1. BIOE 301 Lecture Seven

2. Four Questions What are the problems in healthcare today? Who pays to solve problems in healthcare? How can we use science and technology to solve healthcare problems? Once developed, how do new healthcare technologies move from the lab to the bedside?

3. The Project – Part One Write an editorial advocating a change in public health policy Identify an important health problem Carry out research to understand scope of problem and limitations of current health technologies Propose a policy change to develop and/or implement solutions to the health problem Write an editorial in support of your policy

4. Project – Part One Medline http://www.rice.edu/fondren/ Sample editorials http://www.oneworld.net/article/view/71857/ 1/5294 http://www.oneworld.net/article/view/71857/ 1/5294 http://www.washingtonpost.com/wp- dyn/content/article/2006/01/10/AR200601100 1542.html http://www.washingtonpost.com/wp- dyn/content/article/2006/01/10/AR200601100 1542.html http://www.economist.com/opinion/displaySto ry.cfm?Story_id=4221484&CFID=61903351& CFTOKEN=519df0b-32e6754a-5419-44a1- a79a-a9bf34a378b2 http://www.economist.com/opinion/displaySto ry.cfm?Story_id=4221484&CFID=61903351& CFTOKEN=519df0b-32e6754a-5419-44a1- a79a-a9bf34a378b2

5. Ovary

6. Three Case Studies Prevention of infectious disease HIV/AIDS Early detection of cancer Cervical Cancer Ovarian Cancer Prostate Cancer Treatment of heart disease Atherosclerosis and heart attack Heart failure

7. Today: The process of developing a new medical technology

8. Science of Understanding Disease Emerging Health Technologies Preclinical Testing Clinical Trials Adoption & Diffusion Abandoned due to: poor performance safety concerns ethical concerns legal issues social issues economic issues Bioengineering Ethics of research Cost-Effectiveness

9. Class Activity #1 – Gene Therapy Directions: Place the articles in correct chronological order Contextual clues in the selections Your knowledge of the science of DNA and genes Your recollection of events in the media. Articles reflect current thought for the time First article published in 1953; the last in 2003 Discuss in group; come to consensus Choose one member of your group to speak Did your ideas about the sequence match each other? What clues or events prompted you to make choice? Do not discuss your ideas with other groups

10. Science of Understanding Disease Emerging Health Technologies Preclinical Testing Clinical Trials Adoption & Diffusion Abandoned due to: poor performance safety concerns ethical concerns legal issues social issues economic issues Bioengineering Ethics of research Cost-Effectiveness

11. Question: What is the difference between science and engineering?

12. Definitions Science Body of knowledge about natural phenomena which is: Well founded Testable Purpose is to discover, create, confirm, disprove, reorganize, and disseminate statements that accurately describe some portion of physical, chemical, biological world “Science is the human activity of seeking natural explanations for what we observe in the world around us.”

13. Definitions Engineering Systematic design, production and operation of technical systems to meet practical human needs under specified constraints Time $$ Performance Reliability “Engineering... in a broad sense... is applying science in an economic manner to the needs of mankind “

14. Definitions What is the difference between science and engineering? Science Inquiry to better understand world around us No practical goal necessary Engineering Use of science to solve real world problem in practical way

15. Engineering Design Method Fashioning a product made for a practical goal in the presence of constraints Six design steps: 1. Identify a need 2. Define the problem (goals, constraints) 3. Gather information 4. Develop solutions 5. Evaluate solutions 6. Communicate results Papers, patents, marketing Refine Design SPECS FMEA

16. Class Activity #2 – Take Apart Directions: You have been given a piece of equipment Disassemble the equipment Lay out the pieces in a way that shows the inter-relationships between the parts What are the primary constraints you think the designers were trying to satisfy?

17. Example: Cervical cancer detection Science of precancer Engineering solutions for precancer detection 1. Identify a need 2. Define the problem (goals, constraints) 3. Gather information 4. Develop solutions 5. Evaluate solutions 6. Communicate results

18. Science of Precancer Normal Cervical Tissue Cervical Pre-Cancer Diagnosis based on morphologic features –Nuclear size, shape, texture –Nuclear-to-cytoplasmic ratio

19. AcceptedLight RejectedPlaneImagePlane Webb, J. Investigative Dermatology,1995 Technology: Confocal Microscopy Point Source IlluminationBeamsplitter Detector Pinhole Sample RejectedLight

20. Example: Cervical cancer detection Science of precancer Engineering solutions for precancer detection 1. Identify a need 2. Define the problem (goals, constraints) 3. Gather information 4. Develop solutions 5. Evaluate solutions 6. Communicate results

21. Confocal Microscope

22. Normal CervixAbnormal Cervix Imaging Endogenous Contrast

23. LEEP Study

24. In Vivo Fiber Optic Confocal Microscope Miniature Objective 7 mm outer diameter 22 mm long Liang et al., Appl. Opt., 2002.

25. Portable system for clinical studies

26. Miniature Microscopes Collaboration with M. Descour

28. Example: Cervical cancer detection Science of precancer Engineering solutions for precancer detection 1. Identify a need 2. Define the problem (goals, constraints) 3. Gather information 4. Develop solutions 5. Evaluate solutions 6. Communicate results

29. Journal Article

30. Patent www.uspto.gov Diagnostic Imaging Patent

31. The Project – Part Two Design a new technology to solve a health problem and present a mock design of the new technology Define the problem Define the constraints Develop an alternative solution that meets the constraints Construct a prototype - Materials costs <$10 Communicate results for an in class demonstration and design review

32. Summary of Lecture 7 Science “Science is the human activity of seeking natural explanations for what we observe in the world around us.” Engineering Systematic design, production and operation of technical systems to meet practical human needs under specified constraints Six steps of the engineering design method

33. Assignments Due Next Time Project 2