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  • Translator: Joseph Geni Reviewer: Camille Martínez

    翻訳: Eriko Tsukamoto 校正: Moe Shoji

  • I have a tendency to assume the worst,

    私は つい最悪の事態を 想定してしまうのですが

  • and once in a while, this habit plays tricks on me.


  • For example, if I feel unexpected pain in my body

    例えば 突然 身体に

  • that I have not experienced before and that I cannot attribute,

    今まで感じたことのない 原因不明の痛みを感じ

  • then all of a sudden, my mind might turn a tense back into heart disease

    突然 背中の痛みを心臓病だと思ったり

  • or calf muscle pain into deep vein thrombosis.

    脹脛の痛みを深部静脈血栓症だと 思い込んだりするんです

  • But so far, I haven't been diagnosed with any deadly or incurable disease.

    でも まだ致命的な不治の病を 宣告されたことはありませんよ

  • Sometimes things just hurt for no clear reason.

    身体は時々 訳もなく 痛んだりするものです

  • But not everyone is as lucky as me.

    でも 私のように 幸運な人ばかりではありません

  • Every year, more than 50 million people die worldwide.

    世界中で 毎年 5千万人以上が亡くなっています

  • Especially in high-income economies like ours,

    特に このような高所得経済では

  • a large fraction of deaths is caused by slowly progressing diseases:

    死因の大半は ゆっくりと進行する慢性病です

  • heart disease, chronic lung disease, cancer, Alzheimer's, diabetes,

    心疾患、慢性肺疾患、がん アルツハイマー病、糖尿病

  • just to name a few.


  • Now, humanity has made tremendous progress in diagnosing and treating many of these.

    人類は こうした病気の多くの 診断と治療において大きく進歩してきました

  • But we are at a stage where further advancement in health

    しかし いま 私たちは 新たな治療法を生み出すだけでは

  • cannot be achieved only by developing new treatments.

    ヘルスケアが もはやこれ以上 進歩できない段階に来ています

  • And this becomes evident when we look at one aspect

    このことは これらの疾患の多くに

  • that many of these diseases have in common:


  • the probability for successful treatment

    それは 治療が奏功する確率が

  • strongly depends on when treatment is started.

    その開始時期に 大きく左右されるということです

  • But a disease is typically only detected once symptoms occur.

    しかし通常 疾患は 症状が現れてからしか 見つからないものです

  • The problem here is that, in fact, many diseases can remain asymptomatic,

    問題は 多くの疾患では 症状が現れないこともあるため

  • hence undetected, for a long period of time.

    長い間 見過ごされ 診断されないことです

  • Because of this, there is a persisting need for new ways

    このために 症状が現れるずっと前に

  • of detecting disease at early stage,

    疾患を早期発見する 新しい診断方法が必要なのです

  • way before any symptoms occur.

    疾患を早期発見する 新しい診断方法が必要なのです

  • In health care, this is called screening.

    医療ではこれを 「スクリーニング」と呼びます

  • And as defined by the World Health Organization,

    世界保健機関の定義によると スクリーニングとは

  • screening is "the presumptive identification of unrecognized disease

    「まだ罹患しているか 確かでない疾患の推定を

  • in an apparently healthy person,

    一見 健康な人について

  • by means of tests ... that can be applied rapidly and easily ..."

    迅速かつ簡易に行える 診断技術を用いて行う」ことです

  • That's a long definition, so let me repeat it:

    長々しい定義ですね もう一度言います

  • identification of unrecognized disease

    まだ罹患しているか 確かでない疾患の推定を

  • in an apparently healthy person

    一見 健康な人について

  • by means of tests that can be applied both rapidly and easily.

    迅速かつ簡易に行える 診断技術を用いて行う」

  • And I want to put special emphasis on the words "rapidly" and "easily"

    この「迅速」かつ「簡易に」 という言葉に注目してください

  • because many of the existing screening methods


  • are exactly the opposite.


  • And those of you who have undergone colonoscopy


  • as part of a screening program for colorectal cancer

    内視鏡検査を受けた方には 私が言いたいことが

  • will know what I mean.


  • Obviously, there's a variety of medical tools available

    もちろん 色々な医療ツールで

  • to perform screening tests.


  • This ranges from imaging techniques such as radiography


  • or magnetic resonance imaging


  • to the analysis of blood or tissue.


  • We have all had such tests.

    皆 一度は受けたことがあるものです

  • But there's one medium that for long has been overlooked:

    でも実は 今まで 見過ごされてきた媒体があります

  • a medium that is easily accessible,


  • basically nondepletable,


  • and it holds tremendous promise for medical analysis.

    医療分析へ活用できる 大きな可能性を秘めている―

  • And that is our breath.


  • Human breath is essentially composed of five components:

    ヒトの息は 主に5つの要素で 構成されています

  • nitrogen, oxygen, carbon dioxide, water and argon.

    窒素、酸素、二酸化炭素 水とアルゴンです

  • But besides these five, there are hundreds of other components

    その他にも 数百もの要素が

  • that are present in very low quantity.


  • These are called volatile organic compounds,


  • and we release hundreds, even thousands of them


  • every time we exhale.

    これらを数百から数千 放出しています

  • The analysis of these volatile organic compounds in our breath


  • is called breath analysis.


  • In fact, I believe that many of you have already experienced breath analysis.

    実は おそらく皆さんの多くは すでに呼気分析を経験したはずです

  • Imagine: you're driving home late at night,

    例えば あなたが夜遅く 車を運転して家路についていると

  • when suddenly, there's a friendly police officer

    突然 フレンドリーな警官が

  • who asks you kindly but firmly

    丁寧な でも断固とした口調で あなたに停車を求め

  • to pull over and blow into a device like this one.

    このようなデバイスに 息を吹きかけるように言います

  • This is an alcohol breath tester


  • that is used to measure the ethanol concentration in your breath

    息に含まれるエタノール濃度を 測るのに使われ

  • and determine whether driving in your condition is a clever idea.

    その状態で運転するべきかどうかを 判断するのです

  • Now, I'd say my driving was pretty good,


  • but let me check.


  • (Beep)


  • 0.0, so nothing to worry about, all fine.

    「0.0」つまり 何も心配ないということです

  • (Laughter)


  • Now imagine a device like this one,


  • that does not only measure alcohol levels in your breath,


  • but that detects diseases like the ones I've shown you

    先ほど紹介したような疾患や もっと多様な疾患を

  • and potentially many more.


  • The concept of correlating the smell of a person's breath

    ヒトの呼気の匂いと ある疾患に罹患した状態の

  • with certain medical conditions,


  • in fact, dates back to Ancient Greece.

    実は 古代ギリシャまで遡ります

  • But only recently, research efforts on breath analysis have skyrocketed,

    しかし やっと最近になって 呼気分析研究が盛んになり

  • and what once was a dream is now becoming reality.

    以前は夢だったものが 現実になりつつあります

  • And let me pull up this list again that I showed you earlier.


  • For the majority of diseases listed here,


  • there's substantial scientific evidence


  • suggesting that the disease could be detected by breath analysis.


  • But how does it work, exactly?


  • The essential part is a sensor device


  • that detects the volatile organic compounds in our breath.

    呼気中の揮発性有機化合物を 検知します

  • Simply put: when exposed to a breath sample,

    簡潔に説明すると センサーが息を検知すると

  • the sensor outputs a complex signature

    呼気に含まれる 揮発性有機化合物を表す

  • that results from the mixture of volatile organic compounds that we exhale.


  • Now, this signature represents a fingerprint of your metabolism,

    このシグネチャーは 人それぞれ固有の情報を含んでおり

  • your microbiome

    代謝や細菌叢、体内で起こる 生化学的プロセスを表すものです

  • and the biochemical processes that occur in your body.

    代謝や細菌叢、体内で起こる 生化学的プロセスを表すものです

  • If you have a disease,


  • your organism will change,


  • and so will the composition of your exhaled breath.


  • And then the only thing that is left to do is to correlate a certain signature


  • with the presence or absence of certain medical conditions.


  • The technology promises several undeniable benefits.

    この技術には確実な利点が いくつかあります

  • Firstly, the sensor can be miniaturized


  • and integrated into small, handheld devices


  • like this alcohol breath tester.


  • This would allow the test to be used in many different settings

    これで検査を様々な場所で 行うことができます

  • and even at home,


  • so that a visit at the doctor's office

    検査のたびに 病院へ行かなくても済みます

  • is not needed each time a test shall be performed.

    検査のたびに 病院へ行かなくても済みます

  • Secondly, breath analysis is noninvasive

    次に 呼気分析は非侵襲的です

  • and can be as simple as blowing into an alcohol breath tester.

    アルコール検知器に息を吹きかけるだけの 簡単なものだからです

  • Such simplicity and ease of use would reduce patient burden

    こうした単純さと簡便さは 患者の負担を軽減し

  • and provide an incentive for broad adoption of the technology.


  • And thirdly, the technology is so flexible

    第三に この技術は柔軟性が高く

  • that the same device could be used


  • to detect a broad range of medical conditions.


  • Breath analysis could be used to screen for multiple diseases at the same time.

    呼気分析は同時に複数の疾患を スクリーニングすることもできます

  • Nowadays, each disease typically requires a different medical tool

    こんにち 疾患の診断では それぞれ独自の医療診断ツールで

  • to perform a screening test.


  • But this means you can only find what you're looking for.

    これでは探しているものしか 見つかりません

  • With all of these features, breath analysis is predestined

    従来のスクリーニングテストの 多くに欠けているものを

  • to deliver what many traditional screening tests are lacking.


  • And most importantly,


  • all of these features should eventually provide us

    これら全ての機能によって いずれ

  • with a platform for medical analysis

    魅力的な低コストで診断分析をする プラットフォームが生まれるでしょう

  • that can operate at attractively low cost per test.

    魅力的な低コストで診断分析をする プラットフォームが生まれるでしょう

  • On the contrary, existing medical tools

    逆に 既存の医療技術では

  • often lead to rather high cost per test.


  • Then, in order to keep costs down,

    ならば コストを抑えるために

  • the number of tests needs to be restricted,


  • and this means (a) that the tests can only be performed

    それでは 検査は ごく限られた人々ー

  • on a narrow part of the population, for example, the high-risk population;

    例えば 高リスクな人々だけに 実施されることになり

  • and (b) that the number of tests per person needs to be kept at a minimum.

    そして 1人あたりの検査の数は 最小限に留めなければなりません

  • But wouldn't it actually be beneficial


  • if the test was performed on a larger group of people,

    より多くの人口に 頻繁に 長期間に渡って行われたら

  • and more often and over a longer period of time for each individual?


  • Especially the latter would give access to something very valuable


  • that is called longitudinal data.


  • Longitudinal data is a data set that tracks the same patient

    縦断的データは同じ患者を 何ヶ月あるいは何年も

  • over the course of many months or years.


  • Nowadays, medical decisions are often based on a limited data set,

    現在 医療現場での決断は 限られたデータセットに基づいており

  • where only a glimpse of a patient's medical history


  • is available for decision-making.


  • In such a case,


  • abnormalities are typically detected


  • by comparing a patient's health profile


  • to the average health profile of a reference population.


  • Longitudinal data would open up a new dimension

    それに対して 縦断的データは新たな次元で

  • and allow abnormalities to be detected


  • based on a patient's own medical history.

    異常を検知することを 可能にするでしょう

  • This will pave the way for personalized treatment.

    これが個別化された治療への 扉をひらきます

  • Sounds pretty great, right?


  • Now you will certainly have a question that is something like,


  • "If the technology is as great as he says, then why aren't we using it today?"

    「本当にそんなに凄い技術なら どうして今使われていないんだろう?」

  • And the only answer I can give you is:

    ここで言える たったひとつの答えは

  • not everything is as easy as it sounds.


  • There are technical challenges, for example.

    例えば 技術的な課題もあります

  • There's the need for extremely reliable sensors


  • that can detect mixtures of volatile organic compounds


  • with sufficient reproducibility.


  • And another technical challenge is this:


  • How do you sample a person's breath in a very defined manner

    どのようにすれば 分析結果に影響しないような方法で

  • so that the sampling process itself


  • does not alter the result of the analysis?


  • And there's the need for data.


  • Breath analysis needs to be validated in clinical trials,

    呼気分析は臨床試験で 実証されなければならず

  • and enough data needs to be collected


  • so that individual conditions can be measured against baselines.

    ベースラインに照らし合わせて 個人の状態を測るためです

  • Breath analysis can only succeed


  • if a large enough data set can be generated


  • and made available for broad use.


  • If breath analysis holds up to its promises,


  • this is a technology that could truly aid us


  • to transform our health care system --


  • transform it from a reactive system

    疾患の症状に反応して始まる リアクティブ(反応的)な治療から

  • where treatment is triggered by symptoms of disease

    疾患の症状に反応して始まる リアクティブ(反応的)な治療から

  • to a proactive system,


  • where disease detection, diagnosis and treatment

    早期に疾患の検知、診断、治療を行う プロアクティブ(積極的)なものへと

  • can happen at early stage,

    早期に疾患の検知、診断、治療を行う プロアクティブ(積極的)なものへと

  • way before any symptoms occur.


  • Now this brings me to my last point, and it's a fundamental one.


  • What exactly is a disease?


  • Imagine that breath analysis can be commercialized as I describe it,


  • and early detection becomes routine.


  • A problem that remains is, in fact, a problem


  • that any screening activity has to face


  • because, for many diseases,


  • it is often impossible to predict with sufficient certainty

    その疾患が何らかの症状を伴うか あるいは患者の命に関わるかを

  • whether the disease would ever cause any symptoms


  • or put a person's life at risk.


  • This is called overdiagnosis,


  • and it leads to a dilemma.


  • If a disease is identified,


  • you could decide not to treat it


  • because there's a certain probability that you would never suffer from it.

    一定の確率で それが無害なことがあるからです

  • But how much would you suffer

    でも 致命的かもしれない病気に

  • just from knowing that you have a potentially deadly disease?

    自分が罹っていると知るだけで どれほど苦しむことでしょう?

  • And wouldn't you actually regret that the disease was detected


  • in the first place?


  • Your second option is to undergo early treatment

    2つめの選択肢は 完治する希望を持って

  • with the hope for curing it.


  • But often, this would not come without side effects.

    しかし治療は往々にして 副作用をもたらすものです

  • To be precise:


  • the bigger problem is not overdiagnosis,

    過剰診断よりも問題なのは 「過剰な治療」なんです

  • it's overtreatment,

    過剰診断よりも問題なのは 「過剰な治療」なんです

  • because not every disease has to be treated immediately

    なぜなら治療ができるからといって 全ての疾患がすぐさま

  • just because a treatment is available.

    治療されねばならない 訳ではないからです

  • The increasing adoption of routine screening


  • will raise the question:


  • What do we call a disease that can rationalize treatment,

    治療するのが正当な疾患を 何と呼べばいいのか

  • and what is just an abnormality that should not be a source of concern?

    そして心配のいらない異常は 何と呼ぶべきなのか?

  • My hopes are that routine screening using breath analysis

    私の期待は 呼気分析を用いた定期検診が

  • can provide enough data and insight


  • so that at some point, we'll be able to break this dilemma

    いつか このジレンマを解決し

  • and predict with sufficient certainty

    早期治療をするべきなのか いつするべきなのかを

  • whether and when to treat at early stage.

    十分な精度で 予測できるようになることです

  • Our breath and the mixture of volatile organic compounds that we exhale

    私たちの呼気と 揮発性有機化合物は

  • hold tremendous amounts of information on our physiological condition.

    私たちの生理的状態について 膨大な量の情報を含んでいます

  • With what we know today, we have only scratched the surface.

    現在分かっていることは ほんの表層に過ぎません

  • As we collect more and more data and breath profiles across the population,

    性別、年齢、ルーツ、生活様式などが 多様なサンプルから

  • including all varieties of gender, age, origin and lifestyle,

    データや呼気プロファイルを 更に集めることで

  • the power of breath analysis should increase.


  • And eventually, breath analysis should provide us with a powerful tool

    そして最終的に 呼気分析は 特定の疾患を積極的に検知するだけでなく

  • not only to proactively detect specific diseases

    疾患を予測して 究極には予防するための

  • but to predict and ultimately prevent them.


  • And this should be enough motivation

    これは呼気分析から得られる 機会と課題を

  • to embrace the opportunities and challenges

    フルに活かそうという 十分な動機になるはずです

  • that breath analysis can provide,

    フルに活かそうという 十分な動機になるはずです

  • even for people that are not part-time hypochondriacs like me.

    私のような心気症者以外の 皆さんにとっても

  • Thank you.


  • (Applause)


Translator: Joseph Geni Reviewer: Camille Martínez

翻訳: Eriko Tsukamoto 校正: Moe Shoji


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B1 中級 日本語 TED 診断 分析 治療 スクリーニング 検査

TED】Julian Burschka.あなたの呼吸があなたの健康について明らかにすることができること (What your breath could reveal about your health | Julian Burschka) (【TED】Julian Burschka: What your breath could reveal about your health (What your breath could reveal about your health | Julian Bursch

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    林宜悉 に公開 2021 年 01 月 14 日