Review: The Decision Tree (by Thomas Goetz)

My trail of discovery to The Decision Tree was as follows:

  • Discover Iodine’s in-browser medical translator, become fan for life.
  • Watch Iodine CEO’s (Thomas Goetz) TED talk on the problems with how medical information is currently presented, and his solution.  Become very impressed.
  • Discover Goetz has a whole book on this stuff.  Order from library.

This was maybe not have been the best order to do it in.  Decision Tree is really, really good, but it lacks the specificity of the TED talk or Iodine’s recent work.  If I’d read it first, the other work (which was produced later)  would have been fulfilling the promise of the book.  But reading it last, I kept waiting for the other shoe to drop.  It is an amazing launching pad, but I went in expecting to see what had landed.

That may not even be fair.  Goetz points to a lot of specific things, like the Quantified Self movement, PatientsLikeMe.com, and actual research on how Dr. Internet affects people.  It’s just that none of these so singularly improve the signal to noise ratio the way Goetz’s work on presentation of test metrics did.  I guess what I’m saying is you should watch that TED talk.

Now that I’m over the fact that Decision Tree is not a 250 page TED talk, I can appreciate it for what it is, which is a reasonable 101 text on the concept of individuals monitoring and improving their own health.  It doesn’t give many specifics for either of those because the answers are so specific and so personal, but it does leave the reader better prepared to evaluate possible solutions they find.   That’s actually pretty hard to do, and really useful.  I could also see it as useful for medical professionals who are on the fence about patient-driven care.*  It is extremely helpful in explaining why over-testing is so dangerous, while respecting individuals’ right to data.  And if you’re not reading it during or immediately after a painful, stressful medical procedure, it’s actually a pretty light read. So if this book looks interesting to you I’d recommend it.

*Goetz is unreservedly pro- patient led decision making and research.  I am too, until I remember a lot of the anti-vaxxers have put an enormous amount of research into their idiotic, dangerous, anti-social position.  I don’t know how to preserve the rights of me + my friends to know our own data and correct our doctors’ mistakes while preserving the rights of children to not die of entirely preventable diseases.

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