Reflections on Therapeutic
Interventions
Kieran J. Murphy MD FRCPC,FSIR.
Prof. Vice Chair Medical Imaging,
Director International Health Care
and Intellectual Property Strategy,
University of Toronto,
University Health Network
Canada.
What are the stupid things we have
done in the past or do today?
• Egaz Monitz received the Noble Prize in
1956 for the frontal Lobotomy.
• H Pylori
• IV Chemo
• AVM embolization?
• What Dogmas have changed in our life
time
Does Industry form our opinions
• Vioxx
• Premarin (44 ghost written review articles
in 2004 to 2009)
• Neurontin
• Kyphon (Garfin Spine)
• Hydro Coil? Aseptic meningitis and
hydrocephalus in unruptured aneurysms.
What forms our opinions?
• Medical devices Industry is $140 B per year
• 75% of Industry funded trials are Ghost
written
• 11% of New England Journal articles are
Ghost written
• 500M paid to Key orthopedic Spine opinion
leaders in 2008.
• $63 Million paid to ghost writers per year in
China alone.
What drives innovation
•
•
•
•
The innovation of the User
Clinical experience
Not saying NO.
Not giving a hoot about what is reimbursed
or what you administrators are going to
say.
• mimicking nature
.
An investigation of the intellectual
property contribution of the SIR’s
6000 strong membership
We cross referenced SIR membership
with the filings of the USPTO and PCT
fillings.
Frequency / Inventors
Patents
211
1
76
2
31
3
23
4
15
5
10
6
10
7
10
8
7
9
7
10
8
11
9
12
4
13
2
14
Frequency / Inventors
Patents
1
3
1
15
16
17
1
4
3
18
20
21
1
2
2
22
26
27
2
1
29
33
1
1
35
36
Frequency /
Inventors
Patent
s
Frequency /
Inventors
Patent
s
1
1
2
1
37
38
39
43
1
1
1
2
36
37
38
39
1
1
1
1
1
51
53
58
86
91
1
1
1
1
1
43
51
53
58
86
1
170
1
91
2
1
1
29
33
35
1
170
250
200
150
Se
100
50
0
1960 1964 1965 1966 1967 1968 1969 1970 1971 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Bone/Biopsy
14
12
10
8
Series1
6
4
2
0
1990
1992
1994
1996
1998
2000
2002
2004
2006
2008
2010
Stent
45
40
35
30
25
20
15
10
5
0
1970
1975
1980
1985
1990
1995
2000
2005
2010
2015
85
MRI
1990
1995
2000
2005
20
Embolization
1992
1994
1996
1998
2000
2002
2004
2006
2008
2
Ablation
25
20
15
10
5
0
1985
1990
1995
2000
2005
2010
Obesity
3.5
3
2.5
2
1.5
1
0.5
0
1990
1992
1994
1996
1998
2000
2002
2004
2006
2008
2010
250
200
150
Se
100
50
0
1960 1964 1965 1966 1967 1968 1969 1970 1971 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
IP is growing in Growing
•
•
•
•
Ablation
Endografts
Obesity
Combined Drug Devices
Educational Social network maps
What will drive innovation in the future?
Dissatisfaction with current dogma
Scoliosis
Mimicking Nature
Unmet clinical needs
The two needle technique
Stunning and illogical Ideas
Contained Intradiscal
3 cc Oxygen/Ozone Gas
CT Image of L2-L3 Disc of Patient 027
from the ActiveO Clinical Trial prior to
Ozone-Oxygen Gas Injection
CT Image of L2-L3 Disc of Patient 027
from the ActiveO Clinical Trial after
Ozone-Oxygen Gas Injection
Whats next, Where is the edge
•
•
•
•
The CSF space and stenting the aqueduct
Hydrocephalus
Stem cells in the cord
Intra ventricular TPA for IVH
What damage are we doing to
ourselves?
• What's the toll on us?
• How many of us get SVTs after NBCA or a
Vein of Galen embolization or a bad day?
• How many have autoimmune diseases?
• What's the radiation doing to us?
We do not all live in the same century.
We must not hoard knowledge
www. Osler.edu
Respectfully.
• Kieran.murphy@uhn.on.ca