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  • So, well, I do applied math,

  • and this is a peculiar problem

  • for anyone who does applied math, is that

  • we are like management consultants.

  • No one knows what the hell we do.

  • So I am going to give you some -- attempt today

  • to try and explain to you what I do.

  • So, dancing is one of the most human of activities.

  • We delight at ballet virtuosos and tap dancers

  • you will see later on.

  • Now, ballet requires an extraordinary level of expertise

  • and a high level of skill,

  • and probably a level of initial suitability

  • that may well have a genetic component to it.

  • Now, sadly, neurological disorders such as Parkinson's disease

  • gradually destroy this extraordinary ability,

  • as it is doing to my friend Jan Stripling, who was

  • a virtuoso ballet dancer in his time.

  • So great progress and treatment has been made over the years.

  • However, there are 6.3 million people worldwide

  • who have the disease, and they have to live with

  • incurable weakness, tremor, rigidity

  • and the other symptoms that go along with the disease,

  • so what we need are objective tools

  • to detect the disease before it's too late.

  • We need to be able to measure progression objectively,

  • and ultimately, the only way we're going to know

  • when we actually have a cure is when we have

  • an objective measure that can answer that for sure.

  • But frustratingly, with Parkinson's disease

  • and other movement disorders, there are no biomarkers,

  • so there's no simple blood test that you can do,

  • and the best that we have is like

  • this 20-minute neurologist test.

  • You have to go to the clinic to do it. It's very, very costly,

  • and that means that, outside the clinical trials,

  • it's just never done. It's never done.

  • But what if patients could do this test at home?

  • Now, that would actually save on a difficult trip to the clinic,

  • and what if patients could do that test themselves, right?

  • No expensive staff time required.

  • Takes about $300, by the way,

  • in the neurologist's clinic to do it.

  • So what I want to propose to you as an unconventional way

  • in which we can try to achieve this,

  • because, you see, in one sense, at least,

  • we are all virtuosos like my friend Jan Stripling.

  • So here we have a video of the vibrating vocal folds.

  • Now, this is healthy and this is somebody making speech sounds,

  • and we can think of ourselves as vocal ballet dancers,

  • because we have to coordinate all of these vocal organs

  • when we make sounds, and we all actually

  • have the genes for it. FoxP2, for example.

  • And like ballet, it takes an extraordinary level of training.

  • I mean, just think how long it takes a child to learn to speak.

  • From the sound, we can actually track

  • the vocal fold position as it vibrates,

  • and just as the limbs are affected in Parkinson's,

  • so too are the vocal organs.

  • So on the bottom trace, you can see an example of

  • irregular vocal fold tremor.

  • We see all the same symptoms.

  • We see vocal tremor, weakness and rigidity.

  • The speech actually becomes quieter and more breathy

  • after a while, and that's one of the example symptoms of it.

  • So these vocal effects can actually be quite subtle,

  • in some cases, but with any digital microphone,

  • and using precision voice analysis software

  • in combination with the latest in machine learning,

  • which is very advanced by now,

  • we can now quantify exactly where somebody lies

  • on a continuum between health and disease

  • using voice signals alone.

  • So these voice-based tests, how do they stack up against

  • expert clinical tests? We'll, they're both non-invasive.

  • The neurologist's test is non-invasive. They both use existing infrastructure.

  • You don't have to design a whole new set of hospitals to do it.

  • And they're both accurate. Okay, but in addition,

  • voice-based tests are non-expert.

  • That means they can be self-administered.

  • They're high-speed, take about 30 seconds at most.

  • They're ultra-low cost, and we all know what happens.

  • When something becomes ultra-low cost,

  • it becomes massively scalable.

  • So here are some amazing goals that I think we can deal with now.

  • We can reduce logistical difficulties with patients.

  • No need to go to the clinic for a routine checkup.

  • We can do high-frequency monitoring to get objective data.

  • We can perform low-cost mass recruitment for clinical trials,

  • and we can make population-scale screening

  • feasible for the first time.

  • We have the opportunity to start to search

  • for the early biomarkers of the disease before it's too late.

  • So, taking the first steps towards this today,

  • we're launching the Parkinson's Voice Initiative.

  • With Aculab and PatientsLikeMe, we're aiming

  • to record a very large number of voices worldwide

  • to collect enough data to start to tackle these four goals.

  • We have local numbers accessible to three quarters

  • of a billion people on the planet.

  • Anyone healthy or with Parkinson's can call in, cheaply,

  • and leave recordings, a few cents each,

  • and I'm really happy to announce that we've already hit

  • six percent of our target just in eight hours.

  • Thank you. (Applause)

  • (Applause)

  • Tom Rielly: So Max, by taking all these samples of,

  • let's say, 10,000 people,

  • you'll be able to tell who's healthy and who's not?

  • What are you going to get out of those samples?

  • Max Little: Yeah. Yeah. So what will happen is that,

  • during the call you have to indicate whether or not

  • you have the disease or not, you see. TR: Right.

  • ML: You see, some people may not do it. They may not get through it.

  • But we'll get a very large sample of data that is collected

  • from all different circumstances, and it's getting it

  • in different circumstances that matter because then

  • we are looking at ironing out the confounding factors,

  • and looking for the actual markers of the disease.

  • TR: So you're 86 percent accurate right now?

  • ML: It's much better than that.

  • Actually, my student Thanasis, I have to plug him,

  • because he's done some fantastic work,

  • and now he has proved that it works over the mobile telephone network as well,

  • which enables this project, and we're getting 99 percent accuracy.

  • TR: Ninety-nine. Well, that's an improvement.

  • So what that means is that people will be able to

  • ML: (Laughs)

  • TR: People will be able to call in from their mobile phones

  • and do this test, and people with Parkinson's could call in,

  • record their voice, and then their doctor can check up

  • on their progress, see where they're doing in this course of the disease.

  • ML: Absolutely.

  • TR: Thanks so much. Max Little, everybody.

  • ML: Thanks, Tom. (Applause)

So, well, I do applied math,

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B1 US TED parkinson disease vocal ballet test

【TED】Max Little: A test for Parkinson's with a phone call (Max Little: A test for Parkinson's with a phone call)

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    VoiceTube posted on 2013/03/11
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