Monthly Archives: November 2023

Abstract

Respondents evaluated systematically created vignettes, viz., combinations of elements (messages) about benefits to going to their doctor for a yearly check-up. The vignettes comprised 2-4 elements selected from the set of 16 elements, with the vignettes created by experimental design which ensured both that the elements did not mutually contradict each other, and that the elements were statistically independent of each other. Each of 101 US respondents evaluated a unique set of 24 vignettes, following the standard test protocol used in the emerging science of Mind Genomics. Respondents rated these vignettes on a two-sided scale of motivation and believability. Based upon the pattern of coefficients for equations relating elements to the rating of ‘motivates me’, three clearly different mind-sets emerged; respectively, those focusing on the visit to assess the growth of children, those focusing on obtaining their vital measures and advice about eating, and those focus on advice from the doctor about what to do to maintain an active lifestyle. In contrast, self-profiling classification of attitudes could not uncover these three clearly different and intuitively meaningful mind-sets. The paper finishes by introducing the PVI, personal viewpoint identifier, comprising six elements from the study, a two-point scale, the pattern of answers to which assigned a new person to one of the three mind-sets.

Background

The objective of this paper is the continuing effort of an emerging science, Mind Genomics, to understand how people perceive the world of the ordinary, how people make decisions, and perhaps most important, the existence of and nature of different ways that ordinary people look at topics of their everyday world. Rather than focusing on unusual situations to increase our understanding, Mind Genomics focuses on the daily, quotidian world, in which most people live.

The particular topic dealt with here is the understanding of what ordinary people look for when they think about what is important to the when they make their regular appointments to see their doctor. The notion of regular appointments may seem obvious, but if we were to probe more deeply into the topic, might we end up seeing deep differences which make sense, differences that we intuitively know, but differences which when recognized allow the visit to the doctor to be much more effective for both patient and doctor A simple Google Scholar® query about ‘attitudes regarding ‘attitudes about yearly check up visits to the doctor’ generated 90,400 hits as of October 16, 2023. Many more hits 384,000, emerged when the query was ‘what patients want from doctors during their annual visit’. For Google itself, there were upwards of 400,00 hits. Clearly this is an important topic to people.

The approach present here, Mind Genomics, provides the researcher with the opportunity to structure a situation of the ordinary life, so that situation can be explored with ordinary people, an exploration that can be done in a matter of hours and days, at an affordable price, in a structured, templated fashion anywhere in the world, and with powerful knowledge and tools emerging from the exercise [1,2]. The objective is to see whether or now the Mind Genomics science can produce new-to-the-world information in hours and days, teaching the profession new things, providing new tools for the world of health.

Doing the Study

The Mind Genomics approach works by creating vignettes, combinations of ideas pertaining to the topic, instructing the respondents to rate these vignettes on a scale, and then deconstructing the rating to estimate the contribution of each of the ideas or elements to the overall rating. The rationale for this ‘indirect’ approach is that the test stimuli more naturally approximate what the person might experience in everyday life. Rather than having the respondent evaluate ideas one by one, as is done in typical questionnaires, Mind Genomics reduces the intellectual burden by simply having the respondent respond with an immediate feeling to what is read.

The nature of the stimuli, these vignettes, deserves explication because of the power of the approach:

The vignettes evaluated by the respondents are created by so-called experimental design. The experimental design prescribes the precise combination of elements to appear in each vignette. The use of experimental design to create the combinations means that each respondent’s data can be analyzed totally separately, for that respondent, OR incorporated into an analysis for a defined group of respondents. This is called a ‘within-subjects design,’ and constitutes a powerful features for analysis.
Each respondent evaluates a totally different set of vignettes, the totally different sets created by a systematic permutation of the elements, with the statistical properties of the underlying experimental design maintained [3]. Thus, the researcher can do studies on topics without having had to plan for a long time in order to make sure that the testing is done on the ‘right’ vignettes. Mind Genomics encourages the researcher to ‘do the experiment’ rather than be subject to paralysis, to the overthinking captured by the popular adage ‘measure nine times and cut once.’ Mind Genomics encourages experimentation, not over-thinking, and as we will see below, prevents ’analysis paralysis.’
The respondent is given 24 vignettes to evaluate, one vignette after the other. The underlying experimental design prescribes the combinations. The respondent need only read and react to the vignette. The vignette is created to be simple, comprising a set of phrases, the elements, one phrase on each line, without connecting words which end up cluttering. The structure enables the respondent to ‘graze’ through the information and assign a rating. The structure also ends up being less ‘taxing’ on the respondent because the physical format of the vignette, one line (approximately) per element, requires less effort. Figure 1 shows the distribution of responses times with response times of 9 seconds or longer truncated to 9 seconds. It is clear from Figure 1 that the respondents appeared to be able to assess and rate the vignette very easily. Most of the responses times are three seconds or shorter. Whether or not the data are ‘valid’, make sense, and teach us will be discussed below.
The use of compound vignettes comprising different elements ensures that it is impossible to ‘game the system.’ In study after study, the desire to game the system emerges among academics and professionals, who feel stymied, complaining that they could not ascertain the ‘correct answer.’ It is the combinations of elements of different kinds which creates seeming a ‘blooming, buzzing confusion, ‘ in the words of Harvard’s eminent, late 19^th Century psychologist, William James..

Figure 1: Distribution of response times across all vignettes evaluated in positions 2-24

The Mechanics of Creating the elqements and the Test Vignettes

The actual construction of the study by the researcher is straightforward. The researcher follows a set of templated steps, the first being a request for four questions which explore the topic, and the second being the request for four answers to each question. When first confronted with the task of choosing a topic and then asking four questions which ‘tell a story’ or at least ‘flesh out the topic’, the unpracticed researcher in Mind Genomics finds it easy to choose a topic but becomes flustered when requested to ask four questions which ‘tell a story.’ Simply put, the education that people receive all too often focuses on choosing the right answer, or even coming up with an answer to a question. The ‘thinking’ is structured, and not necessarily good. Memory and perhaps judgment are rewarded, but not the ability to create a new edifice to house knowledge. It is at this point, the request for the four questions, that many would-be researchers ‘freeze’, often abandoning the effort in anticipated frustration.

Figure 2 shows an example of the templated format for a typical study. Panel A at the top shows the screen shots for the four questions. This is the point at which the excitement may turn to dismay. Panel B shows the Idea Coach, with a box encouraging the researcher to write a short paragraph, a ‘squib’ in Mind Genomics language. The squib provides a chance for the researcher to describe the problem in detail, and specify the nature of the answers, both in terms of tonality (explanation vs list), and in terms of style (approximate number of words, reading level, etc.). Panel C shows the types of answers returned by the Idea Coach. The actual results, viz., questions, answers (elements), and results, will constitute the remaining topics of this paper.

Figure 2: A typical set-up template for questions showing where Idea Coach enters and can be invoked. The actual text for the Idea Coach query and the four questions returned by AI are specific to the study.

The AI-enhanced feature of the Mind Genomics platform in BimiLeap.com.com is called Idea Coach. With Idea Coach, the researcher simply types in a paragraph about the topic(called here ‘squib’) , requesting questions to be asked. The Idea Coach returns with 15 questions, and later with an AI-summarization of the themes and other features of those 15 questions. The researcher selects the questions which are of interest or can request a ‘re-run’ of the Idea Coach for another 15 questions. Furthermore, the researcher can modify the paragraph to change the direction of the underlying AI as that AI attempts to create the questions.

Table 1 present the first set of 15 questions, along with the subsequent AI based summarization of patterns in these 15 questions The 15 questions appear immediately, but the AI summarized appears later, after the researcher has completed the selection of questions and answers. When looking at Table 1, one can focus on the original paragraph, the questions, and then the different types of AI summarization. These questions, or more specifically the answer book of ‘logical pages,’ one page for each request for questions (and later for answers to the questions), provides an education in and of itself.

Table 1: Results from the first effort to create 15 questions

The ingoing questions posed by the researcher are the following: Topic: We’re having a problem. We don’t know how to get patients to come back for yearly visits. How can we communicate with our patients to convince them that’s it’s important to come back? Make the questions more of explanations than just a list. Make the questions understandable to a 10-year-old. Make the questions 20 words or fewer.

When looking at the ‘top’, viz. query, it is important to keep in mind that the researcher guided the AI by giving the AI specifics. These specifics describe the topic (get patients to come back), the specific problem (how can we communicate that it’s important), how to shade the question (make the questions more of explanations than just a list), how to ensure the question is understandable (understandable to a 10-year-old), and readable (20 words or fewer). Table 1 shows the success of this effort as well as the aforementioned summarization by AI. It is important to note that the actual effort generated several of these pages, because the research was geared both to answering a question and to learning about the topic. Table 1 is meant just as an example; the final four questions were selected from different iterations of Idea Coach, each iteration taking about 15 seconds.

The final questions selected were then used as inputs to Idea Coach. Once again, each iteration focused on generating 15 answers to the specific question. The answers were obtained from Idea Coach, put into the study, and then edited manually to correct the grammar, and to make the answer simple. Table 2 show a set of answers to one question.

Table 2: Results from the first effort to create 15 answers to the first question

It is important to keep in mind that that the Idea Coach, empowered by AI, becomes itself a tool to teach the researcher. Thus, what had started as a seeming insurmountable obstacle at the time Mind Genomics was born, the issue of thinking about questions and answers, ended up generating an additional and powerful benefit, viz., education at the early stage of thinking, even before the experiment is actually run with real people.

The final set of questions and answers appear in Table 3. Keep in mind that Table 2 presents the actual questions used to generate the different answers, as well as presenting the edited answers; the editing was done by the researcher before the study was run. This process ensures simple questions, simple answers, both short, and understandable to the respondent. In the actual experiment the respondent will only see combinations of answers, and never see the questions. The role of the question is only to generate the answers, either from AI or from the mind of the researcher. One final note is relevant here. Experience shows that this process ends up educating the researcher quickly on the topic, often resulting in the desire for the researcher to put in her or his own ideas rather than relying on the AI. That itself, the creation of confidence and excitement, becomes a strong reason for using the Idea Coach.

Table 3: The four questions and their four sets of answers used in the study

The Rating Scale

The main focus of this study is on the degree to which the messages motivate the respondent, at least within this format. We do not know what the respondent will actually do when giving the messages, although previous studies in the medical world have shown that the proper messages can double the number of colonoscopies [4] , as well as substantially reduce the number of within-30-day-readmissions to the hospital for patients who were suffering from CHF (congestive heart failure) [5].

The opportunity to investigate two aspects of messaging, e.g., motivation and believability, has emerged as a way of increasing the usefulness of the Mind Genomics experiment. To this end, the research used a two-sided five-point scale, a new approach in Mind Genomics. The points on the rating scale enable the respondent to rate both motivating (no/yes) and believable (no/yes). The scale below shows these two sides, and the frequency of their selection across the 2424 vignettes, evaluated by the 101 respondents.

Rating question: Think about going to the doctor. Here’s a paragraph about a visit. How do you feel personally when you read this paragraph Choose how you feel.

Scale Points

1=Does not motivate me…AND…I have no emotional response to it 11.7%

2=Does not motivate me…BUT…I get an emotional response when I read it 10.8%

3=I can’t answer 18.8%

4=Motivates me…BUT…I have no emotional response to it 28.2%

5=Motivates me…AND…I get an emotional response when I read it 30.4%

A separate part of the Mind Genomics experience required the completion of a self-profiling questionnaire, allowing the research to obtain information about the attitudes and behaviors. These questions and answers are shown in Table 4. The respondent was present with each question separately, in a ‘pull down menu’, showing the question and the different answers. The respondent was instructed to select one answer for each question.

Table 4: The self-profiling classification questions

Executing the Study

The actual study is executed in a straightforward manner. The Mind Genomics platform, BimiLeap, enables the researcher to select the respondents, their location, age, etc., through a built-in API linked to the panel provider, Luc.id, Inc., located in Louisiana. Luc.id is actually an aggregator, sourcing respondents from different online providers, located around the world. Thus, it is possible to work with defined respondents, viz., ‘survey takers’, from anywhere in the world. These respondents have already volunteered to participate, knowing that their data is entirely anonymized. The only information obtained about them is from their self-profiling, the questions shown in Table 4, along with age and gender.

Analysis

The data from each respondent is stored in the form of a vector or row of data, one row for each vignette. Thus, each respondent generates 24 rows of data. The first sets of columns are reserved for study identification and respondent identification. The information here includes the answers to the respondents self-profiling questions, this information repeated 24 times, once for each vignette. The second set of columns shows the specific composition of the vignette, starting with the order of testing (1-24), and then 16 columns, one for each of the 16 elements. The cell for each element is given the value ‘0’ when the element is absent from the vignette and the value ‘1’ when the element is present in the vignette. By design, each row will have shown a minimum of two ‘1’s’, and a maximum of four ‘1’s.’ The third set of columns show the rating, and the response time. The last set of columns show transformed rating data, defined and described in the next paragraph.

To prepare for an appropriate analysis, the rating scale data must be transformed to present the data appropriately for subsequent regression analysis using OLS, ordinary least squares regression [6]. The objective of Mind Genomics is to relate the presence/absence of the elements to the response. There are actually two responses here: motivating (vs not motivating), and believable (vs. not motivating). The research here focuses primarily on motivating vs not motivating, but it is also interesting to find out the messages which are believable vs not believable.

The strategy to decouple motivating from believable consists of creating a new set of binary variables through simple transformations:

R5=Motivates and believable. R5=100 when the rating is 5. Otherwise R5=0.
R54=Motivates. R54=100 when the rating is 5 or 4. Otherwise, R5=0.
R52=Believable. R52=100 when the rating is 5 or 2. Otherwise R52=0.
R3=Don’t know. R3=100 when the rating is 3. Otherwise, R3=0.
R41=Not believable. R41=100 when the rating is 4 or 1. Otherwise, R41=0.
R21=Does not motivate and not believable. R21=100 when the rating is 2 or 1. Otherwise R21=0.

RTSeconds=Response time in seconds. The BimiLeap program measures the elapsed time between the appearance of the vignette and the rating assigned by the respondent. The time is measured with a resolution of hundredths of seconds.

To each of the newly created binary variables, viz., those given a value of either 100 or 0, a vanishingly small random number is assigned, this number less than 10^-5. OLS, ordinary least-squares regression, requires that the dependent variable have some minimal variable. In the case that the dependent variable has no variability, either for a given individual or for what will be the relevant subgroup, the OLS regression will ‘crash.’ For example, this might well happen when a respondent avoids the rating ‘3’. For that respondent, R3, Don’t Know, will always have the transformed value of 0. Any effort create a model or equation relating the ratings of that respondent to the presence/absence of the 16 elements will end up with the OLS regression program ‘crashing.’ To avoid that problem is simple; add this vanishingly small random number to every transformed rating, ensuring that all newly created binary values (e.g., R5 …. R21) ends up with some minimum variation. This prophylactic step ensures that all of the equations will run when OLS regression is used.

OLS Regression – Relating the Presence/Absence of the Elements to the Binary Variables and Response Time

The objective of Mind Genomics is to quantify the contribution of the individual ideas or elements as they drive a dependent variable. The key variable in this study is ‘motivates’, captured by the newly created binary variable, R54. Whenever the vignette is rated as motivating (rating 5 or 4), R54 becomes 100. Otherwise, R54 becomes 0. Given this information, can we determine the degree to which each of our 16 elements ‘drives’ that rating of ‘motivates’? The answer to the foregoing question is a simple YES, due to the effort made in the set-up of the vignettes according to experimental design. The permuted experimental design ensures that each of the 16 elements appears statistically independently of every other one of the 16 elements, that there are some ‘incomplete vignettes’, lacking an answer from question or an answer from two questions. These properties enable the OLS regression to estimate the absolute value of the driving power of the element.

The driving power of the element is the magnitude of the coefficient in the equation below:

DV (dependent variable)=k₁A1 + k₂A2 … K₁₆D4

The additive model does not depend upon an interpretation of the data. Rather, the OLS regression simply uses the mathematical properties of the data to estimate the 16 coefficients. The additive constant is not calculated for the simple reason that it is important to be able to compare the coefficients from one study to another, in terms of their absolute values. The only way this comparison can be ensured is to force all of the information to be embedded in the coefficient. By having an additive constant, a baseline, the researcher has to first account for differences in baseline, and then account for differences in coefficients, considering the baseline. That effort is not productive when one is attempting to create a large-scale database across topics, across culture, and across time. It is more reasonable to estimate the coefficients without the complications caused by the additive constant. This change in the computation formula has been slowly emerging, prompted by the desire to understand the ‘stories’ embedded in different studies as they are revealed by the coefficients

Creating the Models or Equations for the Total Panel for the Different Dependent Variables

The Mind Genomics effort ‘comes alive’ when we look at the ‘meaning’ of the strong performing elements, if indeed we do have these elements. For Mind Genomics studies, the notion of ‘strong performing’ has been reserved for those elements of a positive nature with coefficients 21 or higher, and for those elements of a negative nature with coefficients of 15 or higher. Table 5 shows only one strong performing positive element, for motivating (D4: Lifestyle guidance: They can teach you to choose water over sugary drinks, which is better for your body), and only two strong performing negative elements, both for believable (D4: Lifestyle guidance: They can teach you to choose water over sugary drinks, which is better for your body, and C4. For children: They check if the child’s teeth are growing well).

Table 5: Coefficients for models (equations) relating the 16 elements to the newly created binary variables, and for response time (RT), The table is sorted by the values of coefficients for ‘motivate’ (R54).

The foregoing results are confusing. There is clear differentiation across elements in Table 5, both in terms of ‘motivating’ and in terms of ‘believable.’ Thus, the results are not due to the lack of differentiation across the elements, but perhaps to a deeper issue, e.g., the type of respondent. It may be that the 101 respondents comprise different groups of respondents with varying levels of interest and belief in what could be said and done in a routine doctor’s examination. If so, then the specific patterns might be elusive. The next analysis addresses this possibility by focusing on the way people describe themselves.

Responses of Key Subgroups in Terms of Motivate

The Mind Genomics process generates a great deal of data. The most practical way to deal with the plethora of information is to focus on one dependent variable, using that variable as the lens through which to examine the mind of the respondent as the respondent evaluates the vignettes. Once we focus more precisely, using one dependent variable, we will end up with many more strong performing elements, as we see in Table 6, where we focus on one variable (motivates, R54), and were we have divided people by what they say about some of their motivations and activities pertaining to health and lifestyle.

Table 6: Coefficients for the 16 elements for ‘motivates’ emerging from separate analyses of respondents self-defining themselves by their pattern of behavior and thinking (defined by the columns).

Table 6 is more gratifying because it shows many elements driving motivation, not just one element as we saw for the total panel in Table 5. Yet, in this increased number of strong performing elements it is difficult, indeed almost impossible, to synthesize a meaningful pattern. Knowing the way, a person answers questions about her or his attitudes and behaviors regarding the world of health and social interaction does not really allow the doctor to deeply understand the patient, at least in a formal, structured level. There may be some clues in the different classifications, but once again the lack of a clearly interpretable pattern emerges, this time with the plethora of strong performing elements, a plethora which seems to be incapable of simple definition. Face with this type of pattern, it is not surprising that many practitioners fail to understand their patients, at least in a structured way. The literature may be filled with data about specific medical conditions and their correlation with indices, but we fail to see tight connections.

Mind Sets

A hallmark of Mind Genomics is the focus on the search for basic groups in the population defined by the way they think about specific, granular topics. The ‘regular visit to the doctor’ is such a granular topic. The introduction to this paper talked about the general issue of what patients want from their doctors. The topic of a regular visit to the doctor puts the person’s thinking into a far more concrete realm. The material that the respondent may have to examine and evaluate need not be large scale issues, but may paint concrete ‘word pictures’, describing a very ordinary situation. Thus, as a research tool to understand the mind of the patient, or indeed of anyone, the Mind Genomics science provides a tool that can be honed and sharpened to a micro-focus on the minutia of a topic, minutia which might see irrelevant in the big picture, but might be exceptionally relevant to the topic.

The creation of mind-sets is a straightforward process. The researcher follows these steps, each transparent, each simple, using well-defined and statistically valid methods.

Step 1 – For each respondent create a model relating the presence/absence of the 16 elements to the binary transformed rating. The dependent variable here is ‘motivates’, R54. The model, estimated by OLS regression, is valid because the initial experimental design ensured that each respondent would evaluated a set of 24 vignettes, designed analysis by OLS regression [7].

Step 2 – Create the matrix of 101 rows (one row for each respondent) and 16 columns (one column for each element).

Step 3 – Use k-means clustering to divide the set of 101 respondents twice, first into two non-overlapping groups, and then into three non-overlapping groups [8]. The k-means clustering program used by Mind Genomics computes a ‘distance’ between pairs of respondents based upon the degree to which they are parallel, viz., the degree to which they trace out the same pattern. The measure of distance is the quantity ‘1-R’, where R is the Pearson correlation coefficient. R has a high value of +1 when the two sets of coefficients are perfectly parallel, and thus have ‘no dissimilarity’ or ‘no difference’ in their patterns. The value (1-R) is then 0. In contrast, when the two sets of coefficients move in opposite directions, then R has a value of -1, and the quantity (1-R) becomes 2.0. All pairs of respondents generate some number between 2 and 0.

Step 4 – The k-means clustering program assigns the respondents to the clusters so that the distances between pairs of respondents within a cluster are small, whereas the distances between pairs of centroids of the clusters are large.

The clustering is not exact, but rather a heuristic. The objective of the clustering is to discover presumably more meaningful groups of respondents. The clustering algorithm does not consider any meaning attached to the elements, but rather uses numerical magnitudes. That is, there is no effort to interpret the clusters.

Henceforth, this paper will use the phrase ‘mind-set’ instead of the term ‘cluster,’ in order to keep the spotlight on the effort to understand the way the person thinks about a topic.

Table 7 shows the coefficients estimated for Total Panel, for the three-mind-set solution, and for the two-mind-set solution, respectively, both emerging automatically from the BimiLeap program. The three-mind-set solution seems to be the more powerful solution, producing many more coefficients of high magnitudes (21+). The two-mind-set solution seems to be a bit weaker. Furthermore, the three mind-set solutions appear to be more interpretable, indeed quite easy to interpret:

Mind-Set 1 – Focus on visit to monitor the child
Mind-Set 2 – Focus on vitals and advice on eating
Mind-Set 3 – Focus on advice to lead a healthful lifestyle

Table 7: Performance of the elements by total panel, by three mind-sets, and by two-mind sets, respectively. The elements are sorted by the performance among the three emergent mind-sets.

The attraction of the mind-set solutions is undeniable because of its simplicity. Although the experience of participating in these Mind Genomics studies often exasperates professionals because they cannot ‘guess the right answer’, the reality is that ordinary people have no problem suspending their critical thinking, responding intuitively, and generating powerful results.

Identifying the Respondents by Attitude Versus by a ‘PVI’ (Personal Viewpoint Identifier)

A continuing finding in Mind Genomics is that who a person IS, or how the person says she or he thinks about a topic often does not co-vary with how the person responds when confronted with specific, granular issues relevant to the topic. This lack of correspondence between what a person ‘say’s and how the person actually responds can be seen from the pattern of percepts in Table 8. At the start of the Mind Genomics ‘experiment’, before evaluating the vignettes, the respondent completed a self-profiling classificaiton, comprising standard questions of gender and age, and then up to eight questions selected by the researcher, usually questions relevant to the topic.

Table 8: Distribution of answers to self-profiling questions by the total panel, and by the respondents in the three mind-sets.

Table 8 shows the self-profiling classification questions, and the percent of respondents selecting each answer. The clarity so evident in Table 7, based upon the response to the granular elements fails to emerge when the respondents separately profile themselves. Indeed, from Table 8 it would be difficult if not impossible to discern the presence of three radically different mind-sets

In recent years a new focus has been on the identification of individuals belonging to specific mind-sets, an effort which has ended up improving outcomes in the world of medicine. By knowing the mind-sets of patients discharged from the hospital after a bout with congestive heart failure, the results suggested a decrease in the within 30-day readmission from 17% down to 5% for the patients in the ward were ‘mind0typed’ after release and given the appropriate motivation material to put on their refrigerator [9]. The creation of the PVI, the personal viewpoint has been made available world-wide at the website www.pvi360.com. The program to create the PVI uses the output of the Mind Genomics study to create the PVI [10].

Figure 3 shows the first two parts of the PVI. Panel A comprises a set of questions about the respondent, with these questions ‘optional’. The rationale for these questions is primarily patient management, viz., the practical issue of picking up relevant patient data when the PVI data are included in a large-scale database. The PVI user can choose not to ask certain questions. Panel B comprises a set of six questions, coming directly from the results of the study, with the request for the person completing the PVI to choose one of two answers to each question. The six questions are randomized across the people who complete the PVI. The pattern of answers to the six questions map to the most likely of the three mind-sets, assigning the respondent to that mind-set. The important things to remember are that the language of the PVI questions is exactly the same language as that used to create the mind-sets, and that the PVI is an enhanced ‘guess’ about mind-set membership, but a guess based on actual response to relevant questions..

Figure 3: The first two parts of the PVI. Panel A shows the up-front questions about the respondent. Panel B shows the six questions and the two answer for each question.

The desire to know more about the patient and the medical experience has produced an additional feature of the PVI, so-called specialty or additional questions. These questions ‘tag along’ at the end of the actual PVI exercise. They enable the researcher to find out more information about a topic, and at the same time know the mind-set of the respondent who is answering the questions. The additional questions can be up to 20 in number, providing extensive additional information about the way mind-sets feel about other, related topics. These additional questions appear in Figure 4. The combination of additional questions with the PVI provides the researcher with a new tool to understand how to communicate with patients of different mind-sets, for a specific medical (or other) topic.

Figure 4: The third part of the PVI, the specialty or additional questions

How Good are the Data – The IDT (Index of Divergent Thought)

Up to now the focus has been on the use of Mind Genomics to understand how people think. During the years that Mind Genomics has been used, again and again it has become obvious that users of Mind Genomics go through a learning process. The researchers don’t really understand how to think creatively in the way Mind Genomics structures the process. At first the researchers grope around, often relying on Idea Coach to help them, but without a sense of what might be a strong question, and what might be cogent and meaningful answers. Creating a measure of ‘goodness of the study’ has become increasingly important as the use of Mind Genomics has evolved from consumer research professionals to young doctors, college students, and then high school and middle school students, and finally to grade school students.

The IDT (Index of Divergent Thought) is an attempt to quantify the ‘goodness’ of the study, through the summation of the weighted squares of the positive coefficients. Table 9 shows the computational formula. We already know the coefficient of each of the 16 elements for total panel, and for both the two mind-set solution and the three mind-set solution, respectively.

Table 9: The IDT (Index of Divergent Thought), measuring the performance of the study in terms of incorporating ideas which perform strongly.

The IDT is 74, very respectable for a study of this type. The IDT turns into a benchmark, as the researcher searches for elements which represent strong performers, especially for the total panel, or in the case of mind-sets, among at least one of the two mind-sets, and one of the three mind-sets, respectively. After all is said and done, in the end, the IDT can become a way for someone to measure progress in thinking.

AI Interpretation of the Three Mind-sets

At the start of the study, viz., when the elements were being created with the help of Idea Coach, one of the outputs of the process was the ‘Idea Book’, presenting the different sets of questions or answers, each set resulting from a query submitted to AI. After the BimiLeap platform used Idea Coach to develop the 15 questions or answers, these questions or answers were stored and ‘summarized’ set by set using a group of queries. The summarization generated a page of instructive output, shown in Tables 1 and 2, respectively.

The same approach was used for AI summarization of the results for each key subgroup of respondents. The summarization was done only for the elements with coefficients 21+ for positive variables (e.g., R54=motivates), and only for elements 15+ for negative variables (e.g., R21=does not motivate). When no element satisfied the threshold value the summarization was not done.

Table 10 presents the AI summarization for the strong performing elements for the three mind-sets, computed for the dependent variable R54. The AI summarization becomes a way for the researcher to better understand the results and perhaps the patterns emerging from the aspects and commonalities of winning elements.

Table 10: AI summarization for the strong performing elements for each of the three mind-sets emerging from the three-mind-set solution.

Discussion and Conclusions

Although one may often believe that years of experience with patients provides a strong sense of ‘what to say’ to each individual patient, the reality is that the proper communication with patients is necessary, but rarely well understood, and may require far more experience and guidance/coaching than might commonly be thought. Colloquially, some of this is encapsulated in what is colloquially called the ‘bedside manner’, but such a simple catch-all phrase can hardly do justice to the complexities presented in the visit of a patient with a doctor.. The literature about ‘what patients want from doctors’ recognizes the lack of deep information that is readily at the hands of the practitioner, can be sensed from some of these quotes from the public academic literature.

Although much has been written about what patients Then they contact their general practitioner (GP), there are no published data from large cohort studies of what patients expect…… most patients come to the consultation with a particular agenda. Failure to address this agenda is likely to adversely affect the outcome of many consultations [11].

The results showed that people ‘preferred’ the explanations based on what the participants in the earlier study wanted to know about their medicines, rather than those based on what the doctors thought they should be told. They also ‘preferred’ the explanations that did not convey negative information, rather than those that did convey some negative information. In addition, the inclusion of negative information affected ratings of likely compliance with the prescribed medication [12].

Most of the expectations in qualitative studies were related to the function “Fostering the relationship”. Similar expectations arose less often in quantitative studies. Conclusions Patients do have concrete expectations regarding each of the functions to be met in the medical encounters. The research approach tends to bias the results. Practice implications the collected expectations suggest how physicians may perform each of their tasks according to the patient perspective. Future research on patients’ communicative expectations needs to overcome the gap between qualitative and quantitative findings [13].

Patients want many things from their doctors, not all of which are possible. Below, however, is a list of things that patients seem to want from their doctor, and which should be possible. ….Eye contact… [14].

The study presented here is among the first to deal with the use of Mind Genomics to explore in detail the description of the interaction between the medical professional and the prospective patient. Mind Genomics provides the opportunity to describe the different facet of the doctor patient relationship in various conditions, with the descriptions emerging from the combination of AI (Idea Coach) and the doctor as co-generators of ideas, and the response of real people to these descriptions.

The ability to do these research projects with hours and days, from the generation of the topic to the creation of the study and finally to study execution and detailed analysis, promises to create a new corpus of knowledge about the world of everyday health and illness from the point of view of how a person perceives that world. The use of ordinary language, the ability of Mind Genomics to prevent guessing, the objectivity of the study was conducted on a computer, and finally the use of clustering to find mind-sets and typing tools to assign mind-sets, all promise a database of knowledge, at least interesting even if not eventually transformative.

References

Moskowitz HR (2012) ‘Mind genomics’: The experimental, inductive science of the ordinary, and its application to aspects of food and feeding. Physiology & Behavior. [crossref]
Moskowitz HR, Gofman A, Beckley J, Ashman H (2006) Founding a new science: Mind genomics. Journal of Sensory Studies 21: 266-307.
Gofman A, Moskowitz H (2010) Isomorphic permuted experimental designs and their application in conjoint analysis. Journal of Sensory Studies 25: 127-145.
Oyalowo A, Forde KA, Lamanna A, Kochman ML (2022) Effect of patient-directed messaging on colorectal cancer screening: A Randomized Clinical Trial. [crossref]
Gabay G, d Moskowitz HR (2019) “Are we there yet?” Mind-Genomics and data-driven personalized health plans. The Cross-Disciplinary Perspectives of Management: Challenges and Opportunities, pp.7-28.
Dismuke C, Lindrooth R (2006) Ordinary least squares. Methods and Designs for Outcomes Research 93: 93-104.
Gofman A, Moskowitz H (2010) Isomorphic permuted experimental designs and their application in conjoint analysis. Journal of Sensory Studies 25: 127-145
Ahmed M, Seraj R. and Islam SMS (2020) The k-means algorithm: A comprehensive survey and performance evaluation. Electronics 9(8): 1295.
Gabay G &d Moskowitz HR (2019) “Are we there yet?” Mind-Genomics and data-driven personalized health plans. The Cross-Disciplinary Perspectives of Management: Challenges and Opportunities, pp.7-28.
Davidov S, al Humaidan, M, Gere A, Cooper T, Moskowitz H (2021) Sequencing the ‘dairy mind’: Using Mind Genomics to create an “MRI of Consumer Decisions”. In: New Advances in the Dairy Industry. IntechOpen.
McKinley RK, Middleton JF (1999) What do patients want from doctors? Content analysis of written patient agendas for the consultation. British Journal of General Practice. [crossref]
Berry DC, Michas IC, Gillie T, Forster M (1997) What do patients want to know about their medicines, and what do doctors want to tell them? A comparative study. Psychology and Health 12: 467-480.
Deledda G, Moretti F, Rimondini M, Zimmermann C (2013) How patients want their doctor to communicate. A literature review on primary care patients’ perspective. Patient Education and Counseling. [crossref]
Stone M (2003) What patients want from their doctors. BMJ 326(7402): 12326doi: https://doi.org/10.1136/bmj.326.7402.1294 (Published 12 June 2003

The Significance of Sensory Disorders in Autism

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DOI: 10.31038/PSYJ.2023572

Abstract

Background: Autism is said to be a Neurodevelopmental Disorder which has a whole range of different strands. One of the most overlooked and misunderstood is the sensory differences – often referred to as Sensory Processing Disorder (SPD) or Sensory Integration Disorder (SID).

Aim: The aim of this study is to improve the understanding of the sensory differences and their implications in autism.

Methodology: Qualitative methods that include observation, personal accounts and ongoing research.

Current situation: Today unusual responses to sensory stimuli are recognized by many individuals with autism, their families and many professionals working in the field of Occupational therapy who work with them, although their significance is often overlooked by professionals working in other disciplines.

Summary: This study will show that both the sensory differences and their significance has been known for centuries. It will also propose that they are of great significance in autism for they affect every aspect ofindividual’s daily life.

Keywords

Autism, Neurodevelopmental delay, Sensory differences, Sensory processing disorder (SPD), Sensory integration disorder (SID), Soft neurological signs, Aberrant reflexes, Visual differences, Auditory differences, Tactile differences

The significance of our senses in development has been known for centuries, as was summed up by the German philosopher Immanual Kant in the 18^th century when he said, “All our knowledge begins with the senses, proceeds to understanding, and ends with reason.” During the 19^th century great doctors like Drs. John Langdon Down and the French physician Édouard Séguin worked with a range of children with learning disabilities of various kinds, while some of their other contemporaries worked with children who were blind, deaf or deaf-blind. As a group they were all keenly observant as can be seem from their books and papers, all having a real understanding of the sensory differences and their implications. During the time that Dr J.L. Down ran the Earlswood Asylum he noted that some of the children there fitted into different groups, some having savant skills and others having the “mannerisms and behaviour” that we would connect with autism today.

In a paper written in 1907 Dr Séguin made a comment worth repeating and, although his terminology is unpleasant to our ears, its importance is undeniable. As he noted, “Deafness and blindness from birth have the same effects as paralysis on ungifted children, by depriving them of the cognizance of a whole series of phenomena. But it is a fact curious enough to be noted, that partial obliteration of one of these channels of knowledge will produce the symptoms of superficial idiocy surer than its complete destruction.” Moving into the 20^th century we find that the importance of the sensory differences and their possible link to autism was highlighted by Bergman and Escalona in their [1] paper “Unusual Sensitivities in Very Young Children.” As they wrote “Colors, bright lights, noises, unusual sounds, qualities of material, experiences of equilibrium, of taste, of smell, of temperature, seemed to have an extraordinarily intensive impact upon these children at a very early age.”

In 1964 the seminal book Infantile Autism by Dr Bernard Rimland noted that many such children had unusual sensitivities in several, if not in all, their senses; an idea he supported by quoting from several studies that described peculiar reactions such as “ill focused eyes,” “functionally blind,” “blind while seeing, and deaf while hearing.”

Interest in this area has fluctuated over the decades. It gained attention in the 1960s and 1970s due to the work of several experts including the late Dr’s. Ornitz and Ritvo. In their 1968 paper they noted how common, and extremely important, those perceptual differences and their consequences were and postulating that the sensory differences could be the basis of autism [2-4].

In his book The Ultimate Stranger: The Autistic Child, Dr Carl Delcato detailed his research. While it was dismissed by many in the scientific community, his findings are importantbecause he found thatthere were three categories of sensory difference each with its own specific effects. Those three categories included children who were hypersensitive, others who were hyposensitive and a third category that he called White Noise in which those sensitivities were mixed. He also found that their mannerisms were directly linked to the sensory differences. He explained that “One or more of their intake channels (sight, sound, taste, smell, or feel) was deficient in some way. Their strange repetitive behavior was their attempt, through much repetitive stimulation, to normalize that channel or channels [5].

Delacato concluded that the sensory differences were “the most unique feature of autism.” Ornitz took that idea a stage further by suggesting that the seemingly unusual responses to sensory stimuli could be “used to identify autism in young children.”

In their book Deaf-Blind Children and Infants [6] Treffry and McInnes told us about the children they worked with, all of whom had a sensory impairment. The connection being that, as Treffry and McInnes told us, the result of those impairments was “… not a reflection of the child’s ability to process information and draw logical conclusions, but rather a measure of his ability to gather the information in the first place.”

By the late1970s personal accounts had begun to creep into the literature. One came from Jerry, a former patient of Leo Kanner who told Dr. Jules Bemporad about his childhood world which he said had consisted of confusion and terror and was “frightening” because it was full of “painful stimuli that could not be mastered.” Then there was Tony W. who recalled his childhood experiences telling us that “I was afraid of everything! I was terrified to go in the water swimming, [and of] loud noises; in the dark I had severe repetitive nightmares and occasionally hearing electronic noises with nightmares. I would wake up so terrified and disorientated” [7].

In “An Inside View of Autism” Temple Grandin noted that “My senses were oversensitive to loud noise and touch. Loud noise hurt my ears and I withdrew from touch to avoid over-whelming sensation.” She talked about her tactile problems saying that “When people hugged me, I stiffened and pulled away to avoid the all-engulfing tidal wave of stimulation. The stiffening up and flinching was like a wild animal pulling away.” She follows that by noting that “The nerve endings on my skin were supersensitive. Stimuli that were insignificant to most people were like Chinese water torture” [8,9].

Since the 1970’s some professionals (both inside and outside the world of autism) have been researching both neurodevelopment delay and the individual senses. That has led to a strong body of research that links neurodevelopment delay (and what are termed “soft neurological signs” which include aberrant reflexes) to the sensory differences. There is also a great deal of evidence that hearing can have a major impact on behavior from peoplelike Dr. G. Bérard, whose groundbreaking work continues to help many people worldwide, some with autism or other neurodevelopmental conditions [10].

Others work in the field of vision (an area in which the sensitivities are most complex). They include mild to severe Visual Impairment (VI) and what is often termed Visual Stress or Meares-Irlen syndrome. *Today research indicates that most children on the autism spectrum have severe visual stress which cause them to see the world around them as if everything is fragmented or distorted, with some even seeing faces as if they are totally blank. Since those early years there have been an increasing number of accounts (from individuals and families) about the sensory differences and the difficulties they cause. Many people are now taking those account seriously and today research is proving them to be true, as in “The pattern of sensory processing abnormalities in autism” by Janet Kern and her colleagues [11].

In 2007 the neuroscientists Henry and Kamila Markram came up with the Intense World Syndrome, based around hypersensitivity. Their initial interest in this topic was triggered by their son, who has autism. They and their colleague postulated that sensory overload interferes with social communication and language and that those obsessive and repetitive behaviors are the child’s attempt to bring order and predictability into a bewildering world. That led them to suggest that their hypothesis offers a unifying theory of autism. It is certainly a very positive theory and one that (in part) confirms previous research [12].

Comments

Research into NDD has shown that while the sensory differences and their effects are common among the neurodivergent community they are most severe in autism.
The Intense World Syndrome. The idea that sensory overload interferes with social communication and language and that those obsessive and repetitive behaviors are the child’s attempt to bring order and predictability into a bewildering world is certainly correct. The flaw being that it focusses solely on hypersensitivity whereas the sensory issues which are far more complex than that.

Conclusion

The link between sensory differences and autism is far clearer now that it has ever been. That is partially because of accounts by a range of different people from different countries across the world who are living with autism and because there is now a great body of evidence from reputable scholars working in a range of disciplines who confirm that neurodevelopmental delay can cause a range of sensory differences that have a major impact on people’s lives. In Lucy Blackman’s article “Reflections on Language” in [13-22] she asked “So, if one doesn’t have depth perception, what does that mean in terms of facial expression? If one hears the subtle sounds of speech out of order, which I do, how does one process language? If affection in the form of cuddles and kisses cause pain and discomfort in one’s infancy, how on earth does one develop interaction which might compensate for not interacting to speech and glance?” How indeed?

Conflict of Interest

The author has no conflict of interest to declare.

Funding

None

References

Bergman P, Escalona SK (1947) Unusual Sensitivities in Very Young Children. The Psychoanalytic Study of the Child 3: 1
Rimland B (1964) Infantile Autism. New York: Appleton-Century-Crofts.
Ornitz EM, Ritvo ER (1968) Perceptual Inconstancy in Early Infantile Autism: The Syndrome of Early Infant Autism and Its Variants Including Certain Cases of Childhood Schizophrenia. Arch Gen Psychiatry 18: 76-98.
Ornitz EM (1989) Autism at the interface between sensory and information processing. In G. Dawson (Ed.), Autism: Nature, diagnosis, and treatment .The Guilford Press.
Delacato C (1974) The Ultimate Stranger. New York: Doubleday.
McInnes JA, Treffry JM (1982) Deaf-Blind Infants and Children. Buckingham: Open University Press.
Bemporad JR (1979) .Adult recollections of a formerly autistic child.Journal of Autism and Developmental Disorders 9: 179-198.
Grandin T. An Inside View of Autism.
Grandin T., Margaret M. Scariano (1986) Emergence: Labelled Autistic Arena Press.
Berard G (1993) Hearing equals behaviour. New Canaan: Keats Publishing. (Original published 1982).
Kern J. et al. The pattern of sensory processing abnormalities in autism.
Markram K, Markram H (2010) The intense world theory–a unifying theory of the neurobiology of autism. Frontiers in Human Neuroscience 224.
Blackman L (2005) Reflections on Language” pp: 146-167 in Autism and the Myth of the Person Alone ed. by Douglas Biklen. New York University Press.
Mayoral M (2010) Neurological soft signs in juvenile patients with Asperger syndrome, early-onset psychosis, and healthy controls. Early Intervention in Psychiatry.
Parmar KR. et al. Visual Sensory Experiences From the Viewpoint of Autistic Adults, Front Psychol. [crossref]
Volkmar FR, Cohen DJ (1985) ‘The experience of infantile autism: A first person account by Tony W.’ Journal of Autism and Developmental Disorders 15: 45-54.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington: American Psychiatric Publishing, 2013.
https://www.disabilitymuseum.org/dhm/lib/detail.html?id=1531&page=11
http://auditoryintegrationtraining.co.uk/auditory-integration-training-ait-for-hearing-autism-adhd-add-dyslexia-and-other-special-needs-2/clinical-studies-for-auditory-integration-training/
https://blog.donnawilliams.net/2014/09/20/visual-perceptual-disorders-as-a-cause-of-autism/
https://www.brainbalancecenters.com/blog/retained-primitive-reflexes-sign-brain-imbalance
Neurodevelopmental delay – https://www.moveplaythrive.com/research/178-research-summaries-goddard

Pilot Results from the Ambulatory Electronic Health Record (EHR) Evaluation Tool: Lessons Learned

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DOI: 10.31038/JCRM.2023633

Commentary

Most studies focused on electronic health record (EHR) safety, specifically the ability of these systems to detect and prevent adverse drug events (ADEs), has been performed in the inpatient setting. To address this gap, the Ambulatory EHR Evaluation Tool was developed and piloted with seven clinics in 2019. Each of these clinics used one of the leading outpatient EHR systems, as identified by the Office of the National Coordinator (ONC) [1]. The tool consists of a medication safety test and a medication reconciliation module. For the medication safety test, it simulates a physician prescribing medications to their patients. The testing methodology closely follows the inpatient version of the tool, which is administered by the Leapfrog Group. For the medication reconciliation module, clinics were asked to electronically reconcile two medication lists.

To take the medication safety test, clinics downloaded a set of test patients and associated medication test orders to enter into their operational EHR using Computerized Physician Order Entry (CPOE). Included with these test patients were basic demographic details (e.g., age and weight), allergies, and relevant laboratory values. While entering these test orders, licensed prescribers recorded any advice or information they received (if any). The tool assesses basic and advanced decision support features [2]. Once finished with the test, clinics received an overall percentage score of unsafe orders detected, as well as individual order category scores. The test also included two subcategories: nuisance orders and fatal orders. Nuisance orders are low-priority medication combinations (i.e., drug-drug interactions and therapeutic duplications) that should be delivered un-interruptively, as they can contribute to alert fatigue [3]. These orders were reverse scored, in that clinics which alerted on these test orders were scored as “incorrect”. For fatal orders, these were high-priority medication interactions that if prescribed, can lead to serious injury and even death. Lastly, for the medication reconciliation module, we provided clinics with a test patient that was recently discharged from the hospital and is returning to their outpatient clinic for a follow-up visit. Clinics were provided with two medication lists: one from the recent hospitalization, and the most recent ambulatory medication list. These medication lists had the following discrepancies: removal and addition of a medication, and a change in the dose of a medication.

The mean overall score for the medication safety test was 54.6% (Table 1). The range was 42.5%, the minimum score was 37.5%, and the maximum score was 80%. Generally, clinics performed well in areas of basic decision support such as drug allergy (100%), drug-drug interaction (89.3%), drug dose (daily) (78.6%), and drug pregnancy (75%). In contrary, clinics performed poorly in areas of advanced decision support areas like drug age (39.3%). Most alarmingly, none of the clinics in the study had drug laboratory or drug monitoring alerts implemented. In terms of fatal order performance, the mean score was 67.9%. Only one clinic alerted on all the fatal orders in their test. For the nuisance orders, the mean score was 64.3%.

Table 1: Mean percentage scores for each order category

TAB 1

For the medication reconciliation module, three clinics (43%) had an EHR-based medication reconciliation functionality. However, only one clinic (14%) could demonstrate it during the pilot. In addition, none of the clinics’ EHR systems provided CDS during this process. Instead of electronic processes for medication reconciliation, most clinics compared medication lists manually, which was usually performed by a nurse or medical assistant.

The results from the initial pilot of the Ambulatory EHR Evaluation Tool revealed that while basic CDS features like drug allergy and drug interaction checking were widely implemented, areas of more advanced decision support were not implemented. A major commonality between all the clinics was that certain types of alerts were turned off completely. This occurred mostly in advanced decision support areas like drug laboratory, drug monitoring, and drug age; all of which are critical areas for patient safety. In addition, the mean fatal order score was only 68%, which is considered low given the severity of these medication orders. We expected all clinics to score a 100% in this subcategory. In terms of the results of the medication reconciliation module, only one clinic could demonstrate this functionality even though all the clinics were certified through Meaningful Use. Moreover, although most of the clinics understood the importance of medication reconciliation, the electronic processes at their individual facilities were poorly understood and thus unused.

In a broader context, the results from this pilot reveal significant gaps in the implementation of advanced CDS features in the outpatient setting. This is further magnified by the fact that commercial outpatient pharmacies are no longer routinely checking prescriptions for common medication errors, thus leaving the only effective medication safety net at the ambulatory clinic level. This leaves an enormous medication safety gap in the outpatient setting, where most medications are prescribed in the healthcare system. Hopefully, as this tool becomes more widely used, outpatient clinics will use it as a quality improvement tool to assess and identify gaps in the implementation of their medication related CDS, which as of now, is the only critical safety net for outpatient medication use.

References

Office of the National Coordinator for Health Information Technology. Office-based Physician Electronic Health Record Adoption. Published 2016. Accessed January 11, 2019. https://dashboard.healthit.gov/quickstats/pages/physician-ehr-adoption-trends.php
Kuperman GJ, Bobb A, Payne TH, Avery AJ, Gandhi TK, et al. (2007) Medication-related Clinical Decision Support in Computerized Provider Order Entry Systems: A Review. J Am Med Informatics Assoc 14: 29-40. [crossref]
Phansalkar S, van der Sijs H, Tucker AD, Desai AA, Bell DS, et al. (2013) Drug-drug interactions that should be non-interruptive in order to reduce alert fatigue in electronic health records. J Am Med Informatics Assoc 20: 489-493. [crossref]

Solving Epidemics of Lyme and Other Vector-Borne Infections through the Immune System

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DOI: 10.31038/IDT.2023415

“Le microbe n’est rien, le terrain est tout.” “(The microbe is nothing, the terrain is everything).” -Louis Pasteur

Abstract

Vector-borne infections such as Lyme disease and co-infections, rickettsiosis, dengue, West Nile fever, and malaria that are known for their high morbidity, and even mortality, have been globally on the rise due to several key factors. Among these are the increased population of and exposure to ticks and mosquitoes that are caused by climate change and deforestation, as well as a generally more health-compromised population as evidenced by skyrocketing prevalence of chronic diseases. The implicated factors in chronic sickness are continual rise in environmental pollution, unhealthy diet and substance abuse, overuse of antibiotics leading to microbial evolvement into more aggressive forms, disturbed biome, secondary fungal infections and antimicrobial resistance (AMR). Some of the most common vector-borne infections lack effective treatments, including chronic post-treatment Lyme disease with diagnostic tests not always being reliable. Additionally, Lyme’s Borrelia Burgdorferi, that is the most common vector-borne disease in North America and Europe, presents a particular challenge to its treatments by existing in many different genotypes with some being particularly aggressive. This article presents a different approach to vector-borne, and infections in general, based on several principal factors. These concern the increased focus on the host innate immunity to defeat infectious agents using a novel diagnosis to ascertain reasons for suboptimal immunity, treatment to address this and elicit proper immune stimulation by vaccine-like action. Both diagnosis and treatment concern energy medicine, which is formally recognized by the NIH, and based on the physics of the living, water, and all matter in nature.

Keywords

Lyme disease and co-infections, Vector-borne infections, West Nile encephalitis, Antimicrobial resistance, Bioresonance testing, Energy medicine, Homeopathy, Digital medicine

Introduction

According to the US CDC, the incidence of one of the most common vector-borne, Lyme disease has risen by 44% from 1999 to 2019 and has been responsible for almost a half-million new cases in the US annually, at a cost of some $1.3 billion a year. Studies have found that over 14% of the population worldwide in 80 countries, have contracted Lyme disease [1]. Yet, due to the presence of different strains of the bacteria, its ability to mutate, and the likely compromised immune response of the host, laboratory tests are not always reliable or drug therapies efficacious [2-6]. Consequently, as many as up to 20% of these patients remain chronically or post-treatment permanently ill with many seeking alternative treatments. Unfortunately, their shared experience and lack of published convincing results to the contrary, indicate that despite these treatments using prolonged antibiotic courses, antimalarial drugs, herbs, oxygen, ultraviolet light, electrocutions, and many supplements for immune support at the cost of up to six-digit out-of-pocket figures, their failure and harm prevail.

Many patient testimonials reveal unfortunate experiences with “progressive Lyme clinics” in the US or Europe, ending up feeling sicker and even being hospitalized. These treatments had in common the prevailing errors: excessive focus on “killing” the microbe and blinded attempts to stimulate immunity without knowing the fundamental causes of its malfunction. In light of the encountered failures with both conventional and integrative approaches, concerned Lyme specialists have called for seeking a different approach to the problem [7]. However, a true different approach, instead of usual “stronger” pharmaceuticals, must foremost involve the state of the terrain, as noted by the great Pasteur, or immunity that allows the evolvement of infection in the first place. Voluminous toxicological literature documents immunosuppressive effects of environmental pollutants which ae abundant in the modern environments, some 100,000 agents with hardly any safety testing [8-10]. According to Harvard University EPA Working Group 2007 Report, traces of hundreds of environmental pollutants have been found in the bodies of 100% tested Americans that roughly encompasses all industrialized nations.

Some of these, heavy and other metals, affect genetic and epigenetic mechanisms yet cannot be completely excreted or metabolized [11]. The exposure and pathologies commence since pre and postnatal periods and continue to accrue through food, water, and air from modern kitchens to Greenland [12-24]. Among metals, mercury that is the most toxic nonradioactive element exerts multisystemic, including immune invasion and harms through massive use of fossil fuels, and silver amalgam fillings [25-28]. Dental restorations, including silver amalgams, and ubiquitous toxic metals in the bodies of modern populations, also act as conducting receiving antennas for just as ever-present electromagnetic fields, resulting in their enhanced combined pathogenicity, further adding to the immune burden. Electromagnetic fields alone cause immune suppression, leading to chronic infections, cancer and numerous other diseases [29-36].

Also, just as prevalent and steadily rising are opportunistic fungal infections, due to a massive use of antibiotics and the high consumption of simple sugars, which cause increased immune burden, immunosuppression and immune invasion [37,38].

Additionally, antibiotics further impair the host resistance by altering immune response, damaging immune cells, the microbiome, and possibly the human genome that contains numerous bacterial remnants, thus exacerbating the vicious cycle and compromising overall health [39,40]. Consequently, they have been associated with many chronic diseases, including malignancies, with antibiotics produced AMR causing 700,000 global annual mortality that is expected to reach 10 million by 2050 [41,42].

Besides the known serious limitations of laboratory tests to diagnose toxicological agents where it counts the most, inside the internal organs in the living, infectious agents, including Lyme and co-infections bacteria, may elude these tests too [43-45]. Physics-based alternative medicine bioresonance test, applied kinesiology, has been used to address this diagnostic gap. Likewise, physics-based homeopathic or homeopathic-like copies of toxicological, infectious or any pathogen, isodes, have been employed for their established, based on hormetic effect, detoxification of toxicants, and antimicrobial vaccine-like immune stimulation [46-57]. The offered advantage of such immune enhancement therapeutics is the replacement of a direct microbicidal effect to avoid triggering mutations and antimicrobial resistance, with vaccine-like specific immune stimulation against infectious agents. Recently published studies and case reports presented the efficacy of this approach for COVID-19, and resolving pneumonia, and H Pylori infection without antibiotics [58,59].

In the long experience of this author, homeopathic remedies prepared from organs, sarcodes, indicated additional detoxifying and restorative effects likely due to enhancement of homeostatic function to expel xenobiotics. Remedies prepared from bodily fluids in order to dispel contained infectious or toxicological agents represent autoisodes. Isodes, sarcodes, and autoisodes have been registered with the American FDA and its many counterparts worldwide. Since homeopathic remedies largely represent energetic signals, not chemical substances, materials scientists and physicists deem that the prevailing portrayal of these remedies as overdiluted placebos, constitutes “distortion of and ignorance in science,” and “unnecessary confusion.” [60-72]. Considering that physics deems the living to be fundamentally electromagnetic systems, their response to meaningful energetic signals is obligatory [63-75].

Capitalizing on this premise, we can use the immune system, instead of drugs, herbs and other “killing” means, to dispense with infectious agents and also cultivate, unlike antimicrobial agents, future resistance against it, through vaccine-like energetic signals. Well-known matter-energy duality, natural resonance frequency phenomena in physics, and water science support imprint of energy fields of microbes in water, thus creating agent specific energetic vaccines. This approach utilizes the same immune stimulation principle as the pharmaceutical vaccines – delivery of a weakened microbe – but only in its energetic, instead of material molecular form (Figure 1).

Figure 1: Immune stimulation principle

Materials and Methods

The applied sarcodes and isodes were obtained from homeopathic pharmacies. Most of the time, sarcodes and isodes were used after adjusting their potencies by an automated water programming device* in order to better match the patient’s individual disease state, according to bioresonance testing.

The same water programming platform was used to prepare autoisodes. Scientific literature referred to energetically modified high-dilution homeopathic remedies as homeopathic-like [76]. Medical Nobelist Montagnier, among other researchers, produced positive biological responses with electronically modified high dilutions and immunologist Benveniste named this paradigm digital biology [77-81]. An automated platform can be particularly helpful in acute and life-threatening emergencies when effective antimicrobial drugs do not exist, or are available, and shortens the production of vaccines from years, for pharmaceutical ones, to minutes, for energetic ones.

Bioresonance testing, applied kinesiology, is based on phenomena of resonance, matter-energy duality, and natural resonant frequency of all matter in nature, including the living. The diagnostic tissue resonance interaction method has been used as a highly specific and sensitive technique for cancer detection [82]. The test is performed with a subject in a supine position on an examining table, holding a metal rod that is connected to a metal platform through a cable forming a conductive circuit between a testee and the platform. When glass vials with energetic imprints of body organs, toxicological, infectious, or other pathogens are separately placed on the platform, a person responds to their corresponding fields with an involuntary muscle stress response, if a tested substance is related to their pathology [83,84]. Muscle response displays a change of tone and a slight movement of the right leg. This reaction can be likened to self-awareness of meaningful information, as in a lie detector test through stressful brain wave pattern. Due to multiple intertwined connections between skin and internal organs, more than a single mechanism of response might be involved. The conduction circuit would encompass the brain and spinal cord with sensory and motor nerves, autonomic nervous system, widespread connective tissue, and biological water that possesses permittivity and connection with DNA [85-93]. A tester detects the muscle response by holding his/her hands on the subject’s ankles. In the event of a tested substance not being part of the pathology, muscle response is absent. The test can also determine the potential benefit, absence, or iatrogenicity of a tested therapeutic substance. On the whole, the test utilizes the same fundamental properties of the living, electromagnetism and electronics, as all biophysical tests such as ECG, EEG, and MRI.

Treatment of all of the cases was guided by bioresonance testing that also suggested otherwise, undiagnosed Lyme disease. Testing and treatment of the cases primarily focused on detection of toxicological agents, opportunistic fungal, parasitic, and viral infections, residues of antibiotics, endocrine impairment of excessive electromagnetic radiation, all of which have known immunocompromising effects. Basic healthy lifestyle guidance was provided in eliminating simple sugars, and reducing exposure to environmental pollutants and electromagnetic radiation that was not always optimally followed.

___________________________________________________

^*Therapeutic Frequency Imprinting Device, US Patent #10941061

Patient Cases

Case 1

Man in his forties with a recent diagnosis of Lyme disease, but suspecting having had it since his 20s. Complaints: poor memory, anxiety, neurological symptoms, decreased vision, poor energy, sex drive, with head and back pains. He tried many alternative treatments without success. After a fairly short series of remedies, he reported feeling the best he had in years and virtually free of symptoms.

Case 2

An alternative practitioner in her 40s with Lyme disease and head-to-toe problems for several years: decreased memory, burning mouth, fears, knee and back pain, headaches, hypoglycemic spells with sugar cravings, thyroid malfunction, poor energy, and an inability to lose excessive weight. After a few treatments, she reported feeling ‘the best ever in my life.’

Case 3

A woman in her 40s with massive body breakdown over the years, and a tentative Lyme diagnosis. Presented with periodic fevers, debilitating back pains, fatigue, headaches, photophobia, abnormal space perception, food allergies with cravings, multiple infections, parasitic, bacterial, viral, enlarged lymph nodes, and a neurological voice disorder. Many prior treatments did not help. By the end of her treatment course, she reported: “I feel so much better than when I started. I keep being amazed by it.”

Case 4

A woman in her thirties, with debilitating symptoms for years, was diagnosed with Lyme disease and Bartonella, two years prior to the visit. Neither prolonged multiple antibiotic treatments nor integrative treatments worked. She complained of intense pains with other neurological symptoms and fatigue. Other symptoms: excessive weight gain, food intolerances, respiratory and vaginal infections, severe mental impairment with brain fog, falling down after making even a few steps, auditory hallucinations of birds chirping, loose bowel movements, and depression. Her integrative MD was planning on implementing a special Alzheimer’s alternative and pharmaceutical drug program.

Besides Lyme, bioresonance testing detected other pathogens, especially affecting her brain: pesticides, herbicides, (she lived in a farm region), solvents, mercury, and flu virus. Following a single treatment, she reported that she stopped falling down, had a substantial increase in energy, disappearance of auditory hallucinations, and normalized bowel movements. Alzheimer-like mental state disappeared too, with an increase in mental clarity, word recall, and overall feeling much healthier and happier.

Case 5

A middle-aged woman complained of chronic facial pains and twitches, fatigue, anxiety, fears, and headaches. She was unsuccessfully treated by an osteopathic doctor and a pain specialist with a published book on the subject. Among other causes, bioresonance testing identified Lyme infection affecting her trigeminal nerve and TMJ. She responded to the treatment well, and regained a normal life. Her pain specialist doctor supported this approach.

Case 6

A nine-year-old girl was referred to a psychiatrist for psychotropic medications by a surrendered child psychologist, because of the therapist’s inability to remedy her progressing restlessness, OCD, aggressiveness, moodiness, and overall unpredictable behavior over the years. Bioresonance testing suggested mercury, Lyme, and strep infections in the brain. She was 90% cured after a single treatment and completely after the second one. “She is just normal. Huge change, huge, huge, since we came here,” said the mother.

Case 7

A woman in her sixties with generalized joint pains, chronic anemia, and fatigue. She was treated for years by her rheumatologist with two anti-inflammatory drugs for rheumatoid arthritis. Bioresonance testing detected Lyme infection and mercury in her joints and bone marrow. Within a year, she came off both drugs, had her anemia resolved, and quality of life restored to normal.

Case 8

A man in his fifties frequented emergency rooms with typical heart angina pains. All heart tests, including coronary artery catheterization performed at a prestigious university heart center, turned normal and his cardiologists offered no diagnosis. Bio-resonance testing suggested Lyme carditis and following brief treatment his chest pains ceased.

Case 9

A middle-aged woman suffered from debilitating migraine headaches for many years. The major cause seemed to be a missed Lyme infection in the brain. The outcome: resolved migraines.

Case 10

A woman in her sixties underwent a complete personality change with severe depression, anxiety, panic attacks with crying, compromised cognition, blurred vision, sensation of inflamed brain, arthritic pains, fatigue, dizziness, and inability to read due to poor focus, or retain information. After two years of unproductive treatments by conventional specialists, she was diagnosed with Lyme and co-infections by an integrative MD. Weeks of several antibiotic treatments along with supplements hardly helped. I advised her to stop all of her antibiotics and supplements, due to the detected side effects by bioresonance testing. Despite her fear of stopping the antibiotics, she had to discontinue one of these anyway, admitting to suffering its side effects. Following her first treatment she reported that her arthritis, panic attacks with crying, and inflamed brain were resolved; her energy and focus considerably progressed, with brain fog and dizziness being hardly present. She stated: “I can tell you that on your drops, especially the Lyme ones, I felt much more Herxheimer reaction than on my antibiotics.” Following the discontinuation of her second antibiotic and receipt of another treatment, she reported that her problems were gone.

Comment: The more intense Herxheimer reaction implies more intense apoptosis of bacteria, due to a potent immune response.

Case 11

A young woman with dozens of mental, emotional and physical symptoms combined, reluctantly followed my advice to discontinue her antibiotics for Lyme and co-infections. Following her first treatment, she reported no longer looking and feeling like a corpse, and even the return of her five-year absent sex drive since the onset of Lyme disease. She also reported much improvement in her pains leading to decreasing her opiate pain regimen, and internal body vibrations with muscle twitches that she had suffered after using some “Lyme electrocuting machine”. She too, noted stronger Herxheimer reaction to homeopathic-like Lyme drops, compared to all of her prior antibiotics.

Case 12

Man in his early sixties with multiple medical problems for years: sinusitis since infancy, fatigue in the afternoon for decades, brain fog, arthritic pains, and chocolate cravings. All these were resolved in eight-nine visits.

Case 13

Fifteen-year-old boy treated with several courses of antibiotics for Lyme infection. However, his complaints persisted: fatigue, headaches, arthritic pains, shortness of breath on walking, low appetite, difficulty with schoolwork. All of these have been resolved after a few treatments.

Case 14

Athletic man in his twenties, with fatigue, depression, panic attacks, body heaviness, brain fog, compromised short-term memory, motor speech problems, and a sense of body detachment for years. He received over a half dozen psychotropic drugs throughout the ordeal and was still consuming a few. After eight months of the treatment, reported being off psychotropic drugs for months for the first time in twelve years. Most of the problems were resolved, with others better or much better. He noted, “My workplace is so loaded with computers and fluorescent lights which I believe drain me and slow my complete recovery.”

Case 15

A woman in her thirties on a continuous 15-year antibiotics treatment. The latest regimen consisted of four antibiotics for chronic Lyme, Bartonella, sinus, and urinary tract infections. She was receiving other drugs for years, eleven in total, also for chronic Babesiosis, herpes and candida infections, a peptic ulcer, and countless other ailments. Virtually bedridden for many years, she was also receiving intravenous mineral and fluid infusions for severe fluid-mineral imbalance with dehydration and generalized edema. She was managed by prominent Lyme disease specialists who used multiple drug regimens, but her response was so poor that some of them even advised her to seek alternative treatments. The latter harmed her.

The initial bio-resonance testing indicated an even greater number of present chronic bacterial and viral infections, as well as systemic candidiasis. Mercury toxicity was also prominently present, likely due to silver amalgam fillings and a flu shot containing thimerosal received in the past that made her bedridden. Further follow-up testing indicated one of her cats as the Bartonellosis carrier which a blood test confirmed. The total iatrogenic damage in this case was so substantial that there were concerns about it taking years to mitigate. However, within the first two months of weekly treatments, she was able to discontinue all of the drugs and intravenous infusions that she was unable to do for years, since a cessation led to an increase in pain and all of her ailments. Nine months into the treatment, she reported having more energy, stamina, a positive outlook, and a far better quality of life.

Case 16

“My journey began working as an RN in a small rural hospital. During this time, I became a mother of six children and I started having reactions to nearly every medication I tried to put into my body, from lidocaine to antibiotics, to a Mantoux test. I would begin to shake and have involuntary body movements. Following a trip to the Mayo clinic, I was told it was all in my head. In 2009, I began to feel very fatigued and began to experience episodes of involuntary movements that lasted longer and were more dramatic. The naturopath found that I had elevated mercury in my system and then, during the process of removing my mercury fillings, I was introduced to FCT*. I was barely able to work most days, some days I had no ability to figure out how to prepare a meal, and I had no awareness where my limbs were in space. My first FCT testing found that not only did I have mercury in my system, but I also had Lyme and 2 or 3 other co-infections from the tick. This was later confirmed through laboratory blood work. The medical doctor recommended two antibiotics to be taken for a year. I chose to be treated with FCT which involved taking 1 drop of energized water, under my tongue, of each of the different causative agents that were making me ill, and also, ones that would support the tissues that were stressed. I made a complete recovery until I was bitten by a tick again in 2011 and once again chose to treat Lyme with FCT.

I am familiar with many other patients who have chosen the antibiotic route and they still have symptoms, or if they try going off them, their symptoms return. I know one gentleman who has been on antibiotics for 3 years with no resolution to his Lyme symptoms if he tries to go off them. I live a full and wonderful life, hiking, fishing, skating, skiing, and caring for my grandchildren. I am truly fortunate to have found FCT and have witnessed the benefits that many people can have as a result of using it.

As an RN, I appreciate all the science that is behind FCT, so if God would like me to serve others by offering FCT, I will be happy to do so.

Have a wonderful day!”

Annette Roiko, RN 1/17/14

*FCT–Field Control Therapy® expresses the concept that health, or disease, originates from corresponding cellular fields, as per retired Stanford University Professor of Materials Science, William A. Tiller, Ph.D.

Case of a Recovered Dying Dog from Apparently West Nile Encephalitis

Although the incidence of West Nile Virus infection is relatively low, it occurs worldwide, can be lethal due to CNS involvement, and has been on the rise lately [94,95]. According to the CDC, about 1 out of 10 people with severe CNS infection die and no known effective treatment is available. The disease also affects a number of animals, including dogs. In light of these facts, this presented case might be edifying.

An elderly dog of a patient of mine, Duke, was developing limb paralysis and lethargy. As the “control” group, several animals at the same farm treated by a veterinarian for the same pathology had to be euthanized months before. Duke’s evaluation suggested West Nile encephalitis virus infection, which is typical for that climate, as well as toxic metals and other pollutants in his body. My patient stated that the area was frequently exposed to chemtrails and their neighbor often burned some odorous materials outside. The veterinarian suspected the same infection and Duke was given its isode that resulted in a 50% improvement. Soon after, two immune organ sarcodes and two environmental isodes added further progress however, soon after the dog suddenly became completely paralyzed and comatose, with generalized body trembling. To add to the family’s misfortune, another dog suddenly died following a major seizure that was consistent with West Nile encephalitis. My patient notified me of the both events, without mentioning that a veterinarian with a lethal injection for Duke had arrived. I insisted on continuing the treatment but realized that the West Nile virus strain isode at my disposal was not matching his infection strain, as these mosquitoes and viruses vary greatly. My patient also reported another recent exposure to chemtrails. Under the circumstances of unavailable matching isodes, autoisodes can be very helpful. My patient was able to prepare an autoisode in a recommended potency using an automated water imprinting device, after drawing blood with an insulin syringe needle from Duke’s paw and placing a drop in his mouth. The next day the dog showed good progress and completely recovered several days later. Nine months since, he enjoys his daily chores.

A recent study indicated that autoisodes could be successfully used in the COVID-19 pandemic [58].

Conclusion

Since infectious diseases have and will continue their rise, parallel to environmental pollution and climate change, a different approach is compulsory due to the aforementioned limitations of the pharmaceutical paradigm in the treatment of all categories of infections, and to avoid further increases of antimicrobial resistance. As conventional medicine takes pride in being scientific, its neglect of the full body of science that, among others, strongly supports the interface of biology and physics, challenges this assertion [63,96].

Based on the physics of organisms and water, contemporary research demonstrated the effective application of energetic counterparts of environmental and microbial pathogens, as well as immune responses, and its potential to finally address Pasteur’s call for addressing a terrain–human petri dish [97,98]. The presented approach needs to be validated through proper clinical trials.

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