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The Decision Tree: Taking Control of Your Health in the New Era of Personalized Medicine
In The Decision Tree, Thomas Goetz proposes a new strategy for thinking about health, one that applies cutting-edge technology and sound science to put us at the center of the equation. An individual’s Decision Tree begins with genomics, where $400 and a test tube of spit provides a peek at how your DNA influences your health. It taps self-monitoring and collaborative health tools, where iPhone applications and next-generation monitoring gadgets can help individuals successfully change their behavior, once and for all. And it turns to new screening techniques that detect diseases like cancer and diabetes far earlier and with far better prospects for our health. Full of thoughtful, groundbreaking reporting on the impact personalized medicine will have on the average patient, The Decision Tree will show you how to take advantage of this new frontier in health care.
320 pages, Hardcover
First published January 1, 2010
12 people are currently reading
325 people want to read
About the author
Thomas Goetz
8 books36 followersThomas Goetz is the author of the new book, The Remedy: Robert Koch, Arthur Conan Doyle, & the Quest to Cure Tuberculosis. He is also co-founder of Iodine, a health technology company based in San Francisco. His previous book, The Decision Tree, was chosen by the Wall Street Journal as a Best Health book of 2010, and widely hailed as offering a new vision for healthcare in the United States.
Thomas also serves as the Enterpreneur in Residence for the Robert Wood Johnson Foundation, the nation’s leading force for better health and healthcare.
He was previously the executive editor at WIRED, where he led the magazine to a dozen National Magazine Awards from 2001 through 2012. In 2010, under Goetz’s leadership, WIRED was chosen as AdWeek’s “Magazine of the Decade.” His writing there explored topics from the riddle of behavior change to the paradox of cancer screening, and was selected for the Best American Science Writing, Best American Science & Nature Writing, and Best Technology Writing anthologies.
He has been a Curator-in-Residence for the Adobe Digital Museum, and a council member for NASA’s Launch challenge. In 2011, he served as executive producer for the award-winning Discovery Channel documentary Earth 2050: The Future of Energy. His TED talk on redesigning medical data has been viewed 400,000 times.
Goetz holds a Master of Public Health degree from the University of California, Berkeley, and a Master's in American literature from the University of Virginia. He graduated from Bates College, where he learned to juggle five balls at once (he’s
now back down to three).
Thomas also serves as the Enterpreneur in Residence for the Robert Wood Johnson Foundation, the nation’s leading force for better health and healthcare.
He was previously the executive editor at WIRED, where he led the magazine to a dozen National Magazine Awards from 2001 through 2012. In 2010, under Goetz’s leadership, WIRED was chosen as AdWeek’s “Magazine of the Decade.” His writing there explored topics from the riddle of behavior change to the paradox of cancer screening, and was selected for the Best American Science Writing, Best American Science & Nature Writing, and Best Technology Writing anthologies.
He has been a Curator-in-Residence for the Adobe Digital Museum, and a council member for NASA’s Launch challenge. In 2011, he served as executive producer for the award-winning Discovery Channel documentary Earth 2050: The Future of Energy. His TED talk on redesigning medical data has been viewed 400,000 times.
Goetz holds a Master of Public Health degree from the University of California, Berkeley, and a Master's in American literature from the University of Virginia. He graduated from Bates College, where he learned to juggle five balls at once (he’s
now back down to three).
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Displaying 1 - 28 of 28 reviews
July 9, 2010
Boingboing.net featured this book the day it came out and it seemed so interesting that I went right out an ordered it. I know, the year of making do, what was I thinking?
Summary of the Book
The book looks at technology, and reasons that with doctors too busy to take care of you, you need to start taking control of your health. You have become the informed consumer. But what’s a girl to do? Go to medical school? The idea is to make medical decisions more systematic, make information more accessible and understandable, allow technology to help us rather than confuse us, and give people the tools to make changes to people’s lifestyles easier.
For example, if you wanted to quit smoking, then you would have two options, systematically speaking: cold turkey or nicotine replacement. If you chose cold turkey, then you would need to examine the effectiveness of this method. Once you learned that it is not effective then you might change your choice. Then you would need to choose the type of nicotine replacement therapy.
Mr. Goetz provides the reader an updated drug label which shows: who is to take the drug, why you are taking it, who should not take it, the type of testing needed by someone taking the drug, and other considerations. Below that he gives the patient the findings of the study that lead to the FDA approving the drug, and historical information about the drug. The label he has it clearly too big for a drug bottle, but is still a great idea.
A technological help he profiled was the Nike+. This little fob tracks your speed, in concert with our ipod, while you run. Then you synch it with your computer and it tells you how far you ran, and compares it to your other runs. Fun. I got one from Erica, but have had technical difficulties using it with my Vibram Fivefingers, and need to figure out what to do about that. Needless to say, seeing the data motivates me to run more.
One of the problems with reading the book is similar to the problem many medical students encounter: they start thinking that they have the diseases they are studying. I kept thinking my blood pressure was going up or that I was getting diabetes. Great motivator that book.
Finally, he explains genetic testing, why you might consider getting it, and how it works. I will not be doing any genetic testing in the near term.
Tidbits of Info from the Book
One super interesting point made in the book is that acetaminophen is the most common case of liver failure in the US. 50 percent of cases of liver failure are due to acetaminophen, which is also used in Vicoden and Percocet. The medical establishment now believes that this toxicity is not caused by taking too much of the drug but from a genetic problem which causes as many as 1/3 of all people taking acetaminophen to have raised blood levels of alanine transferease.
Criticisms of the Book
There are a few problems with his book, or rather with his examples. First, because he is using the examples to explain high-level ideas, he may not have done the research necessary to check out his high level understanding of the medical facts (a problem all of us face...). One example he uses is of the recent study that came out showing that Hormone Replacement Therapy (HRT) might be causing heart attacks in women. I have subsequently read that it might have been the type of HRT studied (the kind that uses horses urine to create the therapy) which caused the problems, not the therapy itself. A second example, is Weight Watchers. He holds it up as a successful example of a weight loss program. That it is not. Of all weight loss programs, it has the highest success rate, but most people who do Weight Watchers are going to remain heavy.
Finally, the book is really far ranging, from decision trees to Alzheimer’s to genetics. I suppose the point is we all need to know more about these conditions, but I will wait to learn more on a ‘need to know basis.’
And I remain a little annoyed that Mr. Goetz did not have a spare minute to respond to my email. If you want to read the book, I'll send it to you for free.
Summary of the Book
The book looks at technology, and reasons that with doctors too busy to take care of you, you need to start taking control of your health. You have become the informed consumer. But what’s a girl to do? Go to medical school? The idea is to make medical decisions more systematic, make information more accessible and understandable, allow technology to help us rather than confuse us, and give people the tools to make changes to people’s lifestyles easier.
For example, if you wanted to quit smoking, then you would have two options, systematically speaking: cold turkey or nicotine replacement. If you chose cold turkey, then you would need to examine the effectiveness of this method. Once you learned that it is not effective then you might change your choice. Then you would need to choose the type of nicotine replacement therapy.
Mr. Goetz provides the reader an updated drug label which shows: who is to take the drug, why you are taking it, who should not take it, the type of testing needed by someone taking the drug, and other considerations. Below that he gives the patient the findings of the study that lead to the FDA approving the drug, and historical information about the drug. The label he has it clearly too big for a drug bottle, but is still a great idea.
A technological help he profiled was the Nike+. This little fob tracks your speed, in concert with our ipod, while you run. Then you synch it with your computer and it tells you how far you ran, and compares it to your other runs. Fun. I got one from Erica, but have had technical difficulties using it with my Vibram Fivefingers, and need to figure out what to do about that. Needless to say, seeing the data motivates me to run more.
One of the problems with reading the book is similar to the problem many medical students encounter: they start thinking that they have the diseases they are studying. I kept thinking my blood pressure was going up or that I was getting diabetes. Great motivator that book.
Finally, he explains genetic testing, why you might consider getting it, and how it works. I will not be doing any genetic testing in the near term.
Tidbits of Info from the Book
One super interesting point made in the book is that acetaminophen is the most common case of liver failure in the US. 50 percent of cases of liver failure are due to acetaminophen, which is also used in Vicoden and Percocet. The medical establishment now believes that this toxicity is not caused by taking too much of the drug but from a genetic problem which causes as many as 1/3 of all people taking acetaminophen to have raised blood levels of alanine transferease.
Criticisms of the Book
There are a few problems with his book, or rather with his examples. First, because he is using the examples to explain high-level ideas, he may not have done the research necessary to check out his high level understanding of the medical facts (a problem all of us face...). One example he uses is of the recent study that came out showing that Hormone Replacement Therapy (HRT) might be causing heart attacks in women. I have subsequently read that it might have been the type of HRT studied (the kind that uses horses urine to create the therapy) which caused the problems, not the therapy itself. A second example, is Weight Watchers. He holds it up as a successful example of a weight loss program. That it is not. Of all weight loss programs, it has the highest success rate, but most people who do Weight Watchers are going to remain heavy.
Finally, the book is really far ranging, from decision trees to Alzheimer’s to genetics. I suppose the point is we all need to know more about these conditions, but I will wait to learn more on a ‘need to know basis.’
And I remain a little annoyed that Mr. Goetz did not have a spare minute to respond to my email. If you want to read the book, I'll send it to you for free.
January 21, 2012
I think there were some beneficial ideas in the book. It would be intelligent to alter one's behavior before one get's sick. I know my grandfather has diabetes and I am pretty sure my father has high blood pressure. It would be in my best interest to eat healthier and perhaps cut down on my soda intake (which at times ascends to half of a 2 Liter). I may not have control of my genes by I can shape my overall fitness to reduce my risks.
I liked hearing about some of the companies in the novel. If only I had known about 23andMe before my birthday. I would have definitely asked for a spit tube... so I could learn about the sequence of my genes at a couple locations for polymorphisms. Also, a couple of the websites oriented towards managing illnesses seemed fascinating (although i don't have anything to track at the moment).
It will be interesting to see how medicine advances over the next ten or twenty years. Patients have access to a glut of medical information. I really want to see how medicine and technology integrate further to improve patient care.
Overall I thought the book presented some good ideas. One thing did really bother me. I hated how "Decision Tree" was capitalized in the book. It seemed as he was attempting to make it some sort of revolutionary idea. I mean, it is just a flow chart.
I liked hearing about some of the companies in the novel. If only I had known about 23andMe before my birthday. I would have definitely asked for a spit tube... so I could learn about the sequence of my genes at a couple locations for polymorphisms. Also, a couple of the websites oriented towards managing illnesses seemed fascinating (although i don't have anything to track at the moment).
It will be interesting to see how medicine advances over the next ten or twenty years. Patients have access to a glut of medical information. I really want to see how medicine and technology integrate further to improve patient care.
Overall I thought the book presented some good ideas. One thing did really bother me. I hated how "Decision Tree" was capitalized in the book. It seemed as he was attempting to make it some sort of revolutionary idea. I mean, it is just a flow chart.
Read
October 21, 2011This book was...OK. It covered a few topics: we need to take more control of our health and have more access to our medical records/data (including our DNA) so we can make our own decisions, it's better to catch diseases early but the health care system in the US isn't correctly incentivized to encourage that, we need to change the pharmaceutical industry so they don't have to focus on blockbuster drugs. All was mildly interesting, but mostly stuff I had heard before, and tying all of this to a "decision tree" seemed shoehorned.
They did mention Quantified Self, which I appreciated, and there was an example of a Drug Facts box for prescription drugs that is much clearer than what we have today (a PDF example). I also learned about PatientsLikeMe, a website good for people with chronic illnesses to share what treatments work for them.
They did mention Quantified Self, which I appreciated, and there was an example of a Drug Facts box for prescription drugs that is much clearer than what we have today (a PDF example). I also learned about PatientsLikeMe, a website good for people with chronic illnesses to share what treatments work for them.
February 20, 2010
Nothing new: don't smoke, watch your diet, take the right prescriptions .... "This book focuses on pharmaceuticals, mostly, and early screening and testing. Promotes the AMA and FDA which do not have the public's well being at stake; they're motivated by politics and money - always follow the money trail. They want you to forget all those nasty side effects of the meds they're pushing; afterall, they've got another ten meds for those that you can pay for for the rest of your life. They're about money, not health.
Goetz should have put his energy into looking at the GMO and processed foods and chemically hazardous water that are really killing people. 50% of cancer patients are smokers, 50% are not. Clearly, it's something besides the cigarettes. When Goetz digs a bit further and looks at the real cause of illness and the real natural cures, I'm sure he'll write one heck of a book. This book is a mouth piece for the deceptive and duplicitous big pharma and big med industries.
Goetz should have put his energy into looking at the GMO and processed foods and chemically hazardous water that are really killing people. 50% of cancer patients are smokers, 50% are not. Clearly, it's something besides the cigarettes. When Goetz digs a bit further and looks at the real cause of illness and the real natural cures, I'm sure he'll write one heck of a book. This book is a mouth piece for the deceptive and duplicitous big pharma and big med industries.
December 4, 2011
I think this is a pretty solid overview for the general public on the broad problems with the practice of medicine in America. The book follows a logical format, covering the three main thought processes behind medicine: prediction/prevention, diagnosis, and treatment. Really the book makes an argument to push for a Health 3.0 system (not necessarily a term he uses), focusing on early intervention and surveillance, instead of reactionary medicine, which is the mainstay here in America. For more on the 3.0 stuff, check out Neal Halfon. For the intended audience, I think the book is a good launch pad for thinking about screening policies and the like. I'd recommend it for futurists/people looking for inspiration on the next step in healthcare.
March 24, 2011
I happen to be one of those people that thinks people should be more self-aware, self responsible, and take a more scientific and data driven approach to their own health so of course I liked this book. However, while it nicely validated my own personal perspective, it did not give much information in terms of practical ways in which to take charge of your own health care. I expected more specific adviced on how to choose, communicate and manage your doctors and your health records. It barely discussed personal health tracking sites and gave no recommendations as to which may be superior.
So, while on a broad scale it was interesting reading, it wasn't as helpful as I had hoped.
So, while on a broad scale it was interesting reading, it wasn't as helpful as I had hoped.
January 7, 2010
In an easy to read, anecdotal account, Thomas Goetz explains how and why Americans need shift their health care focus from doctor-driven to patient-driven. Goetz aptly discusses monitoring health via a range of collaborative health tools, screening techniques and IPhone applications. While providing ample data and scientific studies, Goetz does not gear his book to those with Phd's in Public Health or to those wanting a no brainer introduction. Rather, his writings provide an engaging thought-provoking approach to healthcare.
June 17, 2010
I expected this book to be something that it wasn't and wish goodreads had a star to reflect that. When I entered to win it from goodreads I thought it would be more about what you can do to be a healthier you--from being proactive by eating healthy, exercising, and using both alternative/complementary medicine, western medicine, and monitoring your own behavior with smart phone aps (or similar technology). But the book is more about envisioning a shift in how people and the medical system need to change from a doctor centered to a patient centered health care system, one where patients are much more pro-active in the care they receive. That sounds great to me, but I am not a fan of the medical system as it is, the AMA, or the FDA and think way too much of the "care" people receive from western medicine is tied into profit for big business. I'm not interested in genetic tests or synthetic drugs. I lean towards the China Study, mind/body awareness, living a healthier lifestyle and alternative medicine, so this book just isn't a good fit for me. I'm passing it on to someone who is more interested in working within the medical system to help transform it from the inside.
June 14, 2010
Goetz offers a compelling call to advance cutting edge developments in the areas of personalized health care and consumer driven care. Offering an interdisciplinary approach that draws from diverse fields and sources, the book is engaging and easy to read. At his best Goetz is emphasizing crucial insights necessary for genuine health reform (i.e. changing doctor pay structure, emphasizing prevention, utilizing patients in care, cost effectiveness, price transparency, etc.). At his worst, which is not often, Goetz betrays a technological enthusiasm that seems to denigrate extended ethical analysis. Nonetheless, I would highly recommend this book.
December 24, 2014
The Decision Tree will show you how to take advantage of this new frontier in health care. It turns to new screening techniques that detect diseases like cancer and diabetes far earlier and with far better prospects for our health. Full of thoughtful, groundbreaking reporting on the impact personalized medicine will have on the average patient. An individuals Decision Tree begins with genomics, where $400 and a test tube of spit provides a peek at how your DNA influences your health. It taps self-monitoring and collaborative health tools, where applications and next-generation monitoring gadgets can help individuals successfully change their behavior, once and for all.
June 30, 2010
An excellent call to arms for personalized medicine and patient activism. At times the book acts as though we don't need doctors at all, or rather, that doctors no longer fit in the new paradigm that Goetz describes. The "decision tree" metaphor is likely an attempt to link the active patient model to evidence-based practice, which is a good idea, but the actual "trees" drawn in the book don't add much to the story. Goetz does a good enough job personalizing the medical decisions in each example he uses, so the diagrams were simply unnecessary in many cases.
March 2, 2015
Smart book, stupid title. The author tries to squish every effective point he has about personalized medicine and data analytics within the framework of a decision tree. There is nothing revolutionary or especially personalized about a medical decision chart and the ones he shares in the book are particularly generic. This book isn't about "taking control of your health," it is about how data- at a personal and population level- can be translated into actionable information with the power to revolutionize healthcare.
March 24, 2010
Won this on first reads.
I am one of a family that has a loooooong line of health issues. The doctors have trouble going through the history and figuring things out. I love this book as it seems like it will assist many of us to get things worked out in our family. I think I may actually be able to get it straight in time to keep my kids from going through the triala, headaches, and frustrations of mine and previous generations!
I am one of a family that has a loooooong line of health issues. The doctors have trouble going through the history and figuring things out. I love this book as it seems like it will assist many of us to get things worked out in our family. I think I may actually be able to get it straight in time to keep my kids from going through the triala, headaches, and frustrations of mine and previous generations!
October 8, 2014
This book saved my life. I learned how to find out what I need to know and what to do "when there is no doctor." I got a copy of my medical chart as recommended and was able to self diagnose based on medical history and eventually get a real diagnosis. Saved my bacon!
It's well written, very easy to understand and that is what gave me hope that I could figure out how to save my own life. Mr Goetz you are a gentleman and a scholar!
It's well written, very easy to understand and that is what gave me hope that I could figure out how to save my own life. Mr Goetz you are a gentleman and a scholar!
November 30, 2013
I really enjoyed reading about the history of specific medical discoveries regarding chronic diseases, clinical drug trials, and the advancement of DNA and proteomics. However, I felt that the whole "Decision Tree" idea seemed a bit tacked on and not really groundbreaking when it was reviewing the process that a specific patient went through.
Read
February 8, 2011I just won this book. I hope it's interesting.
There were a lot of technical explanations which if that was an interest of mine maybe I would have enjoyed this book, but I really didn't. I didn't end up finishing it.
There were a lot of technical explanations which if that was an interest of mine maybe I would have enjoyed this book, but I really didn't. I didn't end up finishing it.
January 19, 2010
Thomas Goetz's book, The Decision Tree taught me, not only that I needed to take charge of my healthcare, but also how to do it. A must read for all during this revolution in healthcare. A great first reads win!!
to-read-tier-2
March 26, 2016Goetz wrote this article.
http://www.wired.com/magazine/2010/06...
http://www.wired.com/magazine/2010/06...
October 10, 2010
Not bad. Useful info for people into personal health knowledge.
June 19, 2016
Technology, patient empowerment and autonomy, interest in personal metrics-gathering, and transparency are transforming modern medical care - for the better.
August 22, 2011
Interesting read about how you can take charge of your health. Leaned a bit about genetics and healthcare decision making, and ways around the current bad healthcare system situation.
April 19, 2012
Goetz provides a compelling case for why the future of medicine will be personalized, but it's obvious that there are still a lot of unknowns in getting from where we are today to where we will be.
April 30, 2012
Lays out an articulate approach to thinking about, and making, decisions that can be used in many areas of life including health care.
March 31, 2014
Somewhere in this book is an idea that will determine my personal and professional path in life. However , there are so many interesting and spot-on ideas that I don't know which one will be it!
Want to read
December 2, 2013"It looks like a timely text, but I haven’t made the time to read it! That time will come…" reported Ragan Healthcare Communications writer Dan Dunlop in the 12/22/13 Newsletter.
March 2, 2015
Great stuff to consider about owning your health!
October 3, 2014
Para todos los interesados en medicina personalizada
May 22, 2013
I useful book for pointing out how much of our health problems are actually common sense problems.
Displaying 1 - 28 of 28 reviews