Team:NUS Singapore/HP/Silver
Human Practices
Survey
Silver
Introduction
In Singapore, a nation-state with a population of 5.5 million, 37 people are diagnosed with cancer every day. It is estimated that in 2015, over 13,000 people were diagnosed with cancer, and this number has been increasing since 2010 (Raymond et al., 2016). Singapore’s Ministry of Health often issues guidelines and support tips on how to combat or deal with the illness, in terms of finance, family and overall psychological well-being.
The standard method by which doctors determine the specific kind of cancer present in a patient, is via a biopsy - the removal of tissue from any part of the body in order to examine it for the presence of cancer cells. Biopsies tend to be highly invasive and lengthy, and may also may result in complications. Current methods of non-invasive biopsies are now being pursued; an example would be the European project LiqBiopSens that is developing a liquid biopsy technology for the early detection of colorectal cancer (Williams & Segal, 2016).
Our Project: The RIOT System
The RIOT System provides an incentive of having a reduced cost and potentially provides better efficiency in cancer diagnosis and treatment, particularly in lesser developed countries where facilities and medical technologies are limited or not present at all. The system is suitable as a diagnostic tool and its financial sustainability and easy mobility allows it to work well as a business, as outlined in our business plan. This gives it the capacity to perhaps reach out to these lesser developed parts of the world in the future.
However, we anticipated that the public might be averse toward using bacteria as a diagnostic or therapeutic tool, due to its role in disease. It may not appear natural to many people to inject bacteria as a means toward curing an illness, rather than causing it. Therefore, the team believes that it is important to explore the Human Practices with regard to public perception of such a system. We wanted to further understand what the public’s views are in Singapore, beyond the knee-jerk aversion, and how we would change their point of view to accept such a tool, which will potentially be a faster and an equally reliable indicator of cancer.
As laws regarding the use of such bacteria-based tools are not spelt out in detail, an official opinion about this has not been established. As such, we wanted to ask how participants would react to such a medical procedure, what their concerns would be and how we could potentially address those concerns.
We carefully crafted a questionnaire which tackled several aspects of introducing a new medical procedure. This survey was distributed online to various age groups in Singapore to assess and thoroughly investigate the public receptivity to bacterial cancer diagnosis and therapy. Questions were asked on how participants felt about such procedures in general, and they went on to identify their perceived safety level of this new tool. The most commonly listed medical risks were also extracted from the survey results.
The pilot survey, with 163 contributors, revealed that there was receptivity to the bacterial detection system, as opposed to our initial hypothesis and worries. This was promising in the continuation of the Human Practices, as it showed that there is a potential demand for the system. However, the questions also established that the public had concerns about its safety, and it became an issue we needed to tackle. We also carried out this survey in two other countries in the Asia-Pacific region, and these surveys will be discussed after the following pages.
The two key points obtained from the survey administered in Singapore are as follows:
In the above figure, 93 out of 163 participants (57.1%) of people fall within the 4-to-5 range of receptiveness. This shows that the majority are potentially be receptive to the RIOT System as a commercial medical procedure. Unlike our initial fears, it appears the majority would not reject the system out-of-hand.
However, after analyzing the safety concerns of the respondents in this next figure, it is clear that the same participants do not deem the system to be a safe one, with only 33.1% of them falling in the 4-to-5 range. It is clear that many of them continue to express reservations about safety. Therefore, our team has identified the issue of safety to be the weaker link when implementing our system. We then integrated the above results to illustrate the connection between receptivity and perceived safety, if any was present. Figure 1 shows the relationship we obtained from the survey between the responses of receptivity, segmented by the respondent’s degree of perceived safety of a bacterial diagnostic system. The key inferences from the plot would be that, firstly, there is a high level of acceptance amongst people who find it very safe, as denoted by the pink area. This indicates a proportion of the public who may have an understanding of how our diagnostic system functions, thus opening up the market for our products. Secondly, even those apprehensive about the safety aspects of the RIOT System still believe that it may be a viable solution to expensive detection methods, as the probability of finding a participant who indicated a receptivity level of 3 to 5 is relatively high , regardless of what safety level was indicated. This indicates an overall positive opinion on the RIOT System, and thus means that our project may potentially have a market within the Singapore community:
Figure 1:Conditional probabilities plotted from Singapore survey results: Probability of selected level of receptivity given a certain level of safety selected by participants (P(Receptive|Safety)). (‘1’ being not at all receptive/safe and ‘5’ being completely receptive/safe)
International Outreach
With the results from the Singapore survey looking promising, we extended our study with the help of collaborators, the Hong_Kong_HKU and Melbourne iGEM teams, by administering the survey in their respective countries. Hong Kong and Australia are home to many different ethnicities, and yet are culturally contrasting. By extending the range of our survey responses to two distinctly different populations, we aimed to find trends in public perception of the RIOT System and, if they are present, to reach an international market for the system. The results are as follows:
The trends in the two countries seem to vary from the results of the Singapore survey. The results from Australia indicate that 32.8% of participants are very receptive to the RIOT System despite many of them believing that it is not completely safe - only 6% rated safety with a ‘5’. In the Hong Kong survey, the trend seems to differ - with only 12.5% of surveyees who were very receptive to the system, and 16.7% believing that is it completely safe.
To explain these results, we can examine the culture and attitudes of the people in each country towards such technologies. In a study conducted by researchers in the region, they discovered that the people of Hong Kong were less keen on using genetically modified organisms (GMOs) for medicinal than for nutritional purposes (Zhu & Xie, 2015).
This may be due to the prevalence of traditional medicine in Hong Kong, which may cause a drift in public perception towards new methods of medicine. 16.7% of the Hong Kong surveyees were above the age of 50, the demographic of the population which is more familiar with and possibly inclined to traditional medical procedures. By contrast, 91% of the Australian surveyees were between the ages of 19 and 25, and this age group tends to be more familiar with western medicine than traditional medicine. This may explain why the survey results from Hong Kong reflect a much smaller proportion of people who are completely receptive to the RIOT System as compared to Australia (12.5% for Hong Kong against 32.5% for the Australian survey), with reference to Figure 2.
References: Raymond, Y. C. F., Glenda, C. S. L., & Meng, L. K. (2016). Effects of High Doses of Vitamin C on Cancer Patients in Singapore Nine Cases. Integrative cancer therapies, 15(2), 197-204. Williams, P. M., & Segal, J. P. (2016). Webinar| Characterizing cancers from liquid biopsies and FFPE samples: The rise of targeted sequencing panels AUDIO. Science, 352(6282), 247-247. Zhu, X., & Xie, X. (2015). Effects of Knowledge on Attitude Formation and Change Toward Genetically Modified Foods. Risk Analysis, 35(5), 790-810.
CLICK TO VIEW
