Medical devices

　　醫療設備

　　Inhaling information

　　有關吸入器的吸入信息

　　How to collect data on asthma while, at the sametime, treating it

　　在處置哮喘的同時如何收集哮喘數據

　　IN 1985 and 1986 an epidemic of asthma hitBarcelona.

　　1985年和1986年巴塞羅那哮喘病流行。

　　The city s researchers first turned to the usual suspects,

　　這個城市的研究人員首先調查了一般的懷疑對象，

　　such as air pollution, pollen and mould.

　　如空氣污染、花粉和霉菌等。

　　But a series of telephone interviews with thesufferers pointed to a much more precise cause.

　　但從一連串對患者的電話隨訪中得出了一個更為確切原因。

　　All the attacks had occurred by the harbour, and at times when ships were unloading soyabeans.

　　所有的哮喘發作都發生在港口，且都在貨船卸大豆的時候。

　　The cause was clear: soya-bean dust.

　　原因很清楚:大豆灰塵。

　　So was the solution: the installation of filters on the harbour s silos.

　　所以解決辦法就是:在港口的筒倉上安裝過濾器。

　　Asthma is one of the world s most common chronic diseases.

　　哮喘是世界上最常見的慢性病之一。

　　It affects about 300m people.

　　大約有3億人患有哮喘。

　　Yet what triggers any given asthma attack is often unclear and,

　　然而，人們往往并不清楚是什么誘發了任何特定哮喘的發作，

　　as a consequence, most asthmatics are not properly treated. Stories of success, like that ofBarcelona, are rare.

　　其結果，大多數哮喘患者得不到妥善處置。象巴塞羅那這樣成功的故事是很罕見的。

　　Part of the reason for that lack of clarity is inadequate data on where and when attackshappen.

　　缺乏確切了解的部分原因在于對哮喘在何時何地發作沒有足夠的數據。

　　But David Van Sickle, an epidemiologist and medical anthropologist who once worked forAmerica s Centres for Disease Control and Prevention, has come up with a solution.

　　但是曾在美國疾病控制和預防中工作過的流行病學家和醫學人類學家大衛凡西科勒想出了一個解決方案。

　　This is to use the asthma inhalers carried around routinely by patients to record the time andlocation of symptoms as they happen.

　　這個解決方案就是利用患者例行性隨身攜帶的哮喘吸入器來記錄他們的哮喘癥狀出現時的時間和位置。

　　To develop his idea, Dr Van Sickle left CDC and founded a company, Asthmapolis, which isbased in Madison, Wisconsin.

　　為了開發他的想法，凡西克爾博士離開美國疾病控制和預防中心并成立了一家公司，公司名為Asthmapolis，總部設在威斯康星州的麥迪遜市。

　　The result is Spiroscout, an inhaler with a built-in Global Positioning System locator and awireless link to the internet.

　　其結果就是一款名為肺量測定法偵察員的吸入器問世，這款吸入器帶有內置的全球定位系統定位和聯到互聯網的無線連接。

　　Whenever someone uses the inhaler, it broadcasts the location and time to a centralcomputer.

　　每當有人使用吸入器時，吸入器就把位置和時間播報到中央計算機。

　　Asthmapolis plots and analyses the data, and sends weekly reports to participating patientsand their doctors summarising the observations and making recommendations.

　　這家公司把播報來的數據繪制成圖并加以分析，每周向參與播報的患者以及他們的醫生發送報告，以便他們的醫生總結觀察并提出建議。

　　That is useful for the individuals involved, since it may illuminate patterns of which theywere unaware.

　　這對有關個人很有用，因為它可以闡釋未明的誘發哮喘模式。

　　It could also help doctors identify those patients whose asthma is not under proper control.

　　它還可以幫助醫生確定那些哮喘無法適當控制的病人。

　　Use of the inhaler more than a couple of times a month suggests there is something wrong,and that the patient s medication may need to be changed.

　　每月使用吸入器超過了一兩次的情況說明有問題存在，而病人的藥物可能需要更換了。

　　Patients do not, however, always report such problems, and so do not get the right drugs.

　　然而，如果患者一直不報告這種問題，那么就無法得到正確的藥物。

　　The big public gain, though, will come from pooling all the data from the inhalers, once theyhave been suitably anonymised.

　　不過，最大公共收益將出自匯集所有吸入器播報的數據，這些數據從前被適當地隱藏了。

　　That will open the way for a much more detailed analysis of what is going on, and mayallow the triggers to be identified and ranked in order of importance.

　　這將開辟一種對發生的事情進行更詳細分析的方法，而且也可能讓哮喘的誘因得以識別并按照重要性的順序加以排列。

　　Over the past three years Dr Van Sickle has run two pilot studies to test the new tool.

　　過去三年來，凡西克爾博士已經完成了兩次試點研究，以測試新的工具。

　　Both of these showed useful improvements in patients management and understanding oftheir disease.

　　兩次試點研究都顯示了對患者管理及疾病認識的有益改進。

　　They have also resulted in him questioning some longstanding theories about asthma,

　　這兩次試點研究也讓凡西克爾博士質疑一些長期存在的哮喘理論，

　　including the ideas that symptoms occur primarily at home and that the affliction is moreprevalent in urban areas than rural ones.

　　包括癥狀主要發生在家里以及在城市地區比農村地區感染更盛行這樣的觀念。

　　If those insights are confirmed, they will change the way asthma is managed.

　　如果這些質疑結果得到證實，它們將改變控制哮喘的方法。

　　The next step, commercialisation, is planned for the autumn.

　　下一步的商業化計劃在秋季進行。

　　With nearly 500,000 asthma-related hospital admissions every year in America alone, themarket could be large.

　　鑒于僅在美國每年就有近50萬與哮喘有關的病人入院治療，市場可能很大。

　　Alternatively, Dr Van Sickle s old friends at the CDC or some other medical-research agencymight think the data sufficiently valuable to buy and distribute the things themselves.

　　另外，在美國疾病控制和預防中心或其它醫療研究機構工作的凡西克爾博士的老朋友們可能會覺得這些數據有足夠的購買價值，并把它們用到自身的研究上。

　　Either way, the upshot would be better lives for patients in the short term and,

　　無論哪種方式，其結果都將會在短期內讓患者的生活更好，

　　if all went well, a true understanding of the triggers of this debilitating and occasionallylife-threatening condition.

　　且一切順利的話，人們就會真正了解這種令人衰弱、有時危及生命的病癥的誘因

　　Medical devices

　　醫療設備

　　Inhaling information

　　有關吸入器的吸入信息

　　How to collect data on asthma while, at the sametime, treating it

　　在處置哮喘的同時如何收集哮喘數據

　　IN 1985 and 1986 an epidemic of asthma hitBarcelona.

　　1985年和1986年巴塞羅那哮喘病流行。

　　The city s researchers first turned to the usual suspects,

　　這個城市的研究人員首先調查了一般的懷疑對象，

　　such as air pollution, pollen and mould.

　　如空氣污染、花粉和霉菌等。

　　But a series of telephone interviews with thesufferers pointed to a much more precise cause.

　　但從一連串對患者的電話隨訪中得出了一個更為確切原因。

　　All the attacks had occurred by the harbour, and at times when ships were unloading soyabeans.

　　所有的哮喘發作都發生在港口，且都在貨船卸大豆的時候。

　　The cause was clear: soya-bean dust.

　　原因很清楚:大豆灰塵。

　　So was the solution: the installation of filters on the harbour s silos.

　　所以解決辦法就是:在港口的筒倉上安裝過濾器。

　　Asthma is one of the world s most common chronic diseases.

　　哮喘是世界上最常見的慢性病之一。

　　It affects about 300m people.

　　大約有3億人患有哮喘。

　　Yet what triggers any given asthma attack is often unclear and,

　　然而，人們往往并不清楚是什么誘發了任何特定哮喘的發作，

　　as a consequence, most asthmatics are not properly treated. Stories of success, like that ofBarcelona, are rare.

　　其結果，大多數哮喘患者得不到妥善處置。象巴塞羅那這樣成功的故事是很罕見的。

　　Part of the reason for that lack of clarity is inadequate data on where and when attackshappen.

　　缺乏確切了解的部分原因在于對哮喘在何時何地發作沒有足夠的數據。

　　But David Van Sickle, an epidemiologist and medical anthropologist who once worked forAmerica s Centres for Disease Control and Prevention, has come up with a solution.

　　但是曾在美國疾病控制和預防中工作過的流行病學家和醫學人類學家大衛凡西科勒想出了一個解決方案。

　　This is to use the asthma inhalers carried around routinely by patients to record the time andlocation of symptoms as they happen.

　　這個解決方案就是利用患者例行性隨身攜帶的哮喘吸入器來記錄他們的哮喘癥狀出現時的時間和位置。

　　To develop his idea, Dr Van Sickle left CDC and founded a company, Asthmapolis, which isbased in Madison, Wisconsin.

　　為了開發他的想法，凡西克爾博士離開美國疾病控制和預防中心并成立了一家公司，公司名為Asthmapolis，總部設在威斯康星州的麥迪遜市。

　　The result is Spiroscout, an inhaler with a built-in Global Positioning System locator and awireless link to the internet.

　　其結果就是一款名為肺量測定法偵察員的吸入器問世，這款吸入器帶有內置的全球定位系統定位和聯到互聯網的無線連接。

　　Whenever someone uses the inhaler, it broadcasts the location and time to a centralcomputer.

　　每當有人使用吸入器時，吸入器就把位置和時間播報到中央計算機。

　　Asthmapolis plots and analyses the data, and sends weekly reports to participating patientsand their doctors summarising the observations and making recommendations.

　　這家公司把播報來的數據繪制成圖并加以分析，每周向參與播報的患者以及他們的醫生發送報告，以便他們的醫生總結觀察并提出建議。

　　That is useful for the individuals involved, since it may illuminate patterns of which theywere unaware.

　　這對有關個人很有用，因為它可以闡釋未明的誘發哮喘模式。

　　It could also help doctors identify those patients whose asthma is not under proper control.

　　它還可以幫助醫生確定那些哮喘無法適當控制的病人。

　　Use of the inhaler more than a couple of times a month suggests there is something wrong,and that the patient s medication may need to be changed.

　　每月使用吸入器超過了一兩次的情況說明有問題存在，而病人的藥物可能需要更換了。

　　Patients do not, however, always report such problems, and so do not get the right drugs.

　　然而，如果患者一直不報告這種問題，那么就無法得到正確的藥物。

　　The big public gain, though, will come from pooling all the data from the inhalers, once theyhave been suitably anonymised.

　　不過，最大公共收益將出自匯集所有吸入器播報的數據，這些數據從前被適當地隱藏了。

　　That will open the way for a much more detailed analysis of what is going on, and mayallow the triggers to be identified and ranked in order of importance.

　　這將開辟一種對發生的事情進行更詳細分析的方法，而且也可能讓哮喘的誘因得以識別并按照重要性的順序加以排列。

　　Over the past three years Dr Van Sickle has run two pilot studies to test the new tool.

　　過去三年來，凡西克爾博士已經完成了兩次試點研究，以測試新的工具。

　　Both of these showed useful improvements in patients management and understanding oftheir disease.

　　兩次試點研究都顯示了對患者管理及疾病認識的有益改進。

　　They have also resulted in him questioning some longstanding theories about asthma,

　　這兩次試點研究也讓凡西克爾博士質疑一些長期存在的哮喘理論，

　　including the ideas that symptoms occur primarily at home and that the affliction is moreprevalent in urban areas than rural ones.

　　包括癥狀主要發生在家里以及在城市地區比農村地區感染更盛行這樣的觀念。

　　If those insights are confirmed, they will change the way asthma is managed.

　　如果這些質疑結果得到證實，它們將改變控制哮喘的方法。

　　The next step, commercialisation, is planned for the autumn.

　　下一步的商業化計劃在秋季進行。

　　With nearly 500,000 asthma-related hospital admissions every year in America alone, themarket could be large.

　　鑒于僅在美國每年就有近50萬與哮喘有關的病人入院治療，市場可能很大。

　　Alternatively, Dr Van Sickle s old friends at the CDC or some other medical-research agencymight think the data sufficiently valuable to buy and distribute the things themselves.

　　另外，在美國疾病控制和預防中心或其它醫療研究機構工作的凡西克爾博士的老朋友們可能會覺得這些數據有足夠的購買價值，并把它們用到自身的研究上。

　　Either way, the upshot would be better lives for patients in the short term and,

　　無論哪種方式，其結果都將會在短期內讓患者的生活更好，

　　if all went well, a true understanding of the triggers of this debilitating and occasionallylife-threatening condition.

　　且一切順利的話，人們就會真正了解這種令人衰弱、有時危及生命的病癥的誘因