introducing ... The Decision Tree

This blog has been silent - okay, dead - for the past three months. You'll get no apologies here, but I do have an explanation: I've begun writing a book, to be called The Decision Tree.

In many respects, this book will be an extension of many of the preoccupations I've pursued here at Epidemix. Those handful of you who follow my magazine writing will no doubt recognize the theme as well. The premise is that we are at a new phase of health and medical care, where more decisions are being made by individuals on their own behalf, rather than by physicians, and that, furthermore, these decisions are being informed by new tools based on statistics, data, and predictions. This is a good thing - it will let us, the general public, live better, happier, and even longer lives. But it will require us to be stewards of our health in ways we may not be prepared for. We will act on the basis of risk factors and predictive scores, rather than on conventional wisdom and doctors recommendations. We will act in collaboration with others, drawing on collective experience with health and disease, rather than in the isolation and ignorance that can come with "privacy" concerns. And we will act early, well before symptoms appear, opting to tap the science of genomics and proteomics in order to mitigate our risks down the road.

Together, these tools will create a new opportunity and a new responsibility for people to act - to make health decisions well before they become patients. This can be characterized as a decision tree, a series of informed choices we will make to minimize uncertainty and optimize our outcomes. Indeed, we will use decision trees to navigate most of our health decisions, sometimes in overt ways - new decision support tools will both inform us and guide us, and they'll be steeped in statistics, predicition, and the power of collective experience.

These ideas have been discussed often here at Epidemix, but with this post they now become the central concerns of this blog. And thus, I've decided to retitle the blog - in a few days, I'll be transferring this blog to TheDecisionTree.com (though the other address will still bounce). There are obvious marketing/branding reasons for this - where this blog has lived a fairly secluded life as a public notepad, I hope that TheDecisionTree.com will take on a more prominent role in the broader discussion of predictive medicine and healthcare. And I think my blogging will improve (in verve if not quantity) with some clear focus, allowing the blog to become a more authoritative resource on these topics. But I also sincerely want to solicit the advice, opinions, and criticism of readers as I hash out the ideas that will emerge in the book. If the book celebrates the central values of early action and openness, I better be practicing those same values here (another central value, statistics, will be somewhat harder to loop in. But there are certain metrics -unique visitors, etc - that I certainly hope to see increase).

I'll post more details on the book itself in coming weeks. But suffice it to say that I'm very excited about it - I think it will lend a clarity of purpose and vision that's been missing from most discussions about personal genomics and predicitive/personalized medicine, and will point towards some compelling virtues and trade-offs that will come with the prospect of better healthcare. So please settle in for what I think will be a nifty exploration of some compelling ideas.