa ukwelashwa kwezimo ezithile zempilo, kuhlanganise nesifo schizophrenia, ukucindezeleka kwe-bipolar, nokucindezeleka. Abanye bathi i-Abilify kwifomu yepilisi yedijithali angeke yamukelwe kahle abantu (kakade) abathola izifiso ze-paranoid futhi banemizwa ephikisayo ababukelwayo noma abashushiswayo. Ukuphakamisela umuntu onomzimba we-schizophrenia ukugwinya iphilisi elizothumela izibonakaliso emzimbeni wabo kungase kube nzima isimo sabo. Ngakho-ke, ukufakelwa kukadokotela kuzoba kubaluleke kakhulu ukusekela ukuthi yibaphi abantu abangase bazuze emiphileni entsha yokulandelela futhi okungase kube nengozi ngayo.
Ukuziphathisa okungcono noma uMfowethu Omkhulu we-Biomedical?
Nakuba amaphilisi e-digital anganikela ngolwazi olubalulekile ngokunamathela kwemithi (kanye nesimo somzimba somuntu kwezinye izimo) ukukhathazeka okuhlukahlukene kuye kwaphakanyiswa mayelana nokusetshenziswa kwabo (isib. Ukuziphatha, ubumfihlo nokuphepha kwedatha). Isibonelo, uma izidakamizwa zedijithali ziphakanyiswa kubantu abangenalo ikhono lokuqonda konke okushiwo ukwabiwa kwedatha, ukuxosha lolu hlobo lobuchwepheshe kubo lungabhekwa njengokuncintisana. Esinye isibonelo sokusetshenziswa okungenangqondo kungabandakanya izinkampani zomshuwalense enikeza izikhuthazo eziphakeme zamaphilisi anomzimba, ukucindezela abantu abathile ukuba bakhethe imishanguzo yedijithali okungenzeka ukuthi iyokwandisa ukusetshenziswa ngokuhambisana.
Kuye kwaphakanyiswa ukuthi esikhathini esizayo, amaphilisi edijithali angaba yisimo sokukhululwa. Bangase babe isimo sokukhishwa esibhedlela-umuntu angacabanga umhlaba lapho kuzodingeka uvumelane ukulandelela ukunamathela kwemithi ngaphambi kokukhishwa. Izinkampani ezifana no-Otsuka kubika akukho ulwazi lwezinhlelo ezinjalo. Noma kunjalo, kunzima ukubikezela ukuthi lobu buchwepheshe buzosetshenziswa kanjani esikhathini esizayo.
U-Amelia Montgomery ubhala ku- Vanderbilt Journal of Entertainment ne-Technology Law ukuthi akucaci ukuthi yimiphi imithetho yobumfihlo ezosebenza kumaphilisi e-digital e-United States. I-Montgomery icacisa ukuthi amaphilisi edijithali angeke afakwe ngaphansi koMthetho we- Health Insurance Portability and Accountability Act (HIPAA) njengoba usebenza kolunye ulwazi lwezempilo. Kuya kuba nzima ukuqiniseka ukuthi i-data isingeniso. Izinzwa, ezinjengalezo ezakhiwe yi-Proteus, zingathatha idatha eminingi mayelana nomuntu, okwenza kube lula ukufaka iphrofayela kumuntu ngendlela umuntu angase angayiqondi.
Ukunika Abantu Ukuzikhethela
Ngenhlanhla, kunezinyathelo eziningi zokulondoloza eziye zafakwa ukuze kuncishiswe ezinye izinto eziphathelene nokuziphatha ngokuphathelene namaphilisi edijithali. Isibonelo, amaphilisi okwamanje aklanyelwe ukuze umsebenzisi abe nokulawula okuphelele mayelana nokuthi ulwazi lwakhe lukwabelana nobani. Ngaphezu kwalokho, umsebenzisi angakwazi ukuhoxisa imvume nganoma yisiphi iphuzu ngaphandle kwemiphumela. Futhi, njengoba ubuchwepheshe bephilisi ye-digital buxhomeke kubantu abagqoka i-patch (noma umthumeli), kanye nokusebenzisa uhlelo lokusebenza lwe-smartphone, ukubamba iqhaza kwabo kuxhomeke ekuzimeni kwabo ukusebenzisa la mathuluzi angeziwe.
Noma kunjalo, abanye ochwepheshe bakholelwa ukuthi ukusetshenziswa kwamaphilisi edijithali kumele kubekwe kuphela ezimweni ezithile, njengokuhlolwa kwezidakamizwa lapho kubalulekile ukuqinisekisa ukuthi imithi ithathwa ngabahlanganyeli ukukhulisa ukufaneleka kocwaningo. Eqinisweni, ukusebenzisa amaphilisi edijithali kunganciphisa kakhulu izindleko zemilingo yokuhlolwa, kanye nokuthuthukisa ukunemba kwabo. Kulindeleke ukuthi amaqembu athile abantu angavuleka kakhulu ukusebenzisa amaphilisi edijithali. Isibonelo, abantu asebekhulile abaye bahlakulela ubunzima bokuzicabangela okungenzeka bangakhohlwa ukuthatha imithi (noma bayithathe kabili) ngaphandle kokusizwa lolu hlobo lobuchwepheshe bezempilo.
Kodwa-ke, abanye bathi ukulinganisela kudinga ukushayisana phakathi kokuvikela ubumfihlo kanye nokweqisa insimu yamaphilisi edijithali. U-Montgomery uphawula ukuthi izingozi kubasebenzisi ziphansi uma kuqhathaniswa nokulula, ukunciphisa izindleko kanye nezinzuzo zezempilo ezihlinzeka ngobuchwepheshe obusha.
Uma nje imvume yokuthola ulwazi isetshenziswe ngokweqile lapho ibeka amaphilisi edijithali, eziningi zokukhathazeka ngokuziphatha zingaphathwa. Uma abasebenzisi bala maphilisi amasha banikwe ukudalulwa okufanele, kanye nokukwazi ukubuza imibuzo, lokhu kubenza bakwazi ukwamukela noma ukunciphisa amaphilisi edijithali ngaphambi kokuwathenga. Ngakolunye uhlangothi, lokhu kungase kwengeze umthwalo owengeziwe nomfutho wesikhathi kunodokotela, ngakho-ke kungenzeka ukuthi akusiyo isisombululo esinengqondo kakhulu.
Amaphilisi Adijithali Angayandisa Ngempela Ukuvumelana?
Akukasungulwa uma lezi zinhlelo zezidakamizwa zizofaka isandla esihle ekuthwaleni imithi. I-MyCite yekhono iphinde ifike nombambano wokuthi ukuqoqwa kwedatha akufanele kusetshenziselwe izimo eziphuthumayo, njengoba ukulandelela kungase kubambezeleke noma kungenzeki nhlobo. Ochwepheshe bezempilo ye-digital, kuhlanganise no-Eric Topol weScripps Science Translational, bathi kungathatha isikhashana ngaphambi kokuba ubuchwepheshe obusha bezempilo bungathinta ukunamathela ngendlela eningi. Abantu abasebenzisa amaphilisi edijithali bangahle, ngokwesibonelo, benqabe (noma ukhohlwe) ukugqoka isiqephu esilandelayo esidinga ukushintshwa njalo emva kwezinsuku eziyisikhombisa ukuqoqa ngokuphumelelayo amatshwayo kusuka ephilisi eligwinyiwe.
Ucwaningo lokuqala lokubambisana luye lwathola ukuthi amathuluzi ahlukene, kokubili aphakeme nakancane, athuthukisa ukunamathela. Ucwaningo oluqhutshwa yiProteus lubonise nokuthi abantu abasebenzisa imishanguzo enomqondo wokunakekelwa kwengozi engalawuleki futhi uhlobo lwe-2 lwesifo sikashukela luzuze imiphumela engcono (futhi bebengase bakwazi ukuthola imigomo yabo yokwelashwa) uma kuqhathaniswa nabantu abathintekayo. Lokhu kungenzeka ukuthi kubangelwe ukunamathela kwemithi okuthuthukisiwe.
Amandla Amakholomu E-Digital Pilill Systems
Njengamanje, abanye abantu ku-Abilify abadinga lesi sidakamizwa sokulwa nezidakamizwa kodwa abangahambisani nemibandela yabo yezidakamizwa ezibekiwe bathola i-Abilify njengemjovo yanyanga zonke ukuvimbela ukuphinde kwenzeke kwezimpawu zabo. Lokhu kubonisa ukuthi sesivele sinesisombululo sokwehluleka kokungabambeleli. Akucaci, noma kunjalo, uma abantu abanezinkinga zokuthobela bangathanda iphilisi ye-digital kumjovo. Ngaphezu kwalokho, kwezinye izinsizakalo zemithi, ukujola njalo ngenyanga akuyona inketho ekhona. Ngakho-ke, izidakamizwa ezinikwe amandla-sensor zingase zithwale ukufaneleka kakhulu ezimweni ezinjalo.
UProfesa ongumsizi uPeter Chai, udokotela wezimo eziphuthumayo eBrigham naseBhithweni Lwabesifazane eBoston, wasebenzisa ubuchwepheshe bepilisi yedijithali ocwaningweni lwakamuva ukuze azame ukuvimbela ukuhlukumeza i-opioid-inkinga ecindezelayo e-United States. Ama-opioid avame ukushiwo ngesisekelo esidingekayo kubantu abanobuhlungu obukhulu. Umthamo kanye nemvamisa kuvame ukushiywa ekuhlakanipheni kobuhlungu obugulayo, obangela izingozi zokudlula ngokweqile nokuhlukunyezwa. U-Chai kanye neqembu lakhe bathola ukuthi izinhlelo zamaphilisi edijithali zingasiza ekuhloleni ukungena kwe-opioid ngesikhathi sangempela.
Basikisela ukuthi ukungenelela kungasetshenziswa ngokushesha uma kutholakala ukuhlukumeza, ukunciphisa ingozi yokulimala. Abantu ababambe iqhaza esifundweni sabo bathola amaphilisi edijithali avumelekile futhi azimisele ukuqhubeka nawo. Ucwaningo lukaChai lubonisa ukuthi amaphilisi anikwe amandla inzwa anesisindo esikhulu sokusetshenziswa, isibonelo, ngemithi engozini kakhulu kanye namaqembu abantu abangenalo ukuxhumana okuvamile nabaqeqeshiwe bezempilo.
Ukubuka Ngesikhathi Esizayo
Ama-patches (kufaka phakathi lawo asetshenziswe ngamaphilisi e-digital) asevele anamandla okuqoqa olunye ulwazi lwe-biometric, njengamaphethini okulala, izimpawu ezibalulekile, nesimo somzimba. Ukusebenzisa i-patch yemithombo eminingi yedatha, uhlelo lwezempilo lwedijithali lungakha isithombe esiphelele somuntu othatha isidakamizwa esithile-kuhlanganise nemiphumela emibi kanye namaphethini wokungenisa. Kulokhu, lezi zinhlelo zinethuba lokuguqula indlela esilashwa ngayo ngemithi.
> Imithombo:
> Brown MT, Bussell JK. Ukwelashwa kwemithi: WHO uyakhathalela? I-Mayo Clinic Proceedings . 2011; 86 (4): 304-314. doi: 10.4065 / mcp.2010.0575.
> Buono E, Vrijens B, Bosworth H, Liu L, Zullig L, Granger B. Ukuza umbuthano ogcwele ngokulinganisa ukunamathela kwemithi: amathuba kanye nemiphumela yokunakekelwa kwezempilo. Ukuthandana Nokubekezela Nokubekezela . 2017; 11: 1009-1017.
> Chai P, Boyer E, Mayer K, et al. Amaphilisi adijithali ukukala amaphethini wokungenisa i-opioid ezigulini zemiphakathi eziphuthumayo ezibuhlungu obukhulu bokuphuka: isifundo sezindiza. I-Journal ye-Medical Internet Research , 2017; 19 (1).
> Montgomery A. Okushiwo udokotela: ukuvikela ubumfihlo ngaphandle kokuvimbela ukuthuthukiswa kwamaphilisi edijithali . I-Vanderbilt Journal of Entertainment kanye neTheknoloji Law . 2016; (1): 147-175.
> Mullard A. Ingabe ufuna ama-chips ngalokho? Amaphilisi e-Digital kadokotela, asetshenziselwa ukushaya imakethe maduzane, unikeze ithuba lokubhekana nezinselele zokunamathela kwezidakamizwa ezibalulekile emitholampilo nasekuhlolweni kwemitholampilo. Ukuhlolwa Kwemvelo Ukutholakala Kwezidakamizwa . 2015; (11): 735-735.