[ExI] good bexarotene article

[Brian Manning Delaney]

El 2012-02-11 18:01, spike escribió:
>
>> ... Brian Manning Delaney
> Subject: Re: [ExI] good bexarotene article
>
> El 2012-02-11 15:59, Isabelle Hakala escribió:
>>> ... How difficult would it be to find someone with Alzheimer AND the
> particular type of cancer that it is used for... Isabelle

>> ...Excellent idea!
>>
>> ...A twist on your question: might it be possible to find enough people who
>> /already have/ taken the drug to look for a meaningful reduction in rate of
>> Alzheimer's compared to matched controls? The matching would be tricky of
>> course: look at age-, sex-, etc.-matched controls who also had skin cancer?
>> Then the sample is tiny. Or forget the cancer in the matching, under the
>> assumption it's not significantly related to the dev. of Alzheimer's?
>> (Though there probably is an indirect relation via cancer's impact on
>> exercise levels and diet, which also affect risk of
>> Alzheimer's.) Either way, there's got to be some useful data already out
>> there, seems to me. The drug has been in use for nearly 13 years. The number
>> of people who've taken it might be many thousands. Let's take a look at
>> them!
>>
>> -Brian

> _______________________________________________
>
> Good ideas from Brian, thanks.

Spike- Thanks. Though I see now in an earlier post of yours I missed 
that this is more your idea than mine:

Spike wrote, earlier:
> This goes back to a discussion we had here a dozen years ago.  There should be a database somewhere, where people can dump medical information, while stripping out identities, so that we can find this kind of signal in the noise.  I am surprised something like that doesn’t exist somewhere.  We could maintain patient privacy while still perhaps filtering out these oddball correlations: a certain type of cancer patient doesn’t seem to get Alzheimer’s or has a lower rate than the general population.  The signal could have been sitting there for years, undiscovered because we have no systematic way to find it among the deep piles of data, hidden away to maintain patient privacy.

This is a great idea. Get as much data out there as we can, and see what 
correlations we find -- about bexarotene, or anything else that might be 
useful!

But about the specific idea of looking for Alzheimer's rates in the many 
people who've taken the drug for skin cancer, it occurred to me after I 
sent my post that the researchers of the new paper have probably already 
thought of that, and are likely working on it. I was about to email Gary 
Landreth (lead researcher) and ask, but I think I'll wait a bit. He's 
probably overwhelmed with inquiries right now.

> Do we have any hipsters here who are medics or have friends who are, who are
> hip to how one gets at this kind of data?  Seems like there is a masters
> degree offered in some places called Public Health, that deals with this
> sort of thing, ja?  If this isn't already a specialized field of study, it
> should be.  Otherwise we would need to create it.  How?

Public health, partly. But I think this is what a lot of basic medical 
research consists of: finding patient records, loooking at them, 
determining the relevant variables, and crunching numbers.

Patient records would be spread out across dozens, perhaps hundreds of 
physicians and clinics, unfortunately. One would have to get enough 
records, look for Alzheimher's diagnoses in the records, but, probably, 
have to look in records located /elsewhere/ for later diagnoses because 
Alz. would have been diagnosed by a diff. doctor.... (This is why the 
absence of the database you hope one could pull together really 
hurts....) Doable, just a huge amount of work. So much so that Landreth 
may have thought of the idea annd rejected it as impractical.

-Brian