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Sure, it’s about dementia research stupid, but don’t forget about wellbeing.
The famous aphorism of Carville is: “It’s the economy stupid, but don’t forget about healthcare.”
This is the way I feel about certain dementia campaigners who unashamedly wish to sideline wellbeing, in the search for a ‘cure’ via well funded biology labs.
Australia will host the next meeting of the Group of Twenty (G20) in November. We ask our Prime Minister, Mr Tony Abbott, to place dementia prominently on the G20 agenda. A petition entitled, “Australian PM Tony Abbott: Make dementia research and prevention a priority agenda item at the G20″ has been created by Professor Perminder Sachdev (Co-Director), from the Centre for Healthy Ageing.
The campaign banner is here.
Firstly, let me say it would be impossible to write this article without acknowledging Kate Swaffer.
Kate is here on Twitter, @KateSwaffer.
Kate is Chair of the Dementia Advisory Committee at Alzheimer’s Australia.
I firmly believe that there is a clear priority for researching good quality dementia care, and wellbeing approaches, as well as funding research into basic biology and applied treatments; and possible preventions, acknowledging that vascular dementias are probably are our best bet for initially reducing the prevalence.
These are potentially exciting times. See for example the recent work on GSK-3 inhibitors which has much promise, if they can tackle ‘known issues’ including potential side effects.
There’s a whole plethora of issues why dementia modifying-drugs have been found to be turkeys not to fly ultimately. These don’t just include a modest effect on benefits and outcomes, but also an inability of the drug to cross the barrier between the body and the rest of the body, and their prohibitive initial price of retail. Notwithstanding, dementia biological research is exceptionally vital to support, and the petition above must be supported for those reasons alone possibly.
But it really is about the quality of life ‘stupid’.
For example, the Dementia Alliance International is a non-profit group of people with dementia from the USA, Canada, Australia and other countries that seek to represent, support, and educate others living with the disease, and an organization that will provide a unified voice of strength, advocacy and support in the fight for individual autonomy and improved quality of life.
There is much to be gained by investing in understanding wellbeing and wellbeing improvements for people living with dementia, allowing greater independence where possible and appropriate. This involves a dialogue about the value that people with dementia bring to the community, along with us all, adaptations and innovations to improve vastly quality of life, design features in a person’s home, ward or external environment, greater choice about care services and better provision of information, promotion of leisure activities and techniques already proven to be of benefit (such as life story or reminiscence approaches).
For research to be moral, we should consider whether it’s moral that Pharma should have the lion’s share. The last decade is littered with failures, with the people should shout loudest, not necessarily anyone with formal academic qualifications in medicine, nursing, social care, or specifically dementia, not acknowledging that the cholinesterase inhibitors do not slow progression in the majority of individuals with Alzheimer’s disease. The modest effects of these drugs on many comes close to being an offensive scam, though the drugs are clearly of benefit in some.
“At the recent G8 summit, the leading economies of the world made a commitment to developing a cure for dementia by 2025. The UK said it would double its annual research funding for dementia to £132m by 2025. The USA has increased its funding for dementia recently by 12.5%. However, all this comes from a low base, with research funding for cancer currently being about 8 times, and for cardiovascular disease about 6 times that for dementia in high income countries (HICs). A huge imbalance will continue to exist.”
Otherwise, we get stuck in the same old tired language of the pharmaceutical industry.
Please do sign the petition, but please do not tolerate these messaging devices which are designed to induce panic and fear. People with dementia do not deserve that.
“[Abbott] will follow the lead of the British Prime Minister who recently hosted the G8 Dementia Summit, and called dementia “the disease that steals lives, wrecks families and beaks hearts” and recognised it as “an increasing threat to global health”.”
This language of “burden” not value has been pervasive in many charities’ attempts at raising money for dementia historically:
“Of course, dementia is a global problem, currently costing more than $600 billion annually, and growing exponentially. The greatest growth is in low and middle income countries (LMICs). Already, there are more dementia patients in LMICs, and by the middle of the century, more than 70% of dementia patients will be in these countries, which are ill-equipped to deal with the burden of dementia.”
Without unpaid carers in the UK, the NHS care for dementia would collapse. And yet they are totally invisible in this narrative.
Certainly, globally low rates of dementia are unacceptable, but also unacceptable is the medical profession not talking about wellbeing at all with their patients preferring to stick to the rubric of “treatment”
If, like me, you’d like to give carers a voice, please support the work of Tommy Whitelaw (@TommyNTour).
“In many countries, there is a lack of awareness of the problem, dementia is poorly diagnosed and facilities for treatment and care are rudimentary. ADI estimated that 3 out of every 4 of the 36 million people worldwide living with dementia have not been formally diagnosed and are not receiving treatment and care. The “treatment gap” is most significant in developing nations. In Australia, the average delay between the onset of noticeable symptoms and a firm diagnosis is 3.1 years. Putting dementia on the G20 agenda and getting a commitment from the leaders of countries like China, India and Brazil is likely to have a remarkable impact on dementia awareness, care and research around the world.”
And the bottom line is..
“More funds are needed for the diagnosis, treatment and care of dementia patients. An investment into dementia research is urgently needed from all countries, led by but not restricted to the rich nations. In many parts of the world, research into dementia is non-existent. This, combined with the relative neglect of dementia research in rich countries, has created a major gap between the disability and suffering attributable to dementia and the research investment into its diagnosis, treatment and appropriate care. Greater research funding will help develop new treatments, but more importantly, exploit the current knowledge to develop strategies to prevent dementia or delay its onset. The G8 has set ambitious targets. We ask Mr Abbott to take the lead and make it a truly global fight against the dementia time bomb.”
Arrrgghh.
It is now more essential than ever to ask persons or ‘users’ of the NHS, and those of jurisdictions beyond such as in Australia, what they want from a strategic response to dementia. This could include, justifiably, better support for carers who include unpaid family caregivers working under considerable stress.
More than ever we need to have research funds to be allocated correctly. It’s going to be vital to have persons with dementia on these research funding allocation boards. For example, shouldn’t we know about the cost/benefit analysis of GPS trackers for people with dementia at risk of wandering?
With all the much trumpeted talk of ‘doctors being in the driving seat’, it cannot be acceptable that persons with dementia, if they are there at all, are tokenistically placed on funding boards.
Persons with dementia and carers should be empowered to tell the people with the money what matters to them the most. This could of course be the noble search for a cure, and much more parity for dementia research as compared with other conditions.
Sure it’s about dementia research stupid, but don’t forget about wellbeing.
The Amazon "1 click" patent
Telstra Corporation Limited v Amazon.com, Inc [2011] APO 28 (9 May 2011)
The patents and patent applications directed to Amazon’s ‘1-click’1 online shopping concept have attracted substantial controversy around the world, in particular in the context of the patentability of business process and software patents. The ‘1-click’ concept allows customers to make online purchases with a single click, with the payment information needed to complete the purchase previously provided by the user.
The Australian Patent Office has rejected Amazon.com Inc’s patent application for its 1-click ordering system after a successful opposition by Telstra Corporation Limited.
Therefore, the decision gives Amazon a clear indication of how it can amend its patent application to overcome the rejection. This decision forms part of a long history of challenges around the world (most notably in the United States and Europe) to patent applications filed by Amazon for its 1-click ordering system which provides for a simplified process for purchasing goods online.
In Australia, the grant of Amazon’s application (AU 762175)2 was opposed by Telstra Corporation Limited (Telstra). The opposition was primarily on the grounds that the claimed invention was not novel and lacked an inventive step in light of a number of prior art documents, including one of Telstra’s own patents. The patent application claims a method for ordering an item in response to a single action performed to order the item.
Construction
Firstly, the construction of the term ‘a single action’ was considered, both with reference to the clarity of the claims and as being pivotal to the questions of novelty and inventive step. The opponent argued that the claimed ‘single action’ was unclear, and did not necessarily mean ‘only a single action’ (the wording used in corresponding US patent 5960411). The Delegate referred to the principles of construction as laid out in Décor Corp Pty Ltd v Dart Industries Inc [1988] 13 IPR 385, and with reference to the specification and dictionary definitions came to the conclusion that the claimed ‘single action’ does mean ‘only a single action’.
In this construction heavy reliance was placed on the description that ‘…the single action generally refers to a single event received by a client system that indicates to place the order.’ In light of this passage, the Delegate goes on to say that despite (semantically) being two actions, an action such as the double click of a mouse button would ‘clearly fall within the scope of ‘a single action’ as that term is to be understood in the claims’.
1-Click ordering is not new in light of Telstra’s “click-to-call” patent
Amazon’s patent application contained 141 claims. The Delegate of the Commissioner of Patents found that some of the claims (including the very broad first claim directed, quite generally, to a single action item ordering system) were not new in view of one of Telstra’s “click-to-call” patents, which Telstra filed before Amazon filed its patent application for the 1-click system.
Telstra’s patent describes a method of making a telephone call in which a person simply selects (clicks on) the telephone number they wish to dial in an electronic directory to place a call. Importantly, the method allowed the parties to the call to make prior billing arrangements, streamlining the calling process and allowing them to make a call in only one step. The Delegate considered the placing of a call to be the ordering of an item.
The Delegate referred to the ‘reverse infringement test’ for novelty, where infringement occurs when each and every essential feature of a claim is disclosed in the alleged anticipating document. Under the construction of the claims adopted, the Delegate found that 10 of the 141 claims did lack novelty in view of Telstra’s own patent.
Some claims not inventive in light of common general knowledge
The Delegate also found that claims 1, 2 and 4 – 61 were not inventive in light of the common general knowledge (“CGK”) known to persons skilled in the art at the priority date. Specifically, the Delegate accepted Telstra’s submission that:
- the display of order or item information for Internet ordering systems and the use of a web browser to access that display; and
- the use of, amongst other things, clicking a mouse button over a pre-defined area of displayed information to select information or send instructions,
formed part of the CGK.
The Delegate concluded that, in respect of claim 1, the “single action” was the only feature which was not already part of the CGK (“CGK”).
He found that, “as a matter of simple logic”, one way to ensure that customers could check-out more easily (a problem the invention was trying to address) was to reduce the number of steps involved in “checking-out”, ideally down to one step.
Interestingly, although the Delegate accepted Telstra’s submission that claim 1 permits there to be one or more additional actions prior to the “single action” claimed, in assessing whether the claimed system was new, the Delegate appeared to count the number of actions required to place the order. On that basis, he excluded a number of documents published before the filing date of Amazon’s patent application which included more than one action when assessing whether Amazon’s invention was “new”.
Inventive step
“Inventive step” was also considered.
Because the application was filed before 1 April 2002, combining two or more unrelated prior art documents or acts to establish lack of an inventive step was not possible. Consequently common general knowledge figured prominently in the case put forward by Telstra and evidence from experts in the field was extensive from both sides.
The Delegate referred to a number of approaches for determining whether the claims were obvious or not, advocating the problem–solution approach whilst being mindful of its limitations – particularly with respect to combination or simple inventions.3 Under this approach the Delegate found that the use of an identifier (such as a ‘cookie’) as defined by claims 3 and 62 to 141 was in fact inventive. This is despite the finding that cookies were, in their own right, common general knowledge at the priority date.
On this finding, 60 of the 141 claims which do not include the identifier feature were found to be invalid.
The future
As would be expected Amazon has been provided with an opportunity to propose amendments to the application to address the Delegate’s findings.
Perhaps what the outcome of this case emphasises is how important it is to bear in mind the common general knowledge and state of the art at the time a specification was filed. The widespread scepticism about how this kind of software implementation could possibly be patented is, arguably, based on the opinion that this solution must have been obvious given e-commerce, storing a computer’s details on a server, and the use of cookies were all known at the time.
Therefore, ultimately, although the Delegate found that a patent could not be granted for many of Amazon’s broader claims, Amazon concentrated its arguments on claims involving the use of cookies to enable 1-click ordering. The Delegate found that claims relating to the use of cookies were new and inventive when Amazon filed its patent application in 1997, and therefore deserving of patent protection. Subject to any appeal to the Federal Court of Australia lodged by Telstra or Amazon, Amazon can now amend its application and obtain a patent for claims relating to its use of cookie technology in the context of 1-click ordering.
