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Welcome to BIOTECH NATION !!! With understandable interviews requiring no background in science, BTN attracts a wide global audience. From everyday people looking for hope in treatments in development, to bioentrepreneurs interested in the experience of their fellow travelers, to venture capitalists looking for possibilities in cutting-edge breakthroughs, to scientists simply interested in the work of others, BioTech Nation is the voice of human endeavor, driving science to new realities for everyone. These interviews are drawn directly from the public radio program, "Tech Nation", which also can be heard in numerous global radio and podcasting venues.
Ever heard of multimodal medicine or multimodal health? Probably not. Technation Health chief correspondent, doctor Daniel Craft, just coined the term. Daniel, welcome back.
Dr. Daniel Kraft:Great to be back.
Dr. Moira Gunn:Now we're gonna talk today about what you're calling multimodal medicine. How do you spell it, and is there a hyphen in it?
Dr. Daniel Kraft:I think I made up the term, so I'm not maybe I did maybe I did. Multimodal, one word, and then and medicine, or multimodal health, I think might be a better term. And the way I'm thinking about multimodal health is that, you know, as a physician, we tend to look at a few metrics on a patient. The classic might be their their vital signs, their weight, their temperature, their blood pressure, Maybe a few of their labs, we often call it chem 20. That would be your basic blood chemistries and maybe your your basic blood counts.
Dr. Daniel Kraft:And maybe once a year, you get your cholesterol numbers done and maybe your hemoglobin a one c. And then another modality, of course, is imaging. It might be a screening mammogram or MRI or a a chest x-ray. So those are different modalities. And, you know, there's things in the realm of pathology and now new forms of modalities like the back of the retina might be another, element that we're trying to bring in with AI as a way of looking at an individual.
Dr. Daniel Kraft:And so when I think about this new era of multimodal health, it's like, how do we pull all these different things together, not just your genome and your steps from your wearable, and maybe your, sleep patterns and and beyond. But how do we put them together in a way that's gonna really be useful for prevention, diagnostics, therapy, and even global and public health? And there's a few things that have bubbled up recently I thought we'd touch on. One is that, you know, we think about usually blood tests being, you know, a few chemistries like I mentioned. But in the blood, there's 1,000 and tens of thousands of proteins that are circulating.
Dr. Daniel Kraft:It's often called the proteome. Right? And the proteome, isn't normally usually collected in a standard, blood test, but some amazing work that was just published in Nature in July of this year, 2024, comes from the UK Biobank, where they've been, taking, I think over 40,000 participants over time, and they've been looking at about 3,000 plasma proteins from this biobank of participants. And they've published some really fascinating results that they could predict early, the protein signatures of, 67 different diseases from cancers like multiple myeloma and non Hodgkin's lymphoma to early forms of motor neuron disease, pulmonary fibrosis, early cardiac problems. And so this has become a new modality, I think, for super early prediction of diseases.
Dr. Daniel Kraft:And, similar research that came out of the UK Biobank showed that just using 6 proteins from the blood, they could predict who is likely to get Parkinson's, several years. I think 6 or 7 years before normal symptoms would develop. And so the proteome, proteins we don't normally measure, particularly when you combine these different proteins, I think will be a whole new lens to early prediction for disease. That might mean, again, you have early warning at stage 0 that you might be developing Parkinson's or a form of cardiovascular disease, and you can take early proactive action, whether that's a drug, better habits, to maybe even a gene therapy.
Dr. Moira Gunn:Hey. I don't even need a nudge for that one.
Dr. Daniel Kraft:Exactly.
Dr. Moira Gunn:What? I'm out of my seat. You know?
Dr. Daniel Kraft:So that's that's one cool modality. The other ones that are getting super interesting now is imaging. And usually imaging is done when you already have symptoms. You've broken your arm. You're getting a a a screen for some sort of, cough or headache or worse.
Dr. Daniel Kraft:But we're entering this year now where we're seeing proactive personalized screening using imaging. So for example, last month, I went and had a Q Bio, MRI scan and what they're calling their Gemini experience. So it wasn't just getting a full body MRI that was read by a radiologist and the enhancement of AI to segment my body, but they also did a whole bunch of bloods. They checked my urine. I did an EKG.
Dr. Daniel Kraft:I did a pulmonary function test. They looked at my genetics. So, again, there's multiple modalities, imaging data, lab data, physiologic data like EKG. And putting that all together, you get a really interesting picture of your health, particularly if you do those measures over time. And particularly now that AI machine learning can start to sift through that data and really start to integrate it.
Dr. Daniel Kraft:And when I had my sort of, debrief, with one of the clinicians from Q Bio, they were able to look at the data with me. And luckily, I'm a physician, so it was maybe a little more seamless. But we could integrate that and and see where there might be hot spots where I could take some action, maybe run a high cholesterol number or some little cyst that showed up on a scan and do things that might really pick up a really bad issue early, which I didn't have. Thank goodness. But also make me more proactive on my behaviors and other elements to do better screenings and to track challenges early.
Dr. Moira Gunn:Now MRIs, a lot of people say I ain't going in the tube. I ain't going in there. You did a full body MRI and it was, I'm assuming, in one of those long tubes. Tell us about that experience.
Dr. Daniel Kraft:Yeah. A standard MRI machine now from companies like GE or, or others, enable you to lie down and put some sometimes little things around you keep your head still and you go to the tube. And if you're not claustrophobic, you know, you can listen to some music or sometimes with a little mirror, watch a watch a movie. Siemens, I believe, has a one where the little mirror that will show you a movie behind you. And those scans, which used to take hours, are now getting faster and faster.
Dr. Daniel Kraft:I did another full body MRI about a year ago from a company called Pranuva. They take about an hour, and they're moving now down to, I think, 45 minutes or 30 minutes. Qbio is developing a smaller version of an MRI, which is more open so folks don't feel claustrophobic and it can be run with less time and less technologists needed. So the ability, I think, in 10 years might be that you go to your corner of Walgreens or pharmacy, CVS, etcetera, you might get a full body MRI done in 10 minutes and read by an AI radiologist. That might be part of our future physical exam, this idea of super quantification to find things early.
Dr. Daniel Kraft:And if you have a condition, do be able to track it much smarter, more precise ways.
Dr. Moira Gunn:I was actually in an old pharmacy the other day, and I couldn't believe it. There was an old telephone booth there, you know, where you go in and you actually call somebody on a telephone booth. Now we know what they can do with that space. Just go in.
Dr. Daniel Kraft:Well
Dr. Moira Gunn:Do you?
Dr. Daniel Kraft:I I once visited the FCC in Washington DC, which is the Federal Communications Commission, whatever. I was shocked in their lobby. There's a whole line of old phones, old pay phones, but I wanna not lose the point here. We often talk about the excitement of technology and AI and convergence, but as a physician, especially in this new AI enabled age, I don't think we wanna lose our ability to use our ears. Our most important diagnostic element is listening to the patient's story.
Dr. Daniel Kraft:And that listening with the ear of the clinician and then communication with the patient is probably the most important diagnostic tool and resource that we still need to maintain even in this GPT enabled era. In fact, you might start telling your story as you can to, OpenAI chat GPT, whether you want to or not is another question, and it can do a pretty good job of doing triage and making that early diagnosis. That it's not gonna be a 100%. But as we've seen, they can already do a better job than many clinicians. But I just wanna belabor the point that it's not always fancy labs, imaging, and other data, but sometimes the story that can really help pick up a problem, especially early that relates to a particular disease.
Dr. Moira Gunn:Well, you are welcome to come and belabor away anytime, Daniel. I'll see you soon.
Dr. Daniel Kraft:Well, see you soon. And I would encourage folks listening to start to do some of your own sort of proactive elements, making sure you stay on top of your colonoscopy, mammograms, screening your urine, particularly if you have hypertension or diabetes to find signs of early kidney disease or check your blood pressure. All these things are very often simple screens. They don't need to be simple super fancy, but being proactive, getting those done on time or even early, can help you stay healthy and and pick up problems early that will save, life challenges, dollars, stress, and and health. So, stay healthy.
Dr. Moira Gunn:Technation Health chief correspondent, doctor Daniel Kraft, is the founder and chair of NextMed Health on the web@nextmed.healthanddigital.health. More information about Daniel at danielcraftmd.net.