Eric Topol

Eric Jeffrey Topol (born 1954) is an American cardiologist, scientist, and author. He is the founder and director of the Scripps Research Translational Institute,[1] a professor of Molecular Medicine at The Scripps Research Institute, and a senior consultant at the Division of Cardiovascular Diseases at Scripps Clinic in La Jolla, California. He is editor-in-chief of Medscape and theheart.org. He has published three bestseller books on the future of medicine.[2] The Creative Destruction of Medicine (2010), The Patient Will See You Now (2015), and Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Again (2019). He was also commissioned by the UK 2018–2019 to lead planning for the National Health Service's future workforce, integrating genomics, digital medicine, and artificial intelligence.

Eric Topol
Born26 June 1954  (age 66)
Alma mater
Websitehttp://www.scripps.edu/ 
Scientific career
FieldsGenetics, cardiology 
Institutions

In 2016, Topol was awarded a US$207 million grant from the National Institutes of Health to lead a significant part of the Precision Medicine Initiative (All of Us Research Program), a one million American prospective research program.[3] This is in addition to his role as principal investigator for a US$35 million grant from the National Institutes of Health to promote innovation in medicine and the education and career training of future medical researchers.

Research

As a researcher, Topol has published over 1,200 peer-reviewed articles, with more than 270,000 citations, h-index 228, elected to the National Academy of Medicine, and is one of the top 10 most cited researchers in medicine. His principal scientific focus has been on the genomic and digital tools, with the use of artificial intelligence analytics, to individualize medicine. He also pioneered the development of many medications that are routinely used in medical practice including t-PA, Plavix, Angiomax, and ReoPro. He has led clinical trials in over 40 countries involving over 200,000 patients (first in series – GUSTO trials).[4] He has edited over 30 books, including the Textbook of Interventional Cardiology (8th ed - Elsevier, 2020), and the Textbook of Cardiovascular Medicine (3rd ed - Lippincott Williams & Wilkins).

Education and career

Topol completed medical school at the University of Rochester (MD with Honor), his residency in internal medicine at the University of California, San Francisco, and his fellowship in cardiovascular medicine at Johns Hopkins University.

Topol was a tenured professor at the University of Michigan for 6 years. At age 36, Topol was named chairman of the Department of Cardiovascular Medicine at the Cleveland Clinic, where he is widely credited for leading its already long outstanding cardiovascular program to being ranked #1 by U.S. News & World Report for more than a decade during his 13 years at the helm.[5] In 2002 he founded the Cleveland Clinic Lerner College of Medicine, the first new medical school in the US in 20 years, with its first class in 2004, and served as its provost and chief academic officer of the Cleveland Clinic. In 2003 he became a professor of genetics at Case Western Reserve University, while maintaining his primary appointment at Cleveland Clinic.

Topol departed from the Cleveland Clinic Lerner College of Medicine in 2006 following the removal of the chief academic officer position, and continued at Case Western Reserve University. He was then recruited by Scripps Health and The Scripps Research Institute in late 2006 to create a new institute, now called Scripps Research Translational, dedicated to individualized medicine.[6] In 2009, Topol worked with Gary and Mary West to create the West Wireless Health Institute, now called West Health Institute, to foster the use of digital tools in medical research and practice.

Genetics and genomics

At the University of Virginia, Topol authored his baccalaureate thesis in 1975 entitled “Prospects for Genetic Therapy in Man” and received a Bachelor of Arts degree With Highest Distinction. During his fellowship at Johns Hopkins, he was involved with the first patient who was administered tissue plasminogen activator (t-PA) in 1984, a genetically engineered protein.[7] In 1996, he started the first dedicated cardiovascular gene bank while at Cleveland Clinic.[8] This effort led to many discoveries in the genetics of cardiovascular disease, including the identification of key genes associated with heart attacks. Both thrombospondin variants and the MEF2A deletion reports were recognized as top 10 advances by the American Heart Association in 2000 and 2004. He was the principal investigator of the National Institutes of Health's Specialized Centers of Clinically Oriented Research grant on the genomics of heart attack with a $17 million award in 2005. His work in genetics has been recognized by the American College of Cardiology with the Simon Dack Award and Lecture in 2005 and by the European Society of Cardiology by the Andreas Gruentzig Award and Lecture in 2004.[9]

Wireless medicine

Topol has been involved with wireless medicine since its inception. He was the first physician to serve on CardioNet's Medical Advisory Board in 1999, the first dedicated wireless medicine company that performs real-time remote, continuous electrocardiogram rhythm monitoring. In 2007 he joined the Board of Sotera Wireless that has developed the first continuous non-invasive blood pressure monitoring device, which also captures all vital signs. In 2008 he forged a new educational program with Qualcomm and Scripps Health to train physicians in wireless medicine, a 2-year clinician scholar program: STSI Wireless Health Scholar. At the 2009 International Wireless CTIA meeting, he gave the keynote address on wireless health, the first time that topic was the subject of a CTIA plenary session. Also in 2009, he served as co-Founder with Gary and Mary West to form the West Wireless Health Institute. He is the vice-chairman of the institute and its chief innovation officer. In 2009 he also presented at TEDMED the rapid progress being made in this field. In addition, in early 2010 Topol gave a wireless medicine presentation at the Consumer Electronic Show. He led the first trial with the GE Vscan device GE Reports, a pocket high resolution, mobile ultrasound imaging device, introduced in the US in 2010 "The Doctor Will “e” You Now" and is currently leading clinical trials of heart rhythm and heart failure monitoring wireless devices.

NHS

He was commissioned by Jeremy Hunt in 2018 to carry out a review of how the NHS workforce, will need to change “to deliver a digital future”. His report suggested that within ten years most patients would be managing their own long-term conditions with wearable devices and sensors, and that that would be much more effective than occasional appointments with a doctor. Patients would not be monitored in hospitals but at home. This rise in regular monitoring would necessitate new workflows and frameworks in digital healthcare.[10] More nursing and physician associates would be required, enabling doctors to focus on the most difficult cases.[11] The report also recommended specific digital training for NHS staff and physicians.[10] His work on "High-performance medicine" that builds on this report was also published in Nature.[12]

Vioxx

Topol served as chairman of cardiovascular medicine at Cleveland Clinic from 1991 to 2005. He was one of the first researchers to question the cardiovascular safety of rofecoxib (Vioxx), culminating in that drug's withdrawal from the market. Topol's advocacy on the subject led to what The New York Times described as an "unusually public dispute" with the Cleveland Clinic's leadership over ties between the academic institution and the pharmaceutical industry,[13] ultimately leading to Topol's departure after his administrative position as head of their academic program was abolished.

Topol gained prominence as the first physician researcher to raise questions about the safety of rofecoxib (Vioxx).[14] and was highly critical of Merck's handling of its safety issues. In a 2004 editorial in The New York Times, he wrote that "Merck finally had to acknowledge the truth [about the drug's cardiovascular risks], but only by accident."[15] Topol also authored an editorial in the New England Journal of Medicine, arguing that "neither Merck nor the FDA fulfilled its responsibilities to the public" and encouraging a "full congressional review" of the situation.[16]

In 2004, Bethany McLean, writing in Fortune, questioned Topol's own potential financial conflicts of interest. She reported that Topol served as a scientific advisor to a hedge fund which profited substantially by short selling Merck stock, which plummeted due to the concerns about Vioxx which Topol had publicized.[17] Topol denied giving the hedge fund advance information, and subsequently severed his ties to industry, donating all such income directly to charity.[13] In a 2005 Journal of the American Medical Association commentary, Topol pointed to these allegations as an example of the complications that physicians can experience when associating with the investment industry, at the same time reiterating that "no true conflict of interest existed in this case."[18]

In November 2005, Topol was subpoenaed in a class action lawsuit against Merck. He testified that Vioxx posed an "extraordinary risk", and that Raymond Gilmartin, former chief executive officer of Merck, had contacted the head of the Cleveland Clinic board to complain about Topol's work on Vioxx.[19] Two days afterward, Topol was informed that the position as chief academic officer at the Cleveland Clinic had been abolished, and he was removed as provost of the Cleveland Clinic Lerner College of Medicine, which he had founded. The clinic described the timing as coincidental.[20] The New York Times described Topol's demotion as part of an "unusually public dispute" between Topol and the Cleveland Clinic's chief executive, Delos Cosgrove, and stated that Topol's criticism of Merck had focused scrutiny and criticism on the clinic's deep and longstanding ties to the pharmaceutical and medical-device industries.[13]

COVID-19

In August, 2020, Topol published an open letter in Medscape to FDA Commissioner Stephen Hahn, criticizing his Emergency Use Authorizations of hydroxychloroquine, convalescent plasma, and remdesivir for COVID-19. "These repeated breaches demonstrate your willingness to ignore the lack of scientific evidence, and to be complicit with the Trump Administration's politicization of America's healthcare institutions," wrote Topol.[21]

Hahn had stated that he was prepared to authorize a vaccine before Phase 3 trials were completed. Topol said that this would not allow the FDA to establish safety and efficacy, would jeopardize the vaccine program, and would betray the public trust. He called on Hahn to either tell the truth in a public statement, or resign.[21]

After conversations with Topol, Hahn retracted some of those claims. In September, Hahn tightened up the rules for approving a vaccine, leading to criticism from Trump. Trump attacked Hahn in a tweet, and said that the rules should be loosened up, in order to have a vaccine by election day. With the support of Topol and others in the scientific community, Hahn held firm, and was not fired.[22][23]

Honors

Topol was selected as one of the 12 “Rock Stars of Science” by GQ and the Geoffrey Beene Foundation in 2009.[24] He was elected to the American Society for Clinical Investigation, the Association of American Physicians, and the Johns Hopkins Society of Scholars. In 2004, he was elected to the Institute of Medicine of the National Academy of Sciences.[25] He was named Doctor of the Decade by the Institute for Scientific Information for being one of the top 10 most cited medical researchers. In 2011, Topol received the Hutchinson Medal from the University of Rochester in addition to giving the commencement speech for the School of Medicine and Dentistry. In 2012, Modern Healthcare ranked Topol as the most influential physician executive in the United States.[26]

Personal life

Eric Jeffrey Topol was born on 26 June 1954.[27] He is married to Susan Merriman Topol with whom he has two children.[27]

Bibliography
  • Topol, Eric. The Patient Will See You Now: The Future of Medicine Is in Your Hands. New York: Basic Books, 2015 — ISBN 9780465054749 [28][29][30]
  • Topol, Eric. The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care. New York: Basic Books, 2012 — ISBN 9780465025503[31]
  • Topol, Eric J., and Paul S. Teirstein. 1st edition, 1989; Textbook of Interventional Cardiology, 7th edition. Philadelphia, PA: Elsevier, 2015 — ISBN 9780323340380; 8th edition, 2019 — ISBN 9780323568142
  • Topol, Eric J. Deep Medicine, 2019 — ISBN 9781541644649[32][33]

See also

References
  1. Scripps Translational Science Institute
  2. Deep Medicine. Hachette Book Group. 17 July 2018. Retrieved March 3, 2019.
  3. Comstock, Jonah (6 October 2016). "NIH expands grant for Scripps-led Precision Medicine group to $207M". MobiHealthNews. HIMSS Media.
  4. The GUSTO investigators (1993). "An international randomized trial comparing four thrombolytic strategies for acute myocardial infarction". New England Journal of Medicine. 329 (10): 673–82. doi:10.1056/NEJM199309023291001. hdl:1765/5468. PMID 8204123.
  5. "Cleveland Clinic Boasts the Nation's Top Heart Center for the 15th Straight Year". Cleveland Leader. 2009. Archived from the original on 2010-02-13.
  6. "Noted Cardiologist Eric J. Topol Comes to Scripps". 15 February 2008.
  7. Collen D, Topol EJ, Tiefenbrunn AJ, et al. (1 December 1984). "Coronary thrombolysis with recombinant human tissue-type plasminogen activator: a prospective, randomized, placebo-controlled trial". Circulation. 70 (6): 1012–7. doi:10.1161/01.CIR.70.6.1012. PMID 6388898.
  8. Topol EJ, McCarthy J, Gabriel S, et al. (27 November 2001). "Single nucleotide polymorphisms in multiple novel thrombospondin genes may be associated with familial premature myocardial infarction". Circulation. 104 (22): 2641–4. doi:10.1161/hc4701.100910. PMID 11723011.
  9. "Archived copy". Archived from the original on 2011-07-26. Retrieved 2010-07-24.CS1 maint: archived copy as title (link)
  10. "The Topol Review — NHS Health Education England". The Topol Review — NHS Health Education England. Retrieved 2020-03-11.
  11. "Could patients become their own doctors?". BBC. 12 February 2019. Retrieved 14 February 2019.
  12. Ej, Topol (January 2019). "High-performance Medicine: The Convergence of Human and Artificial Intelligence". Nature Medicine. 25 (1): 44–56. doi:10.1038/s41591-018-0300-7. PMID 30617339. S2CID 57574615.
  13. Abelson, Reed; Saul, Stephanie (December 17, 2005). "Ties to Industry Cloud a Clinic's Mission". The New York Times. Retrieved July 16, 2010.
  14. Mukherjee D, Nissen SE, Topol EJ (2001). "Risk of Cardiovascular Events Associated With Selective COX-2 Inhibitors". JAMA. 286 (8): 954–959. doi:10.1001/jama.286.8.954. PMID 11509060. S2CID 1117265.
  15. Topol, Eric (October 2, 2004). "Good Riddance to a Bad Drug". The New York Times. Retrieved July 9, 2010.
  16. Topol EJ (October 2004). "Failing the public health—rofecoxib, Merck, and the FDA". New England Journal of Medicine. 351 (17): 1707–9. doi:10.1056/NEJMp048286. PMID 15470193. S2CID 12516952.
  17. McLean, Bethany (December 13, 2004). "A Bitter Pill for One Merck Critic". Fortune. Retrieved July 16, 2010.
  18. Topol EJ, Blumenthal D (June 2005). "Physicians and the investment industry". JAMA. 293 (21): 2654–7. doi:10.1001/jama.293.21.2654. PMID 15928288.
  19. Feeley, Jef; Laurel Brubaker Calkins (December 3, 2005). "Merck's Vioxx Posed 'Extraordinary' Risk, Cardiologist Contends". Bloomberg. Retrieved July 24, 2010.
  20. Specter, Michael (2009). Denialism: How Irrational Thinking Hinders Scientific Progress, Harms the Planet, and Threatens Our Lives. Penguin Books. ISBN 978-1-59420-230-8.
  21. Eric Topol (August 31, 2020). "Dear Commissioner Hahn: Tell the Truth or Resign. An Open Letter to Stephen Hahn, MD, From Eric Topol, MD". Medscape.
  22. H. Holden Thorp (16 Oct 2020). "EDITORIAL. Not throwing away our shot". Science. 370 (6514): 266. doi:10.1126/science.abf2306. PMID 33060334. S2CID 222413062.
  23. Regalado, Antonio, One doctor’s campaign to stop a covid-19 vaccine being rushed through before Election Day, MIT Technology Review, October 19, 2020
  24. "Eric Topol". Geoffrey Beene Rock Stars of Science. Geoffrey Beene Foundation. 2009. Archived from the original on 2 June 2013. Retrieved 2010-05-12.
  25. Stencel, Christine; Shamir, Judith (18 October 2004). "Institute of Medicine Elects 65 New Members, Five Foreign Associates" (Press release). Washington: The National Academies of Sciences, Engineering, and Medicine. Archived from the original on 31 October 2006.
  26. Robbins, Gary (21 April 2012). "San Diego's Topol named nation's top physician executive". San Diego Union–Tribune. Archived from the original on 19 May 2012. Retrieved 2012-04-23.
  27. Eric, Topol (2012-10-01). "Curriculum Vitae Eric J. Topol, M.D" (PDF). stsiweb.org. Archived from the original (PDF) on 2013-01-20. Retrieved 2018-02-14.
  28. Chitty, Mary (January 14, 2015). "The Future According to Topol". Clinical Informatics News. Needham, Massachusetts, United States: Cambridge Healthtech Institute.
  29. Jauhar, Sandeep (13 February 2015). "Review of "The Patient Will See You Now" by Eric Topol". The New York Times.
  30. Klass, Perri (16 January 2015). "Review of "The Patient Will See You Now" by Eric Topol". The Washington Post.
  31. Kim, Jung A. (September 2013). "Book Review: "Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care" by Eric Topol". Healthcare Informatics Research. 19 (3): 229–231. doi:10.4258/hir.2013.19.3.229. PMC 3810531.
  32. "Review of Deep Medicine by Eric Topol". Kirkus Reviews. 2019.
  33. Atkinson, Robert D. (2019). "Review of Deep Medicine by Eric Topol". New York Journal of Books.
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