The Challenge of Diagnosing Predisease in Our Healthcare Delivery System

New technology is inexorably driving medical diagnostics toward more frequent discovery of predisease. Medical diagnostics here should be taken to encompass both the clinical laboratories and medical imaging. Below is an article describing one further example of how a new nanotechnology technique is "thousands of times more sensitive than conventional methods to low levels of proteins or nucleic acids that show a person could develop a certain disease (see: Inventor to Receive MIT Prize). Below is an excerpt from it:

The Massachusetts Institute of Technology expects to name Chad Mirkin, creator of a range of sensitive diagnostic tests for diseases, as the winner of the $500,000 Lemelson-MIT Prize, a premier award recognizing invention....Mr. Mirkin's products use nanotechnology, which is based on the science of very small particles, to help researchers study diseases. His disease-detecting method, branded as Verigene, is thousands of times more sensitive than conventional methods to low levels of proteins or nucleic acids that show a person could develop a certain disease. The method can return results in an hour as compared with several days, in some cases....The scanning technique -- called dip-pen nanolithography -- creates patterns on several materials on an extremely small scale. Scientists can then use the patterns to learn more about the nature of certain cells and distinguish between normal and cancerous cells.

Our healthcare delivery system is ill-prepared for an influx of large numbers of patients with predisease (see: Predisposition to Disease and Pre-Disease on the Health Continuum; Wellness, Preventive Medicine, and the Classic Disease Model; Genomic Testing, Pre-Symptomatic Disease, and Health Insurance). Put another way, our capacity to diagnose disease is becoming less aligned with our ability to treat disease and reimburse physicians and hospitals for these treatments. Another unintended consequence of this fundamental shift in medical diagnostics is that many of our diagnosticians may be required to make therapeutic recommendations for which they may be unprepared. For now, perhaps the only solution is watchful waiting until we have a better understanding of this trend of increasing numbers of patients carrying predisease diagnoses.