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Mar 02 2013

MetaMed: The best second opinion

There’s a pretty cool new company I’ve been working for lately. It’s called MetaMed Research, and it’s a concierge medicine service that researches treatment options for unresolved health problems. When someone has already seen several doctors, tried all the common treatments, and nobody knows why they’re still suffering, what can they do now? Is that the end of the line? It shouldn’t be. This is the role that MetaMed seeks to fill: finding possible solutions for unanswered questions. Not everyone has the resources to start a biotech company just to develop a treatment for their dying children, but we think we can provide people with the same kind of opportunity through personalized medicine and comprehensive research.

In addressing a client’s needs, we tackle multiple problems that come to bear on their health issues: giving them personal attention that takes into account their individual biological variations, separating relevant and valid literature from useless and poor-quality studies, and rationally evaluating the strengths and weaknesses of all of the available evidence. These are a lot of words to say that we do our best to figure out what’s true, what’s false, and how this can help someone with a particular condition.

Why is this necessary? First, people can miss things, even things that they really should not miss. When patients diagnosed with breast cancer were referred to a board of specialists, 52% had their surgical recommendations changed. 45% received a new interpretation of their imaging results – in some cases, second cancers were identified that had been missed the first time. For 29%, their test results were interpreted differently by pathologists, affecting the staging of their cancer. How many of these patients would have had improper or inadequate treatment if it weren’t for this second opinion? How many patients are getting the wrong treatment every day, when errors in diagnosis are this common even for deadly diseases like cancer? We believe that teams of specialists can similarly apply their expertise to a variety of health conditions and make better diagnoses that may have been missed.

Second, scientific studies aren’t necessarily reliable merely because they’re scientific studies. In 2010, a psychologist designed an experiment based on the idea that there would be an evolutionary advantage to being able to perceive the future possibility of sex – essentially, precognitive detection of sexually available partners would aid in successful reproduction, and thus select for itself. In the experiment, study participants were asked to select which of two concealed images they believed would contain “erotic stimuli”. Said stimuli was placed randomly, after a participant made their selection. The original study found that they were able to select the correct image – “predicting” events that had not yet happened – with slightly better accuracy than would be expected from chance alone. This was widely reported as evidence of human precognitive ability. However, even when numerous replications showed negative results, the original journal refused to publish them, simply because they were replications. It would seem that while “Porn Travels Backward Through Time” was an appealing headline for the Journal of Personality and Social Psychology, “Porn Does Not Travel Backward Through Time” was not quite so attention-grabbing. This isn’t just a one-off, anomalous disgrace. A majority of published research findings may actually be false, and it’s crucial to evaluate a study’s strength instead of taking it at face value. MetaMed weighs studies according to how well-supporting their findings are, taking into account any flaws or biases that would compromise their results.

Third, not all relevant information is taken into account when treating patients. Why do some drugs work only for some people and not others? It’s because there are vast individual differences in how people metabolize those drugs, and most medical treatment fails to recognize those variations. Patients are often treated with one-size-fits-all regimens, and their unique genetic and metabolic features aren’t taken into account. Doctors also don’t have the time to research every patient’s case individually, and there’s no way for one person to keep up with the volume of published literature that could be relevant to each patient. MetaMed can offer them a kind of support team, focusing on the details of a patient’s disease process and searching medical literature to find potential interventions.

It’s a pretty simple idea: more evidence, better evidence, better answers. Yet this kind of highly personalized medical practice is rare enough that there’s a niche for MetaMed to fill. That’s the service we offer, and I think we’ve got a decent shot at this.

7 comments

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  1. 1
    abbeycadabra

    How’$ the availability of the$e new advance$?

    1. 1.1
      Zinnia Jones

      Pretty expen$ive, probably.

  2. 2
    ibbica

    Do they have a ‘careers’ page at all? I can’t find one, but this is exactly the sort of thing I’ve been trying to get into recently, and I’m wondering if they’d be hiring. I’m tempted to just “cold-call” them, but would prefer going through a ‘proper’ channel, if it exists…

    1. 2.1
      Sarah Constantin

      Yes, we are hiring!

      We need:

      Researchers
      Doctors
      Administrative assistants

      Researchers write our reports. They’re the core of our company. We’re looking for exceptional scientists, especially biologists who also have strong quantitative backgrounds. One way of looking at a research report is that it’s a cross between a meta-study and a consulting report; we need you to be rigorous in evaluating study methodology, but also creative and pragmatic in problem-solving for the client even in the absence of complete information. The best researchers stand out for their curiosity and intellectual self-reliance. If that sounds like you, I’m the VP of research, send me your resume at [email protected].

      Doctors take medical histories, serve as medical experts in the research process, and scrupulously evaluate our reports for accuracy. If you’re a doctor who wants to work with us, send Laura Baur an email at [email protected] with your resume.

      Administrative assistants keep the company running, in big and small ways. If you’re conscientious and interested in making the world a better place, we need you; bonus points if you’re a good writer or talented with social media. Contact [email protected] with your resume.

  3. 3
    psanity

    Zinnia, your timing on this is amazing for me. My SO has autoimmune issues that are not responding to medication, and we just keep hitting the wall. We’re far from any major medical centers/teaching hospitals, and out on the bleeding edge of knowledge of the immune system and pharmaceuticals. Just knowing that a service like this is out there is wonderful news.

    Our medical insurance has a program that connects us with nurses and pharmacists who will research for us. This looks like a possible next step. I think we’d better see if we can get our insurance to pay for it.

    Since I’m finally commenting on your great blog, I ought to mention how much your writing has meant to me. I’ve always been a person who doesn’t really get why it’s a big deal for people to be who they are, and get medical treatment they need, but that’s not enough. Reading your blog )and Natalie’s) has given me more, what I guess I’d call technical knowledge of the issues trans folk deal with. This has made it possible, on more than one occasion, for me to have conversations with transitioning young people I ran into as an event volunteer, that were supportive and not totally square one clueless, rather than well-meaning but awkward and strange.

    Spreading knowledge and understanding around makes the world better. Keep it up Thanks.

    1. 3.1
      Sarah Constantin

      We are not covered by insurance, unfortunately.

  4. 4
    neuroturtle

    Haha, ibbica, I was going to ask the same thing. I think cold-calling isn’t such a bad idea.

  1. 5
    MetaMed

    [...] different bloggers I read–Yvain and Zinnia–are both involved in a new startup called MetaMed. It sounds really cool, because it sounds [...]

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