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Danilatou V, Dimopoulos D, Kostoulas T, Douketis J. Machine Learning-Based Predictive Models for Patients with Venous Thromboembolism: A Systematic Review. Thromb Haemost 2024. [PMID: 38574756 DOI: 10.1055/a-2299-4758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
BACKGROUND Venous thromboembolism (VTE) is a chronic disorder with a significant health and economic burden. Several VTE-specific clinical prediction models (CPMs) have been used to assist physicians in decision-making but have several limitations. This systematic review explores if machine learning (ML) can enhance CPMs by analyzing extensive patient data derived from electronic health records. We aimed to explore ML-CPMs' applications in VTE for risk stratification, outcome prediction, diagnosis, and treatment. METHODS Three databases were searched: PubMed, Google Scholar, and IEEE electronic library. Inclusion criteria focused on studies using structured data, excluding non-English publications, studies on non-humans, and certain data types such as natural language processing and image processing. Studies involving pregnant women, cancer patients, and children were also excluded. After excluding irrelevant studies, a total of 77 studies were included. RESULTS Most studies report that ML-CPMs outperformed traditional CPMs in terms of receiver operating area under the curve in the four clinical domains that were explored. However, the majority of the studies were retrospective, monocentric, and lacked detailed model architecture description and external validation, which are essential for quality audit. This review identified research gaps and highlighted challenges related to standardized reporting, reproducibility, and model comparison. CONCLUSION ML-CPMs show promise in improving risk assessment and individualized treatment recommendations in VTE. Apparently, there is an urgent need for standardized reporting and methodology for ML models, external validation, prospective and real-world data studies, as well as interventional studies to evaluate the impact of artificial intelligence in VTE.
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Affiliation(s)
- Vasiliki Danilatou
- School of Medicine, European University of Cyprus, Nicosia, Cyprus
- Healthcare Division, Sphynx Technology Solutions, Nicosia, Cyprus
| | - Dimitrios Dimopoulos
- School of Engineering, Department of Information and Communication Systems Engineering, University of the Aegean, North Aegean, Greece
| | - Theodoros Kostoulas
- School of Engineering, Department of Information and Communication Systems Engineering, University of the Aegean, North Aegean, Greece
| | - James Douketis
- Department of Medicine, McMaster University, Hamilton, Canada
- Department of Medicine, St. Joseph's Healthcare Hamilton, Ontario, Canada
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Anandpara G, Kharadi A, Vidja P, Chauhan Y, Mahajan S, Patel J. A Comprehensive Review on Digital Detox: A Newer Health and Wellness Trend in the Current Era. Cureus 2024; 16:e58719. [PMID: 38779255 PMCID: PMC11109987 DOI: 10.7759/cureus.58719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 04/22/2024] [Indexed: 05/25/2024] Open
Abstract
This research investigates the effects of an electronic detox treatment on the utilization of social media and smartphones, addiction levels, and the general health of individuals. Remarkably, individuals discovered that the digital detox was less challenging than anticipated, with a significant number expressing sensations of pleasure and alleviation. Although a few individuals encountered instances of alienation and solitude, the majority managed to adapt to the limited availability of the internet. Notably, individuals saw heightened tedium and replaced their use of social networking sites with additional tasks using screens. After the procedure, measures demonstrated favorable or neutral enhancements in addictions and health-related results. The quantitative findings indicate an increased understanding of online conduct and the use of self-regulating strategies. Concrete recommendations put forward by respondents include reducing stringent deadlines, implementing personalized limitations, and devising tactics to regulate alerts and their use. These observations may be used to shape subsequent digital detox programs in order to improve their efficacy and increase participation from participants.
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Affiliation(s)
- Gaurang Anandpara
- Biochemistry, Chimanlal Ujamshibhai Shah Medical College & Hospital, Surendranagar, IND
| | - Ashish Kharadi
- Surgery, Gujarat Medical Education and Research Society Medical College, Godhra, IND
| | - Prakash Vidja
- Pathology, Pre Cure Pathology Laboratory, Morbi, IND
| | - Yashkumar Chauhan
- Medicine, Smt. Nathiba Hargovandas Lakhmichand Municipal Medical College, Ahmedabad, IND
| | - Swati Mahajan
- Physiology, Gujarat Medical Education and Research Society Medical College, Godhra, IND
| | - Jitendra Patel
- Physiology, Gujarat Medical Education and Research Society Medical College, Vadnagar, IND
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3
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Nazi KM, Newton T, Armstrong CM. Unleashing the Potential for Patient-Generated Health Data (PGHD). J Gen Intern Med 2024; 39:9-13. [PMID: 38252246 PMCID: PMC10937868 DOI: 10.1007/s11606-023-08461-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 10/06/2023] [Indexed: 01/23/2024]
Abstract
Patient-generated health data (PGHD) is data created, captured, or recorded by patients in between healthcare appointments, and is an important supplement to data generated during periodic clinical encounters. PGHD has potential to improve diagnosis and management of chronic conditions, improve health outcomes, and facilitate more "connected health" between patients and their care teams. Electronic PGHD is rapidly accelerating due to the proliferation of consumer health technologies, remote patient monitoring systems, and personal health platforms. Despite this tremendous growth in PGHD and anticipated benefits, broadscale use of PGHD has been challenging to implement with significant gaps in current knowledge about how PGHD can best be employed in the service of high-quality, patient-centered care. While the role of PGHD in patient self-management continues to grow organically, we need a deeper understanding of how data collection and sharing translate into actionable information that supports shared decision-making and informs clinical care in real-world settings. This, in turn, will foster both clinical adoption and patient engagement with PGHD. We propose an agenda for PGHD-related research in the Veterans Health Administration that emphasizes this clinical value to enhance our understanding of its potential and limitations in supporting shared decision-making and informing clinical care.
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Affiliation(s)
- Kim M Nazi
- Trilogy Federal, LLC, Arlington, VA, USA.
- KMN Consulting Services, LTD, Coxsackie, NY, USA.
- Trilogy Federal, LLC, 44 Mountain View Drive, Coxsackie, NY, 12051, USA.
| | - Terry Newton
- Office of Connected Care, US Department of Veterans Affairs, Washington, DC, USA
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4
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Brown SA, Beavers C, Bauer B, Cheng RK, Berman G, Marshall CH, Guha A, Jain P, Steward A, DeCara JM, Olaye IM, Hansen K, Logan J, Bergom C, Glide-Hurst C, Loh I, Gambril JA, MacLeod J, Maddula R, McGranaghan PJ, Batra A, Campbell C, Hamid A, Gunturkun F, Davis R, Jefferies J, Fradley M, Albert K, Blaes A, Choudhuri I, Ghosh AK, Ryan TD, Ezeoke O, Leedy DJ, Williams W, Roman S, Lehmann L, Sarkar A, Sadler D, Polter E, Ruddy KJ, Bansal N, Yang E, Patel B, Cho D, Bailey A, Addison D, Rao V, Levenson JE, Itchhaporia D, Watson K, Gulati M, Williams K, Lloyd-Jones D, Michos E, Gralow J, Martinez H. Advancing the care of individuals with cancer through innovation & technology: Proceedings from the cardiology oncology innovation summit 2020 and 2021. AMERICAN HEART JOURNAL PLUS : CARDIOLOGY RESEARCH AND PRACTICE 2024; 38:100354. [PMID: 38510746 PMCID: PMC10945974 DOI: 10.1016/j.ahjo.2023.100354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 12/10/2023] [Accepted: 12/12/2023] [Indexed: 03/22/2024]
Abstract
As cancer therapies increase in effectiveness and patients' life expectancies improve, balancing oncologic efficacy while reducing acute and long-term cardiovascular toxicities has become of paramount importance. To address this pressing need, the Cardiology Oncology Innovation Network (COIN) was formed to bring together domain experts with the overarching goal of collaboratively investigating, applying, and educating widely on various forms of innovation to improve the quality of life and cardiovascular healthcare of patients undergoing and surviving cancer therapies. The COIN mission pillars of innovation, collaboration, and education have been implemented with cross-collaboration among academic institutions, private and public establishments, and industry and technology companies. In this report, we summarize proceedings from the first two annual COIN summits (inaugural in 2020 and subsequent in 2021) including educational sessions on technological innovations for establishing best practices and aligning resources. Herein, we highlight emerging areas for innovation and defining unmet needs to further improve the outcome for cancer patients and survivors of all ages. Additionally, we provide actionable suggestions for advancing innovation, collaboration, and education in cardio-oncology in the digital era.
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Affiliation(s)
- Sherry-Ann Brown
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Craig Beavers
- University of Kentucky College of Pharmacy, Lexington, KY, USA
| | - Brenton Bauer
- COR Healthcare Associates, Torrance Memorial Medical Center, Torrance, CA, USA
| | - Richard K. Cheng
- Cardio-Oncology Program, Division of Cardiology, University of Washington, Seattle, WA, USA
| | | | - Catherine H. Marshall
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD, USA
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Avirup Guha
- Cardio-Oncology Program, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Prantesh Jain
- Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | | | - Jeanne M. DeCara
- Section of Cardiology, Department of Medicine, University of Chicago Medicine, Chicago, IL, USA
| | - Iredia M. Olaye
- Division of Clinical Epidemiology, Department of Medicine, Weill Cornell Medicine, New York, NY, USA
| | | | - Jim Logan
- University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Carmen Bergom
- Department of Radiation Oncology, Washington University in St. Louis, St. Louis, MO, USA
- Cardio-Oncology Center of Excellence, Washington University in St. Louis, St. Louis, MO, USA
| | - Carri Glide-Hurst
- Department of Human Oncology, University of Wisconsin, Madison, WI, USA
| | - Irving Loh
- Ventura Heart Institute, Thousand Oaks, CA, USA
- Division of Cardiology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - John Alan Gambril
- Cardio-Oncology Program, Division of Cardiology, The Ohio State University Medical Center, Columbus, OH, USA
| | | | | | - Peter J. McGranaghan
- Department of Cardiothoracic Surgery, German Heart Center, Berlin, Germany
- Department of Internal Medicine and Cardiology, Charité Campus Virchow-Klinikum, Berlin, Germany
- Miami Cancer Institute, Baptist Health South Florida, Miami, FL, USA
| | - Akshee Batra
- Department of Medicine, University of Vermont Medical Center, Burlington, VT, USA
| | - Courtney Campbell
- Cardio-Oncology Center of Excellence, Washington University in St. Louis, St. Louis, MO, USA
| | | | - Fatma Gunturkun
- Center for Biomedical Informatics, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Robert Davis
- Center for Biomedical Informatics, University of Tennessee Health Science Center, Memphis, TN, USA
- St. Jude Children's Research Hospital, Memphis, TN, USA
| | - John Jefferies
- Center for Biomedical Informatics, University of Tennessee Health Science Center, Memphis, TN, USA
- St. Jude Children's Research Hospital, Memphis, TN, USA
- The Heart Institute at Le Bonheur Children's Hospital, University of Tennessee Health and Science Center, Memphis, TN, USA
| | - Michael Fradley
- Cardio-Oncology Center of Excellence, Division of Cardiology, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Katherine Albert
- Helen and Arthur E. Johnson Beth-El College of Nursing and Health Sciences, University of Colorado at Colorado Springs, Denver, CO, USA
| | - Anne Blaes
- Division of Hematology/Oncology, University of Minnesota, Minneapolis, MN, USA
| | - Indrajit Choudhuri
- Department of Electrophysiology, Froedtert South Hospital, Milwaukee, WI, USA
| | - Arjun K. Ghosh
- Cardio-Oncology Service, Barts Heart Centre and University College London Hospital, London, UK
| | - Thomas D. Ryan
- Department of Pediatrics, University of Cincinnati College of Medicine; Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Ogochukwu Ezeoke
- Department of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Douglas J. Leedy
- Division of Cardiology, University of Washington, Seattle, WA, USA
| | | | - Sebastian Roman
- Department of Internal Medicine III: Cardiology, Angiology and Pulmonology, Heidelberg University Hospital, Heidelberg, Germany
| | - Lorenz Lehmann
- Department of Internal Medicine III: Cardiology, Angiology and Pulmonology, Heidelberg University Hospital, Heidelberg, Germany
| | - Abdullah Sarkar
- Department of Medicine, Cleveland Clinic Florida, Weston, FL, USA
| | - Diego Sadler
- Department of Medicine, Cleveland Clinic Florida, Weston, FL, USA
| | - Elizabeth Polter
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | | | - Neha Bansal
- Division of Pediatric Cardiology, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Eric Yang
- Cardio-Oncology Program, University of California, Los Angeles, Los Angeles, CA, USA
| | - Brijesh Patel
- Division of Cardiology, West Virginia University Heart and Vascular Institute, West Virginia University, Morgantown, WV, USA
| | - David Cho
- Division of Cardiovascular Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Alison Bailey
- Center for Heart, Lung, and Vascular Health at Parkridge, HCA Healthcare, Chattanooga, TN, USA
| | - Daniel Addison
- Cardio-Oncology Program, Division of Cardiology, The Ohio State University Medical Center, Columbus, OH, USA
| | - Vijay Rao
- Indiana Heart Physicians, Franciscan Health, Indianapolis, IN, USA
| | - Joshua E. Levenson
- Division of Cardiology, UPMC Heart and Vascular Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | - Dipti Itchhaporia
- Cardiology, University of California Irvine, Hoag Hospital Newport Beach, Newport Beach, CA, USA
| | - Karol Watson
- Division of Cardiovascular Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Martha Gulati
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, USA
| | - Kim Williams
- Division of Cardiology, Rush University Medical Center, Chicago, IL, USA
| | - Donald Lloyd-Jones
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Erin Michos
- Division of Cardiology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Julie Gralow
- American Society of Clinical Oncology, Alexandria, VA, USA
| | - Hugo Martinez
- St. Jude Children's Research Hospital, Memphis, TN, USA
- The Heart Institute at Le Bonheur Children's Hospital, University of Tennessee Health and Science Center, Memphis, TN, USA
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5
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Masterson Creber R, Dodson JA, Bidwell J, Breathett K, Lyles C, Harmon Still C, Ooi SY, Yancy C, Kitsiou S. Telehealth and Health Equity in Older Adults With Heart Failure: A Scientific Statement From the American Heart Association. Circ Cardiovasc Qual Outcomes 2023; 16:e000123. [PMID: 37909212 DOI: 10.1161/hcq.0000000000000123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
Enhancing access to care using telehealth is a priority for improving outcomes among older adults with heart failure, increasing quality of care, and decreasing costs. Telehealth has the potential to increase access to care for patients who live in underresourced geographic regions, have physical disabilities or poor access to transportation, and may not otherwise have access to cardiologists with expertise in heart failure. During the COVID-19 pandemic, access to telehealth expanded, and yet barriers to access, including broadband inequality, low digital literacy, and structural barriers, prevented many of the disadvantaged patients from getting equitable access. Using a health equity lens, this scientific statement reviews the literature on telehealth for older adults with heart failure; provides an overview of structural, organizational, and personal barriers to telehealth; and presents novel interventions that pair telemedicine with in-person services to mitigate existing barriers and structural inequities.
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6
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Garcia Gonzalez-Moral S, Beyer FR, Oyewole AO, Richmond C, Wainwright L, Craig D. Looking at the fringes of MedTech innovation: a mapping review of horizon scanning and foresight methods. BMJ Open 2023; 13:e073730. [PMID: 37709340 PMCID: PMC10503360 DOI: 10.1136/bmjopen-2023-073730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 08/21/2023] [Indexed: 09/16/2023] Open
Abstract
OBJECTIVES Horizon scanning (HS) is a method used to examine signs of change and may be used in foresight practice. HS methods used for the identification of innovative medicinal products cannot be applied in medical technologies (MedTech) due to differences in development and regulatory processes. The aim of this study is to identify HS and other methodologies used for MedTech foresight in support to healthcare decision-making. METHOD A mapping review was performed. We searched bibliographical databases including MEDLINE, Embase, Scopus, Web of Science, IEEE Xplore and Compendex Engineering Village and grey literature sources such as Google, CORE database and the International HTA database. Our searches identified 8888 records. After de-duplication, and manual and automated title, abstracts and full-text screening, 49 papers met the inclusion criteria and were data extracted. RESULTS Twenty-five single different methods were identified, often used in combination; of these, only three were novel (appearing only once in the literature). Text mining or artificial intelligence solutions appear as early as 2012, often practised in patent and social media sources. The time horizon used in scanning was not often justified. Some studies regarded experts both as a source and as a method. Literature searching remains one of the most used methods for innovation identification. HS methods were vaguely reported, but often involved consulting with experts and stakeholders. CONCLUSION Heterogeneous methodologies, sources and time horizons are used for HS and foresight of MedTech innovation with little or no justification provided for their use. This review revealed an array of known methods being used in combination to overcome the limitations posed by single methods. The review also revealed inconsistency in methods reporting, with a lack of any consensus regarding best practice. Greater transparency in methods reporting and consistency in methods use would contribute to increased output quality to support informed timely decision-making.
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Affiliation(s)
- Sonia Garcia Gonzalez-Moral
- NIHR Innovation Observatory at Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Fiona R Beyer
- NIHR Innovation Observatory at Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Anne O Oyewole
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Catherine Richmond
- NIHR Innovation Observatory at Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Luke Wainwright
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Dawn Craig
- NIHR Innovation Observatory at Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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7
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Stevenson LW, Ross HJ, Rathman LD, Boehmer JP. Remote Monitoring for Heart Failure Management at Home. J Am Coll Cardiol 2023; 81:2272-2291. [PMID: 37286258 DOI: 10.1016/j.jacc.2023.04.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 04/04/2023] [Accepted: 04/06/2023] [Indexed: 06/09/2023]
Abstract
Early telemonitoring of weights and symptoms did not decrease heart failure hospitalizations but helped identify steps toward effective monitoring programs. A signal that is accurate and actionable with response kinetics for early re-assessment is required for the treatment of patients at high risk, while signal specifications differ for surveillance of low-risk patients. Tracking of congestion with cardiac filling pressures or lung water content has shown most impact to decrease hospitalizations, while multiparameter scores from implanted rhythm devices have identified patients at increased risk. Algorithms require better personalization of signal thresholds and interventions. The COVID-19 epidemic accelerated transition to remote care away from clinics, preparing for new digital health care platforms to accommodate multiple technologies and empower patients. Addressing inequities will require bridging the digital divide and the deep gap in access to HF care teams, who will not be replaced by technology but by care teams who can embrace it.
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Affiliation(s)
| | - Heather J Ross
- Ted Rogers Centre for Heart Research, Peter Munk Centre, Toronto, Ontario, Canada
| | - Lisa D Rathman
- PENN Medicine Lancaster General Health, Lancaster, Pennsylvania, USA
| | - John P Boehmer
- Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
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8
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Fry ETA, Maddox TM, Bhatt AB. Innovation in Cardiovascular Care Delivery. J Am Coll Cardiol 2023; 81:2207-2209. [PMID: 37257956 DOI: 10.1016/j.jacc.2023.04.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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9
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Thorlu-Bangura Z, Poole L, Sood H, Khan N, Stevenson F, Khunti K, Gill P, Sajid M, Hanif W, Bhala N, Modha S, Patel K, Blandford A, Banerjee A, Ramasawmy M. Digital health, cardiometabolic disease and ethnicity: an analysis of United Kingdom government policies from 2010 to 2022. J Public Health Policy 2023:10.1057/s41271-023-00410-z. [PMID: 37085565 PMCID: PMC10120476 DOI: 10.1057/s41271-023-00410-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2023] [Indexed: 04/23/2023]
Abstract
Recent health policies in the United Kingdom (UK) and internationally have focussed on digitisation of healthcare. We examined UK policies for evidence of government action addressing health inequalities and digital health, using cardiometabolic disease as an exemplar. Using a systematic search methodology, we identified 87 relevant policy documents published between 2010 and 2022. We found increasing emphasis on digital health, including for prevention, diagnosis and management of cardiometabolic disease. Several policies also focused on tackling health inequalities and improving digital access. The COVID-19 pandemic amplified inequalities. No policies addressed ethnic inequalities in digital health for cardiometabolic disease, despite high prevalence in minority ethnic communities. Our findings suggest that creating opportunities for digital inclusion and reduce longer-term health inequalities, will require future policies to focus on: the heterogeneity of ethnic groups; cross-sectoral disadvantages which contribute to disease burden and digital accessibility; and disease-specific interventions which lend themselves to culturally tailored solutions.
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Affiliation(s)
| | - Lydia Poole
- Department of Psychological Interventions, School of Psychology, University of Surrey, Guildford, Surrey, UK
| | | | - Nushrat Khan
- Institute of Health Informatics, UCL, 222 Euston Road, London, NW1 2DA, UK
| | - Fiona Stevenson
- Department of Primary Care and Population Health, University College London, London, UK
| | - Kamlesh Khunti
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK
| | - Paramjit Gill
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Madiha Sajid
- Patient and Public Involvement Representative, DISC Study, London, UK
| | - Wasim Hanif
- Department of Diabetes, University Hospital Birmingham, Birmingham, UK
| | - Neeraj Bhala
- Institute of Applied Health Research, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHSFT, Edgbaston, Birmingham, UK
| | - Shivali Modha
- Patient and Public Involvement Representative, DISC Study, London, UK
| | - Kiran Patel
- Warwick Medical School, University of Warwick, Coventry, UK
- University Hospitals Coventry and Warwickshire, Coventry, UK
| | | | - Amitava Banerjee
- Institute of Health Informatics, UCL, 222 Euston Road, London, NW1 2DA, UK
| | - Mel Ramasawmy
- Institute of Health Informatics, UCL, 222 Euston Road, London, NW1 2DA, UK.
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10
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Shen CP, Freed BC, Walter DP, Perry JC, Barakat AF, Elashery ARA, Shah KS, Kutty S, McGillion M, Ng FS, Khedraki R, Nayak KR, Rogers JD, Bhavnani SP. Convolution Neural Network Algorithm for Shockable Arrhythmia Classification Within a Digitally Connected Automated External Defibrillator. J Am Heart Assoc 2023; 12:e026974. [PMID: 36942628 DOI: 10.1161/jaha.122.026974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
Background Diagnosis of shockable rhythms leading to defibrillation remains integral to improving out-of-hospital cardiac arrest outcomes. New machine learning techniques have emerged to diagnose arrhythmias on ECGs. In out-of-hospital cardiac arrest, an algorithm within an automated external defibrillator is the major determinant to deliver defibrillation. This study developed and validated the performance of a convolution neural network (CNN) to diagnose shockable arrhythmias within a novel, miniaturized automated external defibrillator. Methods and Results There were 26 464 single-lead ECGs that comprised the study data set. ECGs of 7-s duration were retrospectively adjudicated by 3 physician readers (N=18 total readers). After exclusions (N=1582), ECGs were divided into training (N=23 156), validation (N=721), and test data sets (N=1005). CNN performance to diagnose shockable and nonshockable rhythms was reported with area under the receiver operating characteristic curve analysis, F1, and sensitivity and specificity calculations. The duration for the CNN to output was reported with the algorithm running within the automated external defibrillator. Internal and external validation analyses included CNN performance among arrhythmias, often mistaken for shockable rhythms, and performance among ECGs modified with noise to mimic artifacts. The CNN algorithm achieved an area under the receiver operating characteristic curve of 0.995 (95% CI, 0.990-1.0), sensitivity of 98%, and specificity of 100% to diagnose shockable rhythms. The F1 scores were 0.990 and 0.995 for shockable and nonshockable rhythms, respectively. After input of a 7-s ECG, the CNN generated an output in 383±29 ms (total time of 7.383 s). The CNN outperformed adjudicators in classifying atrial arrhythmias as nonshockable (specificity of 99.3%-98.1%) and was robust against noise artifacts (area under the receiver operating characteristic curve range, 0.871-0.999). Conclusions We demonstrate high diagnostic performance of a CNN algorithm for shockable and nonshockable rhythm arrhythmia classifications within a digitally connected automated external defibrillator. Registration URL: https://clinicaltrials.gov/ct2/show/NCT03662802; Unique identifier: NCT03662802.
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Affiliation(s)
- Christine P Shen
- Division of Cardiology Healthcare Innovation Laboratory Scripps Clinic San Diego CA
| | | | | | - James C Perry
- University of California San Diego, Rady Children's Hospital San Diego CA
| | - Amr F Barakat
- University of Pittsburg Medical Center Pittsburgh PA
| | | | - Kevin S Shah
- University of Utah Health Sciences Center Salt Lake City UT
| | | | | | - Fu Siong Ng
- Imperial College of London London United Kingdom
| | - Rola Khedraki
- Division of Cardiology Healthcare Innovation Laboratory Scripps Clinic San Diego CA
| | - Keshav R Nayak
- Division of Interventional Cardiology Scripps Mercy Hospital San Diego CA
| | - John D Rogers
- Division of Cardiology Healthcare Innovation Laboratory Scripps Clinic San Diego CA
| | - Sanjeev P Bhavnani
- Division of Cardiology Healthcare Innovation Laboratory Scripps Clinic San Diego CA
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11
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Nursing students’ genomics literacy: Basis for genomics nursing education course development. TEACHING AND LEARNING IN NURSING 2023. [DOI: 10.1016/j.teln.2022.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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12
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In-ear infrasonic hemodynography with a digital health device for cardiovascular monitoring using the human audiome. NPJ Digit Med 2022; 5:189. [PMID: 36550288 PMCID: PMC9780339 DOI: 10.1038/s41746-022-00725-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 11/29/2022] [Indexed: 12/24/2022] Open
Abstract
Human bodily mechanisms and functions produce low-frequency vibrations. Our ability to perceive these vibrations is limited by our range of hearing. However, in-ear infrasonic hemodynography (IH) can measure low-frequency vibrations (<20 Hz) created by vital organs as an acoustic waveform. This is captured using a technology that can be embedded into wearable devices such as in-ear headphones. IH can acquire sound signals that travel within arteries, fluids, bones, and muscles in proximity to the ear canal, allowing for measurements of an individual's unique audiome. We describe the heart rate and heart rhythm results obtained in time-series analysis of the in-ear IH data taken simultaneously with ECG recordings in two dedicated clinical studies. We demonstrate a high correlation (r = 0.99) between IH and ECG acquired interbeat interval and heart rate measurements and show that IH can continuously monitor physiological changes in heart rate induced by various breathing exercises. We also show that IH can differentiate between atrial fibrillation and sinus rhythm with performance similar to ECG. The results represent a demonstration of IH capabilities to deliver accurate heart rate and heart rhythm measurements comparable to ECG, in a wearable form factor. The development of IH shows promise for monitoring acoustic imprints of the human body that will enable new real-time applications in cardiovascular health that are continuous and noninvasive.
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13
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Raparelli V, Wright CX, Corica B, Sharma G, Lindley K, Brackett A, Pilote L, Wood MJ, Dreyer RP. Interventions Targeted to Address Social Determinants of Health in Ischemic Heart Disease: A Sex- and Gender-Oriented Scoping Review. Can J Cardiol 2022; 38:1881-1892. [PMID: 35809812 DOI: 10.1016/j.cjca.2022.06.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 06/21/2022] [Accepted: 06/28/2022] [Indexed: 12/14/2022] Open
Abstract
The burden of ischemic heart disease (IHD) is a major health problem worldwide. The detrimental effect of gendered (ie, unevenly distributed between female and male) socioeconomic determinants of health (SDOH) on outcomes has been demonstrated, more so in female individuals. Therefore, addressing SDOH is a priority for the care implementation of patients with IHD. We conducted a scoping review to identify the types of SDOH-tailored interventions tested in randomised controlled trials (RCTs) among IHD patients, and whether the reporting of findings was sex-unbiased. We identified 8 SDOH domains: education, physical environment, health care system, economic stability, social support, sexual orientation, culture/language, and systemic racism. A total of 28 RCTs (2 ongoing) were evaluated. Since the 1990s, 26 RCTs have been conducted, mainly in the Middle East and Asia, and addressed only education, physical environment, health care system, and social support. The 77% of studies focused on patient-education interventions, and around 80% on SDOH-based interventions achieved positive effects on a variety of primary outcome(s). Among the limitations of the conducted RCTs, the most relevant were an overall low participation of female and racial/ethnical minority participants, a lack of sex-stratified analyses, and a missing opportunity of tailoring some SDOH interventions relevant for health. The SDOH-tailored interventions tested so far in RCTs, enrolling predominantly male patients and mainly targeting education and health literacy, were effective in improving outcomes among patients with IHD. Future studies should focus on a wider range of SDOH with an adequate representation of female and minority patients who would most benefit from such interventions.
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Affiliation(s)
- Valeria Raparelli
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy; University Centre for Studies on Gender Medicine, University of Ferrara, Ferrara, Italy; Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Catherine X Wright
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Bernadette Corica
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Garima Sharma
- Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Kathryn Lindley
- Cardiovascular Division, Washington University School of Medicine, St Louis, Missouri, USA
| | - Alexandria Brackett
- Harvey Cushing/John Hay Whitney Medical Library, Yale University, New Haven, Connecticut, USA
| | - Louise Pilote
- Centre for Outcomes Research and Evaluation, McGill University Health Centre Research Institute, Montréal, Québec, Canada; Divisions of Clinical Epidemiology and General Internal Medicine, McGill University Health Centre Research Institute, Montréal, Québec, Canada
| | - Malissa J Wood
- Massachusetts General Hospital Corrigan Minehan Heart Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Rachel P Dreyer
- Center for Outcomes Research and Evaluation, New Haven, Connecticut, USA; Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA; Department of Biostatistics (Health Informatics), Yale School of Public Health, New Haven, Connecticut, USA.
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14
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Bhavnani SP, Khedraki R, Cohoon TJ, Meine FJ, Stuckey TD, McMinn T, Depta JP, Bennett B, McGarry T, Carroll W, Suh D, Steuter JA, Roberts M, Gillins HR, Shadforth I, Lange E, Doomra A, Firouzi M, Fathieh F, Burton T, Khosousi A, Ramchandani S, Sanders WE, Smart F. Multicenter validation of a machine learning phase space electro-mechanical pulse wave analysis to predict elevated left ventricular end diastolic pressure at the point-of-care. PLoS One 2022; 17:e0277300. [PMID: 36378672 PMCID: PMC9665374 DOI: 10.1371/journal.pone.0277300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 10/25/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Phase space is a mechanical systems approach and large-scale data representation of an object in 3-dimensional space. Whether such techniques can be applied to predict left ventricular pressures non-invasively and at the point-of-care is unknown. OBJECTIVE This study prospectively validated a phase space machine-learned approach based on a novel electro-mechanical pulse wave method of data collection through orthogonal voltage gradient (OVG) and photoplethysmography (PPG) for the prediction of elevated left ventricular end diastolic pressure (LVEDP). METHODS Consecutive outpatients across 15 US-based healthcare centers with symptoms suggestive of coronary artery disease were enrolled at the time of elective cardiac catheterization and underwent OVG and PPG data acquisition immediately prior to angiography with signals paired with LVEDP (IDENTIFY; NCT #03864081). The primary objective was to validate a ML algorithm for prediction of elevated LVEDP using a definition of ≥25 mmHg (study cohort) and normal LVEDP ≤ 12 mmHg (control cohort), using AUC as the measure of diagnostic accuracy. Secondary objectives included performance of the ML predictor in a propensity matched cohort (age and gender) and performance for an elevated LVEDP across a spectrum of comparative LVEDP (<12 through 24 at 1 mmHg increments). Features were extracted from the OVG and PPG datasets and were analyzed using machine-learning approaches. RESULTS The study cohort consisted of 684 subjects stratified into three LVEDP categories, ≤12 mmHg (N = 258), LVEDP 13-24 mmHg (N = 347), and LVEDP ≥25 mmHg (N = 79). Testing of the ML predictor demonstrated an AUC of 0.81 (95% CI 0.76-0.86) for the prediction of an elevated LVEDP with a sensitivity of 82% and specificity of 68%, respectively. Among a propensity matched cohort (N = 79) the ML predictor demonstrated a similar result AUC 0.79 (95% CI: 0.72-0.8). Using a constant definition of elevated LVEDP and varying the lower threshold across LVEDP the ML predictor demonstrated and AUC ranging from 0.79-0.82. CONCLUSION The phase space ML analysis provides a robust prediction for an elevated LVEDP at the point-of-care. These data suggest a potential role for an OVG and PPG derived electro-mechanical pulse wave strategy to determine if LVEDP is elevated in patients with symptoms suggestive of cardiac disease.
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Affiliation(s)
- Sanjeev P. Bhavnani
- Division of Cardiovascular Medicine, Healthcare Innovation & Practice Transformation Laboratory, Scripps Clinic, San Diego, California, United States of America
- * E-mail:
| | - Rola Khedraki
- Division of Cardiology, Section Advanced Heart Failure, Scripps Clinic, San Diego, California, United States of America
| | - Travis J. Cohoon
- Division of Cardiovascular Medicine, Healthcare Innovation & Practice Transformation Laboratory, Scripps Clinic, San Diego, California, United States of America
| | - Frederick J. Meine
- Novant Health New Hanover Regional Medical Center, Wilmington, North Carolina, United States of America
| | - Thomas D. Stuckey
- Cone Health Heart and Vascular Center, Greensboro, North Carolina, United States of America
| | - Thomas McMinn
- Austin Heart, Austin, Texas, United States of America
| | - Jeremiah P. Depta
- Rochester General Hospital, Rochester, New York, United States of America
| | - Brett Bennett
- Jackson Heart Clinic, Jackson, Mississippi, United States of America
| | - Thomas McGarry
- Oklahoma Heart Hospital, Oklahoma City, Oklahoma, United States of America
| | - William Carroll
- Cardiology Associates of North Mississippi, Tupelo, Mississippi, United States of America
| | - David Suh
- Atlanta Heart Specialists, Atlanta, Georgia, United States of America
| | | | - Michael Roberts
- Lexington Medical Center, West Columbia, South Carolina, United States of America
| | | | - Ian Shadforth
- CorVista Health, Inc., Washington, DC, United States of America
| | - Emmanuel Lange
- CorVista Health, Toronto, Ontario, Canada
- Analytics For Life Inc., d.b.a CorVista Health, Toronto, Canada
| | - Abhinav Doomra
- CorVista Health, Toronto, Ontario, Canada
- Analytics For Life Inc., d.b.a CorVista Health, Toronto, Canada
| | - Mohammad Firouzi
- CorVista Health, Toronto, Ontario, Canada
- Analytics For Life Inc., d.b.a CorVista Health, Toronto, Canada
| | - Farhad Fathieh
- CorVista Health, Toronto, Ontario, Canada
- Analytics For Life Inc., d.b.a CorVista Health, Toronto, Canada
| | - Timothy Burton
- CorVista Health, Toronto, Ontario, Canada
- Analytics For Life Inc., d.b.a CorVista Health, Toronto, Canada
| | - Ali Khosousi
- CorVista Health, Toronto, Ontario, Canada
- Analytics For Life Inc., d.b.a CorVista Health, Toronto, Canada
| | - Shyam Ramchandani
- CorVista Health, Toronto, Ontario, Canada
- Analytics For Life Inc., d.b.a CorVista Health, Toronto, Canada
| | | | - Frank Smart
- LSU Health Science Center, New Orleans, Louisiana, United States of America
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15
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Chen Y, Zhao Z, Dai W. Effect of medical innovation policies on the prevention and control of the COVID-19 and the impact of the "Belt and Road" economy. Front Public Health 2022; 10:862487. [PMID: 36106163 PMCID: PMC9464824 DOI: 10.3389/fpubh.2022.862487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 08/08/2022] [Indexed: 01/21/2023] Open
Abstract
With the spread of the COVID-19, it is urgent for everyone to protect themselves. The introduction of the medical innovation policy has also brought certain effects to the prevention and control of the COVID-19. The specific effect will be reflected in the following research. This paper firstly analyzed research results related to medical innovation policy, COVID-19 prevention and control, and the "One Belt, One Road" economy, finding out the content that fits this research, and innovates the research work on this basis. Then, this paper provided a detailed explanation of medical innovation policies, the prevention and control of the COVID-19, and the "One Belt, One Road" economy. Among them, this paper focuses on the "One Belt and One Road," uses the α-convergence model to analyze the economic changes of the "One Belt and One Road," and conducts experimental tests in the medical field. The results have shown that from 2017 to 2019, the average hospitalization expenses paid by the pooled funds were 4986.19, 4997.34, and 4888.60 yuan, respectively.
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16
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Maddula R, MacLeod J, Painter S, McLeish T, Steward A, Rossman A, Hamid A, Ashwath M, Martinez HR, Guha A, Patel B, Addison D, Blaes A, Choudhuri I, Brown SA. Connected Health Innovation Research Program (C.H.I.R.P.): A bridge for digital health and wellness in cardiology and oncology. AMERICAN HEART JOURNAL PLUS : CARDIOLOGY RESEARCH AND PRACTICE 2022; 20:100192. [PMID: 37800118 PMCID: PMC10552440 DOI: 10.1016/j.ahjo.2022.100192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
Study objective Cancer and heart disease are leading causes of mortality, and cardio-oncology is emerging as a new field addressing the cardiovascular toxicities related to cancer and cancer therapy. Interdisciplinary research platforms that incorporate digital health to optimize cardiovascular health and wellness in cancer survivors are therefore needed as we advance in the digital era. Our goal was to develop the Connected Health Innovation Research Program (C.H.I.R.P.) to serve as a foundation for future integration and assessments of adoption and clinical efficacy of digital health tools for cardiovascular health and wellness in the general population and in oncology patients. Design/setting/participants Partner companies were identified through the American Medical Association innovation platform, as well as LinkedIn and direct contact by our team. Company leaders met with our team to discuss features of their technology or software. Non-disclosure agreements were signed and data were discussed and obtained for descriptive or statistical analysis. Results A suite of companies with technologies focused on wellness, biometrics tracking, audio companions, oxygen saturation, weight trends, sleep patterns, heart rate variability, electrocardiogram patterns, blood pressure patterns, real-time metabolism tracking, instructional video modules, or integration of these technologies into electronic health records was collated. We formed an interdisciplinary research team and established an academia-industry collaborative foundation for connecting patients with wellness digital health technologies. Conclusions A suite of software and device technologies accessible to the cardiology and oncology population has been established and will facilitate retrospective, prospective, and case research studies assessing adoption and clinical efficacy of digital health tools in cardiology/oncology.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Hugo R. Martinez
- The Heart Institute at Le Bonheur Children’s Hospital, Memphis, TN, USA
- St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Avirup Guha
- Cardio-Oncology Program, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | | | - Daniel Addison
- Cardio-Oncology Program, Ohio State University, Columbus, OH, USA
| | - Anne Blaes
- Division of Hematology, Oncology and Transplantation, University of Minnesota Medical School, MN, USA
| | | | - Sherry-Ann Brown
- Cardio-Oncology Program, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
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17
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Waldman CE, Min JH, Wassif H, Freeman AM, Rzeszut AK, Reilly J, Theriot P, Soliman AM, Thamman R, Bhatt A, Bhavnani SP. COVID-19 telehealth preparedness: a cross-sectional assessment of cardiology practices in the USA. Per Med 2022; 19:411-422. [PMID: 35912812 DOI: 10.2217/pme-2021-0179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Aim: The COVID-19 pandemic forced medical practices to augment healthcare delivery to remote and virtual services. We describe the results of a nationwide survey of cardiovascular professionals regarding telehealth perspectives. Materials & methods: A 31-question survey was sent early in the pandemic to assess the impact of COVID-19 on telehealth adoption & reimbursement. Results: A total of 342 clinicians across 42 states participated. 77% were using telehealth, with the majority initiating usage 2 months after the COVID-19 shutdown. A variety of video-based systems were used. Telehealth integration requirements differed, with electronic medical record integration being mandated in more urban than rural practices (70 vs 59%; p < 0.005). Many implementation barriers surfaced, with over 75% of respondents emphasizing reimbursement uncertainty and concerns for telehealth generalizability given the complexity of cardiovascular diseases. Conclusion: Substantial variation exists in telehealth practices. Further studies and legislation are needed to improve access, reimbursement and the quality of telehealth-based cardiovascular care.
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Affiliation(s)
- Carly E Waldman
- Department of Internal Medicine, Scripps Clinic, San Diego, CA, USA.,Division of Cardiology, Healthcare Innovation Laboratory, Prebys Cardiovascular Institute, Scripps Clinic, San Diego, CA 92037,USA
| | - Jean H Min
- Department of Internal Medicine, Scripps Clinic, San Diego, CA, USA.,Division of Cardiology, Healthcare Innovation Laboratory, Prebys Cardiovascular Institute, Scripps Clinic, San Diego, CA 92037,USA
| | - Heba Wassif
- Department of Cardiovascular Medicine, Section of Clinical Cardiology, Heart, Vascular & Thoracic Institute, Cleveland Clinic Foundation, Cleveland, OH 44103, USA
| | - Andrew M Freeman
- Department of Medicine, Division of Cardiology, National Jewish Health, Denver, CO 80206, USA
| | - Anne K Rzeszut
- American College of Cardiology, Heart House, Washington, DC 20037, USA
| | - Jack Reilly
- American College of Cardiology, Heart House, Washington, DC 20037, USA
| | - Paul Theriot
- American College of Cardiology, Heart House, Washington, DC 20037, USA
| | - Ahmed M Soliman
- Division of Cardiology, Houston Methodist DeBakey Cardiology Associates, Houston, TX 77030, USA
| | - Ritu Thamman
- Division of Medicine, University of Pittsburg School of Medicine, Pittsburg, PA 15213, USA
| | - Ami Bhatt
- Division of Cardiology, Adult Congenital Heart Disease Program, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Sanjeev P Bhavnani
- Division of Cardiology, Healthcare Innovation Laboratory, Prebys Cardiovascular Institute, Scripps Clinic, San Diego, CA 92037,USA
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18
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Waldman CE, Hermel M, Hermel JA, Allinson F, Pintea MN, Bransky N, Udoh E, Nicholson L, Robinson A, Gonzalez J, Suhar C, Nayak K, Wesbey G, Bhavnani SP. Artificial intelligence in healthcare: a primer for medical education in radiomics. Per Med 2022; 19:445-456. [PMID: 35880428 DOI: 10.2217/pme-2022-0014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The application of artificial intelligence (AI) to healthcare has garnered significant enthusiasm in recent years. Despite the adoption of new analytic approaches, medical education on AI is lacking. We aim to create a usable AI primer for medical education. We discuss how to generate a clinical question involving AI, what data are suitable for AI research, how to prepare a dataset for training and how to determine if the output has clinical utility. To illustrate this process, we focused on an example of how medical imaging is employed in designing a machine learning model. Our proposed medical education curriculum addresses AI's potential and limitations for enhancing clinicians' skills in research, applied statistics and care delivery.
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Affiliation(s)
- Carly E Waldman
- Division of Internal Medicine, Scripps Clinic, La Jolla, CA 92037, USA
| | - Melody Hermel
- Division of Cardiology, Scripps Clinic, La Jolla, CA 92037, USA
| | - Jonathan A Hermel
- Medical Student, Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - Francis Allinson
- Division of Internal Medicine, Scripps Clinic, La Jolla, CA 92037, USA
| | - Mark N Pintea
- Medical Student, California University of Science & Medicine, Colton, CA 95757, USA
| | - Natalie Bransky
- Medical Student, University of California, San Diego School of Medicine, San Diego, CA 92037, USA
| | - Emem Udoh
- Division of Internal Medicine, Scripps Clinic, La Jolla, CA 92037, USA
| | - Laura Nicholson
- Associate Program Director for Resident Research, Division of Internal Medicine, Scripps Clinic, La Jolla, CA 92037, USA
| | - Austin Robinson
- Advanced Cardiovascular Imaging, Divisions of Cardiology & Radiology, Scripps Clinic, La Jolla, CA 92037, USA
| | - Jorge Gonzalez
- Advanced Cardiovascular Imaging, Divisions of Cardiology & Radiology, Scripps Clinic, La Jolla, CA 92037, USA
| | - Christopher Suhar
- Fellowship Program Co-Director, Division of Cardiology, Scripps Clinic, La Jolla, CA 92037, USA
| | - Keshav Nayak
- Director, Structural Heart Program, Division of Cardiology, Scripps Mercy, San Diego, CA 92037, USA
| | - George Wesbey
- Advanced Cardiovascular Imaging, Divisions of Cardiology & Radiology, Scripps Clinic, La Jolla, CA 92037, USA
| | - Sanjeev P Bhavnani
- Principal Investigator Healthcare Innovation & Practice Transformation Laboratory, Division of Cardiology, Scripps Clinic, La Jolla, CA 92037, USA
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19
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Yeung AWK, Kulnik ST, Parvanov ED, Fassl A, Eibensteiner F, Völkl-Kernstock S, Kletecka-Pulker M, Crutzen R, Gutenberg J, Höppchen I, Niebauer J, Smeddinck JD, Willschke H, Atanasov AG. Research on Digital Technology Use in Cardiology: Bibliometric Analysis. J Med Internet Res 2022; 24:e36086. [PMID: 35544307 PMCID: PMC9133979 DOI: 10.2196/36086] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 03/14/2022] [Accepted: 03/15/2022] [Indexed: 12/11/2022] Open
Abstract
Background Digital technology uses in cardiology have become a popular research focus in recent years. However, there has been no published bibliometric report that analyzed the corresponding academic literature in order to derive key publishing trends and characteristics of this scientific area. Objective We used a bibliometric approach to identify and analyze the academic literature on digital technology uses in cardiology, and to unveil popular research topics, key authors, institutions, countries, and journals. We further captured the cardiovascular conditions and diagnostic tools most commonly investigated within this field. Methods The Web of Science electronic database was queried to identify relevant papers on digital technology uses in cardiology. Publication and citation data were acquired directly from the database. Complete bibliographic data were exported to VOSviewer, a dedicated bibliometric software package, and related to the semantic content of titles, abstracts, and keywords. A term map was constructed for findings visualization. Results The analysis was based on data from 12,529 papers. Of the top 5 most productive institutions, 4 were based in the United States. The United States was the most productive country (4224/12,529, 33.7%), followed by United Kingdom (1136/12,529, 9.1%), Germany (1067/12,529, 8.5%), China (682/12,529, 5.4%), and Italy (622/12,529, 5.0%). Cardiovascular diseases that had been frequently investigated included hypertension (152/12,529, 1.2%), atrial fibrillation (122/12,529, 1.0%), atherosclerosis (116/12,529, 0.9%), heart failure (106/12,529, 0.8%), and arterial stiffness (80/12,529, 0.6%). Recurring modalities were electrocardiography (170/12,529, 1.4%), angiography (127/12,529, 1.0%), echocardiography (127/12,529, 1.0%), digital subtraction angiography (111/12,529, 0.9%), and photoplethysmography (80/12,529, 0.6%). For a literature subset on smartphone apps and wearable devices, the Journal of Medical Internet Research (20/632, 3.2%) and other JMIR portfolio journals (51/632, 8.0%) were the major publishing venues. Conclusions Digital technology uses in cardiology target physicians, patients, and the general public. Their functions range from assisting diagnosis, recording cardiovascular parameters, and patient education, to teaching laypersons about cardiopulmonary resuscitation. This field already has had a great impact in health care, and we anticipate continued growth.
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Affiliation(s)
- Andy Wai Kan Yeung
- Division of Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.,Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
| | - Stefan Tino Kulnik
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria
| | - Emil D Parvanov
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria.,Department of Translational Stem Cell Biology, Research Institute of the Medical University of Varna, Varna, Bulgaria
| | - Anna Fassl
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
| | - Fabian Eibensteiner
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria.,Division of Pediatric Nephrology and Gastroenterology, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Sabine Völkl-Kernstock
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
| | - Maria Kletecka-Pulker
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria.,Institute for Ethics and Law in Medicine, University of Vienna, Vienna, Austria
| | - Rik Crutzen
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria.,Department of Health Promotion, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Johanna Gutenberg
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria.,Department of Health Promotion, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Isabel Höppchen
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria.,Center for Human Computer Interaction, Paris Lodron University Salzburg, Salzburg, Austria
| | - Josef Niebauer
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria.,University Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University Salzburg, Salzburg, Austria.,REHA Zentrum Salzburg, Salzburg, Austria
| | - Jan David Smeddinck
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria
| | - Harald Willschke
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria.,Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University Vienna, Vienna, Austria
| | - Atanas G Atanasov
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria.,Institute of Genetics and Animal Biotechnology of the Polish Academy of Sciences, Jastrzebiec, Poland
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20
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Brown SA, Hudson C, Hamid A, Berman G, Echefu G, Lee K, Lamberg M, Olson J. The pursuit of health equity in digital transformation, health informatics, and the cardiovascular learning healthcare system. AMERICAN HEART JOURNAL PLUS : CARDIOLOGY RESEARCH AND PRACTICE 2022; 17:100160. [PMID: 38559893 PMCID: PMC10978355 DOI: 10.1016/j.ahjo.2022.100160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 06/20/2022] [Accepted: 06/22/2022] [Indexed: 04/04/2024]
Abstract
African Americans have a higher rate of cardiovascular morbidity and mortality and a lower rate of specialty consultation and treatment than Caucasians. These disparities also exist in the care and treatment of chemotherapy-related cardiovascular complications. African Americans suffer from cardiotoxicity at a higher rate than Caucasians and are underrepresented in clinical trials aimed at preventing cardiovascular injury associated with cancer therapies. To eliminate racial and ethnic disparities in the prevention of cardiotoxicity, an interdisciplinary and innovative approach will be required. Diverse forms of digital transformation leveraging health informatics have the potential to contribute to health equity if they are implemented carefully and thoughtfully in collaboration with minority communities. A learning healthcare system can serve as a model for developing, deploying, and disseminating interventions to minimize health inequities and maximize beneficial impact.
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Affiliation(s)
- Sherry-Ann Brown
- Cardio-Oncology Program, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | | | | | - Gift Echefu
- Baton Rouge General Medical Center, Department of Internal Medicine, Baton Rouge, LA, USA
| | - Kyla Lee
- Tulane School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Morgan Lamberg
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Jessica Olson
- Institute for Health & Equity, Medical College of Wisconsin, Milwaukee, WI, USA
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21
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Dai H, Younis A, Kong JD, Puce L, Jabbour G, Yuan H, Bragazzi NL. Big Data in Cardiology: State-of-Art and Future Prospects. Front Cardiovasc Med 2022; 9:844296. [PMID: 35433868 PMCID: PMC9010556 DOI: 10.3389/fcvm.2022.844296] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 02/24/2022] [Indexed: 11/23/2022] Open
Abstract
Cardiological disorders contribute to a significant portion of the global burden of disease. Cardiology can benefit from Big Data, which are generated and released by different sources and channels, like epidemiological surveys, national registries, electronic clinical records, claims-based databases (epidemiological Big Data), wet-lab, and next-generation sequencing (molecular Big Data), smartphones, smartwatches, and other mobile devices, sensors and wearable technologies, imaging techniques (computational Big Data), non-conventional data streams such as social networks, and web queries (digital Big Data), among others. Big Data is increasingly having a more and more relevant role, being highly ubiquitous and pervasive in contemporary society and paving the way for new, unprecedented perspectives in biomedicine, including cardiology. Big Data can be a real paradigm shift that revolutionizes cardiological practice and clinical research. However, some methodological issues should be properly addressed (like recording and association biases) and some ethical issues should be considered (such as privacy). Therefore, further research in the field is warranted.
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Affiliation(s)
- Haijiang Dai
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON, Canada
| | - Arwa Younis
- Clinical Cardiovascular Research Center, University of Rochester Medical Center, Rochester, New York, NY, United States
| | - Jude Dzevela Kong
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON, Canada
| | - Luca Puce
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - Georges Jabbour
- Physical Education Department, College of Education, Qatar University, Doha, Qatar
| | - Hong Yuan
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China
- Hong Yuan
| | - Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON, Canada
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- Postgraduate School of Public Health, Department of Health Sciences, University of Genoa, Genoa, Italy
- Section of Musculoskeletal Disease, Leeds Institute of Molecular Medicine, NIHR Leeds Musculoskeletal Biomedical Research Unit, University of Leeds, Chapel Allerton Hospital, Leeds, United Kingdom
- *Correspondence: Nicola Luigi Bragazzi
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Khedraki R, Srivastava AV, Bhavnani SP. Framework for Digital Health Phenotypes in Heart Failure. Heart Fail Clin 2022; 18:223-244. [DOI: 10.1016/j.hfc.2021.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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23
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Brown SA, Beavers C, Martinez HR, Marshall CH, Olaye IM, Guha A, Cho D, Bailey A, Bergom C, Bansal N, Bauer B, Cheng RK. Bridging the gap to advance the care of individuals with cancer: collaboration and partnership in the Cardiology Oncology Innovation Network (COIN). CARDIO-ONCOLOGY (LONDON, ENGLAND) 2022; 8:2. [PMID: 35139920 PMCID: PMC8827263 DOI: 10.1186/s40959-022-00129-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 01/05/2022] [Indexed: 01/21/2023]
Abstract
Cardiovascular diseases and cancer continue to be the two leading causes of death in the United States. While innovations in artificial intelligence, digital health, and telemedicine may revolutionize cardio-oncology clinical practice, barriers to widespread adoption continue to exist. The most effective way to advance these technologies is through a broad range of stakeholders sharing a common vision. Additionally, as we enter the digital era in healthcare, we must help lead this charge for the benefit of our cardiology and oncology patients. Bolstering collaborations in cardiology and oncology is key, in partnership with technology firms, industry, academia, and private practice, with an emphasis on various forms of innovation. The ultimate goal is to connect our patients and their health to informatics-based opportunities to advance cardiovascular disease prevention in cancer patients. We have established the Cardiology Oncology Innovation Network in accordance with this vision, to develop new care delivery options through the use of innovative technological strategies. Our tripartite mission - innovation, collaboration, and education - aims to increase access to and expertise in digital transformation to prevent cardiovascular diseases in cancer patients. Here we describe network initiatives, early accomplishments, and future milestones.
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Affiliation(s)
- Sherry-Ann Brown
- grid.30760.320000 0001 2111 8460Cardio-Oncology Program, Division of Cardiovascular Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226 USA
| | - Craig Beavers
- grid.266539.d0000 0004 1936 8438University of Kentucky College of Pharmacy, Lexington, KY USA
| | - Hugo R. Martinez
- grid.267301.10000 0004 0386 9246The Heart Institute at Le Bonheur Children’s Hospital, University of Tennessee Health and Science Center, Memphis, TN USA ,grid.240871.80000 0001 0224 711XSt. Jude Children’s Research Hospital, Memphis, TN USA
| | - Catherine H. Marshall
- grid.21107.350000 0001 2171 9311Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD USA ,grid.21107.350000 0001 2171 9311Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - Iredia M. Olaye
- grid.5386.8000000041936877XDivision of Clinical Epidemiology, Department of Medicine, Weill Cornell Medicine, New York, NY USA
| | - Avirup Guha
- grid.410427.40000 0001 2284 9329Cardio-Oncology Program, Division of Cardiology, Department of Internal Medicine, Medical College of Georgia at Augusta University, Augusta, GA USA
| | - David Cho
- grid.19006.3e0000 0000 9632 6718University of California, Los Angeles, Division of Cardiovascular Medicine, Los Angeles, CA USA
| | - Alison Bailey
- Center for Heart, Lung, and Vascular Health at Parkridge, HCA Healthcare, Chattanooga, TN USA
| | - Carmen Bergom
- grid.4367.60000 0001 2355 7002Department of Radiation Oncology, Washington University in St. Louis, St. Louis, MO USA ,grid.4367.60000 0001 2355 7002Cardio-Oncology Center of Excellence, Washington University in St. Louis, St. Louis, MO USA
| | - Neha Bansal
- grid.251993.50000000121791997Division of Pediatric Cardiology, Children’s Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY USA
| | - Brenton Bauer
- grid.431038.d0000 0004 0474 1180COR Healthcare Associates, Torrance Memorial Medical Center, Torrance, CA USA
| | - Richard K. Cheng
- grid.34477.330000000122986657Cardio-oncology Program, Division of Cardiology, University of Washington, Seattle, WA USA
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24
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Fezza GC, Sansone S, Nolan RP. Therapeutic components of digital counseling for chronic heart failure. Front Psychiatry 2022; 13:888524. [PMID: 36339841 PMCID: PMC9631313 DOI: 10.3389/fpsyt.2022.888524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 09/29/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Task force statements support the use of cognitive behavioral therapy (CBT) and motivational interviewing (MI) to promote self-care in chronic heart failure (CHF) patients. Digital counseling interventions have the potential to complement conventional programs. However, therapeutic components of digital programs associated with improved outcomes are not clearly established. OBJECTIVE Identify therapeutic components of the Canadian e-Platform to Promote Behavioral Self-Management in Chronic Heart Failure (CHF-CePPORT) protocol that were associated with improved health-related quality of life (HRQL). MATERIALS AND METHODS Ordinal logistic regression was used to identify therapeutic components of the CHF-CePPORT protocol. The primary outcome was the 12-month Kansas City Cardiomyopathy Questionnaire Overall Summary (KCCQ-OS) tertile. Logistic regressions determined the association between 12-month KCCQ-OS tertile, using logon hours for key segments of the protocol, modality of content delivery, and clinical themes. RESULTS A total of 117 patients were enrolled in the e-Counseling arm of the CHF-CePPORT trial. Median age was 60 years (IQR 52-69). Total logon hours in the initial 4-month segment of CHF-CePPORT (Sessions 1-16) was associated with increased 12-month KCCQ-OS tertile (Odds Ratio, OR = 1.31, 95% CI, 1.1-1.5, P = 0.001). Within sessions 1-16, improved KCCQ-OS was associated with logon hours for self-assessment tools/trackers (OR = 1.49, 95% CI, 1.1-2.0, P = 0.007), and videos (OR = 1.57, 95% CI, 1.03-2.4, P = 0.04), but not for CHF information pages. CONCLUSION This study highlights the importance of using evidence-based guidelines from CBT and MI as core components of digital counseling, delivered through videos and interactive tools/trackers, to improve HRQL with CHF.
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Affiliation(s)
- Gabriel C Fezza
- Behavioral Cardiology Research Unit, University Health Network (UHN), Toronto, ON, Canada.,Faculty of Health, York University, Toronto, ON, Canada
| | - Stephanie Sansone
- Behavioral Cardiology Research Unit, University Health Network (UHN), Toronto, ON, Canada.,Faculty of Health, York University, Toronto, ON, Canada
| | - Robert P Nolan
- Behavioral Cardiology Research Unit, University Health Network (UHN), Toronto, ON, Canada.,Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Peter Munk Cardiac Centre, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.,Ted Rogers Centre for Heart Research, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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Dahdah N, Kung SC, Friedman KG, Marelli A, Gordon JB, Belay ED, Baker AL, Kazi DS, White PH, Tremoulet AH. Falling Through the Cracks: The Current Gap in the Health Care Transition of Patients With Kawasaki Disease: A Scientific Statement From the American Heart Association. J Am Heart Assoc 2021; 10:e023310. [PMID: 34632822 PMCID: PMC8751858 DOI: 10.1161/jaha.121.023310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background Health care transition (HCT) is a period of high vulnerability for patients with chronic childhood diseases, particularly when patients shift from a pediatric to an adult care setting. An increasing number of patients with Kawasaki disease (KD) who develop medium and large coronary artery aneurysms (classified by the American Heart Association according to maximal internal coronary artery diameter Z‐scores ≥5 and ≥10, respectively) are becoming adults and thus undergoing an HCT. However, a poor transition to an adult provider represents a risk of loss to follow‐up, which can result in increasing morbidity and mortality. Methods and Results This scientific statement provides a summary of available literature and expert opinion pertaining to KD and HCT of children as they reach adulthood. The statement reviews the existing life‐long risks for patients with KD, explains current guidelines for long‐term care of patients with KD, and offers guidance on assessment and preparation of patients with KD for HCT. The key element to a successful HCT, enabling successful transition outcomes, is having a structured intervention that incorporates the components of planning, transfer, and integration into adult care. This structured intervention can be accomplished by using the Six Core Elements approach that is recommended by the American Academy of Pediatrics, the American Academy of Family Physicians, and the American College of Physicians. Conclusions Formal HCT programs for patients with KD who develop aneurysms should be established to ensure a smooth transition with uninterrupted medical care as these youths become adults.
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Sangarapillai T, Hajizadeh M, Daskalopoulou SS, Dasgupta K. Cost-Comparison Analysis of a Physician-Delivered Step-Count Prescription Strategy. CJC Open 2021; 3:1043-1050. [PMID: 34505044 PMCID: PMC8413227 DOI: 10.1016/j.cjco.2021.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 04/19/2021] [Indexed: 12/03/2022] Open
Abstract
Background Increments of 1000 steps/d predict cardiovascular disease (CVD) event reductions. In adults with type 2 diabetes and/or hypertension, our Step Monitoring to Improve Arterial Health (SMARTER) trial demonstrated a physician-delivered step-count prescription strategy to increase steps by more than this amount over 1 year, compared to usual care. In the present analysis, we aimed to determine the costs of the intervention compared to usual care, incorporating 1-year intervention costs and projected savings from lower CVD hospitalizations over the subsequent 5 years. Methods We considered Canadians aged 55 to 74 years with type 2 diabetes and/or hypertension. Using time estimates from our trial, we computed nursing costs corresponding to patient support time over 1 year, and pedometer costs for an anticipated 50% of patients without a smartphone. We estimated the number of CVD hospitalizations, the reduction expected with a mean 1000 steps/d increase, and the associated savings. We calculated the net cost (savings), the proportion of patients with their own device required for cost neutrality, and costs (savings) if all patients needed to be provided with a device. Results At an average intervention cost of $51.28/patient, the total cost would be $168 million. With an estimated 8875 CVD events prevented, $208 million would be saved. This savings would result in ~$40 million in net savings with 50% device ownership, cost neutrality with 25% device ownership, and ~$42 million in net costs if all patients required the healthcare system to provide a device. Conclusions At current levels of smartphone ownership, adoption of the SMARTER strategy is cost-saving to cost-neutral from the healthcare system perspective.
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Affiliation(s)
- Tarsan Sangarapillai
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Mohammad Hajizadeh
- School of Health Administration, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - Kaberi Dasgupta
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada.,Department of Medicine, McGill University, Montreal, Quebec, Canada
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Yang YC, Islam SU, Noor A, Khan S, Afsar W, Nazir S. Influential Usage of Big Data and Artificial Intelligence in Healthcare. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2021; 2021:5812499. [PMID: 34527076 PMCID: PMC8437645 DOI: 10.1155/2021/5812499] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 08/09/2021] [Indexed: 01/07/2023]
Abstract
Artificial intelligence (AI) is making computer systems capable of executing human brain tasks in many fields in all aspects of daily life. The enhancement in information and communications technology (ICT) has indisputably improved the quality of people's lives around the globe. Especially, ICT has led to a very needy and tremendous improvement in the health sector which is commonly known as electronic health (eHealth) and medical health (mHealth). Deep machine learning and AI approaches are commonly presented in many applications using big data, which consists of all relevant data about the medical health and diseases which a model can access at the time of execution or diagnosis of diseases. For example, cardiovascular imaging has now accurate imaging combined with big data from the eHealth record and pathology to better characterize the disease and personalized therapy. In clinical work and imaging, cancer care is getting improved by knowing the tumor biology and helping in the implementation of precision medicine. The Markov model is used to extract new approaches for leveraging cancer. In this paper, we have reviewed existing research relevant to eHealth and mHealth where various models are discussed which uses big data for the diagnosis and healthcare system. This paper summarizes the recent promising applications of AI and big data in medical health and electronic health, which have potentially added value to diagnosis and patient care.
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Affiliation(s)
- Yan Cheng Yang
- Foreign Language Department, Luoyang Institute of Science and Technology, Luoyang, Henan, China
- Foreign Language Department/Language and Cognition Center, Hunan University, Changsha, Hunan, China
| | - Saad Ul Islam
- Department of Computer Science, University of Swabi, Swabi, Pakistan
| | - Asra Noor
- Department of Computer Science, University of Swabi, Swabi, Pakistan
| | - Sadia Khan
- Department of Computer Science, University of Swabi, Swabi, Pakistan
| | - Waseem Afsar
- Department of Computer Science, University of Swabi, Swabi, Pakistan
| | - Shah Nazir
- Department of Computer Science, University of Swabi, Swabi, Pakistan
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Sharma AK, Baig VN, Ahuja J, Sharma S, Panwar RB, Katoch VM, Gupta R. Efficacy of IVRS-based mHealth intervention in reducing cardiovascular risk in metabolic syndrome: A cluster randomized trial. Diabetes Metab Syndr 2021; 15:102182. [PMID: 34330073 DOI: 10.1016/j.dsx.2021.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 06/17/2021] [Accepted: 06/18/2021] [Indexed: 11/26/2022]
Abstract
AIMS Efficacy of mobile-phone based intervention for reducing cardiovascular risk in metabolic syndrome (MetSyn). METHODS We screened adults 20-60 years in 10 villages in India for MetSyn using stratified cluster sampling. Lifestyle and biochemical risk factors were assessed. International Harmonized Criteria were used for diagnosis. Villages were randomized with 5 each in control and intervention groups. Interactive voice response system (IVRS) in Hindi was developed. In intervention clusters two messages for promotion of healthy lifestyle and medical treatment were broadcast daily over 12-months and risk factors reassessed. RESULTS 1012/1200(84%) persons were screened and MetSyn diagnosed in 286(28.3%). Villages were divided into 5 control(n = 136) and 5 intervention(n = 147) clusters. Baseline characteristics in both clusters were similar. Acceptability of intervention was >60% in 80% participants. At 12 months, significantly greater participants in intervention vs control clusters had healthier lifestyle (healthy diet 28.8vs14.7%, physical activity 25.9vs13.1%, tobacco 13.7vs32.5%), anthropometry (waist circumference 85.7 ± 6.3vs88.6 ± 14.0 cm, body mass index 21.9 ± 2.8vs23.1 ± 2.9 kg/m2), systolic BP 123.6 ± 7.7vs128.6 ± 14.1 mmHg, fasting glucose 95.6 ± 19.4vs109.4 ± 43.7 mg/dl, cholesterol 175.5 ± 36.5vs186.4 ± 43.3 mg/dl, and triglycerides 147.6 ± 48.3vs159.5 ± 60.7 mg/dl (p < 0.01). Prevalence of metabolic syndrome declined in intervention group by 22.3%vs3.9%, p < 0.001). CONCLUSION An interactive voice response system based technology significantly reduced multiple cardiovascular risk factors and prevalence of metabolic syndrome.
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Affiliation(s)
- Arvind K Sharma
- Departments of Community Medicine, RUHS College of Medical Sciences, Jaipur, 302033, India.
| | - Vaseem Naheed Baig
- Departments of Community Medicine, RUHS College of Medical Sciences, Jaipur, 302033, India
| | - Jitendra Ahuja
- Departments of Biochemistry, RUHS College of Medical Sciences, Jaipur, 302033, India
| | - Sonali Sharma
- Departments of Biochemistry, RUHS College of Medical Sciences, Jaipur, 302033, India
| | - Raja Babu Panwar
- Academic Research Development Unit, Rajasthan University of Health Sciences, 302033, Jaipur, India
| | - Vishwa Mohan Katoch
- Academic Research Development Unit, Rajasthan University of Health Sciences, 302033, Jaipur, India
| | - Rajeev Gupta
- Academic Research Development Unit, Rajasthan University of Health Sciences, 302033, Jaipur, India
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The Assessment of Big Data Adoption Readiness with a Technology–Organization–Environment Framework: A Perspective towards Healthcare Employees. SUSTAINABILITY 2021. [DOI: 10.3390/su13158379] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Big data is rapidly being seen as a new frontier for improving organizational performance. However, it is still in its early phases of implementation in developing countries’ healthcare organizations. As data-driven insights become critical competitive advantages, it is critical to ascertain which elements influence an organization’s decision to adopt big data. The aim of this study is to propose and empirically test a theoretical framework based on technology–organization–environment (TOE) factors to identify the level of readiness of big data adoption in developing countries’ healthcare organizations. The framework empirically tested 302 Malaysian healthcare employees. The structural equation modeling was used to analyze the collected data. The results of the study demonstrated that technology, organization, and environment factors can significantly contribute towards big data adoption in healthcare organizations. However, the complexity of technology factors has shown less support for the notion. For technology practitioners, this study showed how to enhance big data adoption in healthcare organizations through TOE factors.
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Abstract
OBJECTIVE Established and emerging technologies-such as wearable sensors, smartphones, mobile apps, and artificial intelligence-are shaping positive healthcare models and patient outcomes. These technologies have the potential to become precision health (PH) innovations. However, not all innovations meet regulatory standards or have the required scientific evidence to be used for health applications. In response, an assessment framework was developed to facilitate and standardize the assessment of innovations deemed suitable for PH. METHODS A scoping literature review undertaken through PubMed and Google Scholar identified approximately 100 relevant articles. These were then shortlisted (n = 12) to those that included specific metrics, criteria, or frameworks for assessing technologies that could be applied to the PH context. RESULTS The proposed framework identified nine core criteria with subcriteria and grouped them into four categories for assessment: technical, clinical, human factors, and implementation. Guiding statements with response options and recommendations were used as metrics against each criterion. CONCLUSION The proposed framework supports health services, health technology innovators, and researchers in leveraging current and emerging technologies for PH innovations. It covers a comprehensive set of criteria as part of the assessment process of these technologies.
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Diller GP, Arvanitaki A, Opotowsky AR, Jenkins K, Moons P, Kempny A, Tandon A, Redington A, Khairy P, Mital S, Gatzoulis MΑ, Li Y, Marelli A. Lifespan Perspective on Congenital Heart Disease Research: JACC State-of-the-Art Review. J Am Coll Cardiol 2021; 77:2219-2235. [PMID: 33926659 DOI: 10.1016/j.jacc.2021.03.012] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 03/04/2021] [Accepted: 03/09/2021] [Indexed: 12/19/2022]
Abstract
More than 90% of patients with congenital heart disease (CHD) are nowadays surviving to adulthood and adults account for over two-thirds of the contemporary CHD population in Western countries. Although outcomes are improved, surgery does not cure CHD. Decades of longitudinal observational data are currently motivating a paradigm shift toward a lifespan perspective and proactive approach to CHD care. The aim of this review is to operationalize these emerging concepts by presenting new constructs in CHD research. These concepts include long-term trajectories and a life course epidemiology framework. Focusing on a precision health, we propose to integrate our current knowledge on the genome, phenome, and environome across the CHD lifespan. We also summarize the potential of technology, especially machine learning, to facilitate longitudinal research by embracing big data and multicenter lifelong data collection.
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Affiliation(s)
- Gerhard-Paul Diller
- Department of Cardiology III-Adult Congenital and Valvular Heart Disease, University Hospital Muenster, Muenster, Germany; Adult Congenital Heart Centre and National Centre for Pulmonary Hypertension, Royal Brompton and Harefield National Health Service Foundation Trust, Imperial College London, London, UK; National Register for Congenital Heart Defects, Berlin, Germany.
| | - Alexandra Arvanitaki
- Department of Cardiology III-Adult Congenital and Valvular Heart Disease, University Hospital Muenster, Muenster, Germany; Adult Congenital Heart Centre and National Centre for Pulmonary Hypertension, Royal Brompton and Harefield National Health Service Foundation Trust, Imperial College London, London, UK; First Department of Cardiology, American Hellenic Educational Progressive Association University Hospital, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Alexander R Opotowsky
- The Cincinnati Adult Congenital Heart Disease Program, Cincinnati Children's Hospital, Cincinnati, Ohio, USA; Heart Institute, Cincinnati Children's Hospital and University of Cincinnati, Cincinnati, Ohio, USA
| | - Kathy Jenkins
- Department of Cardiology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Philip Moons
- Department of Public Health and Primary Care, Katholieke Universiteit Leuven, Leuven, Belgium; Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden; Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
| | - Alexander Kempny
- Adult Congenital Heart Centre and National Centre for Pulmonary Hypertension, Royal Brompton and Harefield National Health Service Foundation Trust, Imperial College London, London, UK
| | - Animesh Tandon
- Pediatric Cardiology, Department of Pediatrics, University of Texas Southwestern Medical Center and Children's Health, Dallas, Texas, USA; Department of Radiology, University of Texas Southwestern Children's Medical Center, Dallas, Texas, USA
| | - Andrew Redington
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA; Montreal Heart Institute, Université de Montréal, Montreal, Québec, Canada
| | - Paul Khairy
- Montreal Heart Institute, Université de Montréal, Montreal, Québec, Canada
| | - Seema Mital
- Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Michael Α Gatzoulis
- Adult Congenital Heart Centre and National Centre for Pulmonary Hypertension, Royal Brompton and Harefield National Health Service Foundation Trust, Imperial College London, London, UK
| | - Yue Li
- Department of Computer Science, McGill University, Montréal, Québec, Canada
| | - Ariane Marelli
- McGill Adult Unit for Congenital Heart Disease Excellence (MAUDE Unit), Department of Medicine, McGill University, Montréal, Québec, Canada.
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Wongvibulsin S, Habeos EE, Huynh PP, Xun H, Shan R, Porosnicu Rodriguez KA, Wang J, Gandapur YK, Osuji N, Shah LM, Spaulding EM, Hung G, Knowles K, Yang WE, Marvel FA, Levin E, Maron DJ, Gordon NF, Martin SS. Digital Health Interventions for Cardiac Rehabilitation: Systematic Literature Review. J Med Internet Res 2021; 23:e18773. [PMID: 33555259 PMCID: PMC7899799 DOI: 10.2196/18773] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 11/22/2020] [Accepted: 12/07/2020] [Indexed: 12/19/2022] Open
Abstract
Background Cardiovascular disease (CVD) is the leading cause of death worldwide. Despite strong evidence supporting the benefits of cardiac rehabilitation (CR), over 80% of eligible patients do not participate in CR. Digital health technologies (ie, the delivery of care using the internet, wearable devices, and mobile apps) have the potential to address the challenges associated with traditional facility-based CR programs, but little is known about the comprehensiveness of these interventions to serve as digital approaches to CR. Overall, there is a lack of a systematic evaluation of the current literature on digital interventions for CR. Objective The objective of this systematic literature review is to provide an in-depth analysis of the potential of digital health technologies to address the challenges associated with traditional CR. Through this review, we aim to summarize the current literature on digital interventions for CR, identify the key components of CR that have been successfully addressed through digital interventions, and describe the gaps in research that need to be addressed for sustainable and scalable digital CR interventions. Methods Our strategy for identifying the primary literature pertaining to CR with digital solutions (defined as technology employed to deliver remote care beyond the use of the telephone) included a consultation with an expert in the field of digital CR and searches of the PubMed (MEDLINE), Embase, CINAHL, and Cochrane databases for original studies published from January 1990 to October 2018. Results Our search returned 31 eligible studies, of which 22 were randomized controlled trials. The reviewed CR interventions primarily targeted physical activity counseling (31/31, 100%), baseline assessment (30/31, 97%), and exercise training (27/31, 87%). The most commonly used modalities were smartphones or mobile devices (20/31, 65%), web-based portals (18/31, 58%), and email-SMS (11/31, 35%). Approximately one-third of the studies addressed the CR core components of nutrition counseling, psychological management, and weight management. In contrast, less than a third of the studies addressed other CR core components, including the management of lipids, diabetes, smoking cessation, and blood pressure. Conclusions Digital technologies have the potential to increase access and participation in CR by mitigating the challenges associated with traditional, facility-based CR. However, previously evaluated interventions primarily focused on physical activity counseling and exercise training. Thus, further research is required with more comprehensive CR interventions and long-term follow-up to understand the clinical impact of digital interventions.
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Affiliation(s)
| | | | - Pauline P Huynh
- Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Helen Xun
- Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Rongzi Shan
- Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,UCLA David Geffen School of Medicine, Los Angeles, CA, United States
| | | | - Jane Wang
- Johns Hopkins University School of Medicine, Baltimore, MD, United States.,UCLA David Geffen School of Medicine, Los Angeles, CA, United States
| | | | - Ngozi Osuji
- Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Lochan M Shah
- Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | | | - George Hung
- Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Kellen Knowles
- Department of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, MD, United States
| | - William E Yang
- Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Francoise A Marvel
- Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Eleanor Levin
- Department of Medicine, Division of Cardiology, Stanford University School of Medicine, Stanford, CA, United States
| | - David J Maron
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, United States
| | - Neil F Gordon
- INTERVENT International, Savannah, GA, United States.,Centre for Exercise Science and Sports Medicine, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Seth S Martin
- Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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Rumsfeld JS, Shah RU, Druz RS. Innovation in Cardiology: The ACC Innovation Program. Methodist Debakey Cardiovasc J 2021; 16:304-308. [PMID: 33500759 DOI: 10.14797/mdcj-16-4-304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
The last half century has seen extraordinary advances in the field of cardiology, including innovations in medications, diagnostic modalities, and therapeutics. Even so, cardiovascular disease remains the leading cause of morbidity and mortality globally, with suboptimal quality of care, inconsistent health outcomes, and unsustainable costs. It is clear that cardiovascular medicine must undergo a digital transformation to enhance the delivery of quality care and to improve outcomes. To meet this need, the American College of Cardiology developed an innovation program focused on the digital transformation of cardiovascular care, with the goal of improving heart health for individuals and populations.
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Affiliation(s)
| | - Rashmee U Shah
- UNIVERSITY OF UTAH SCHOOL OF MEDICINE, SALT LAKE CITY, UTAH
| | - Regina S Druz
- ST. FRANCIS HOSPITAL, CATHOLIC HEALTH SERVICES OF LONG ISLAND, ROSLYN, NEW YORK
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35
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Bhavnani SP. Digital Health: Opportunities and Challenges to Develop the Next-Generation Technology-Enabled Models of Cardiovascular Care. Methodist Debakey Cardiovasc J 2021; 16:296-303. [PMID: 33500758 DOI: 10.14797/mdcj-16-4-296] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The wide gap between the development of new healthcare technologies and their integration into clinical practice argues for a deeper understanding of how effective quality improvement can be designed to meet the needs of patients and their clinical teams. The COVID-19 pandemic has forced us to address this gap and create long-term strategies to bridge it. On the one hand, it has enabled the rapid implementation of telehealth. On the other hand, it has raised important questions about our preparedness to adopt and employ new digital tools as part of a new process of care. While healthcare organizations are seeking to improve the quality of care by integrating innovations in digital health, they must also address key issues such as patient experience, develop clinical decision support systems that analyze digital health data trends, and create efficient clinical workflows. Given the breadth of such requirements, embracing new technologies as a core competency of a modern healthcare system introduces a host of questions, such as "How best do patients participate in digital health programs that promote behavioral changes and mitigate risk?" and "What type of data analytics are required that enable a deeper understanding of disease phenotypes and corresponding treatment decisions?" This review presents the challenges in implementing digital health technology and discusses how patient-centered digital health programs are designed within real-world models of remote monitoring. It also provides a framework for developing new devices and wearables for the next generation of data-driven, technology-enabled cardiovascular care.
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36
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Nolan RP, Ross HJ, Farkouh ME, Huszti E, Chan S, Toma M, D'Antono B, White M, Thomas S, Barr SI, Perreault S, McDonald M, Zieroth S, Isaac D, Wielgosz A, Mielniczuk LM. Automated E-Counseling for Chronic Heart Failure: CHF-CePPORT Trial. Circ Heart Fail 2021; 14:e007073. [PMID: 33464959 DOI: 10.1161/circheartfailure.120.007073] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND International task force statements advocate telehealth programs to promote health-related quality of life for patients with chronic heart failure (CHF). To that end, we evaluated the efficacy and usability of an automated e-counseling program. METHODS This Canadian multi-site double-blind randomized trial assessed whether usual care plus either internet-based e-counseling (motivational and cognitive-behavioral tools for CHF self-care) or e-based conventional CHF self-care education (e-UC) improved 12-month Kansas City Cardiomyopathy Questionnaire Overall Summary (KCCQ-OS). Secondary outcomes included program engagement (total logon weeks, logons, and logon hours), total CHF self-care behaviors, diet (fruit and vegetable servings), 6-minute walk test, and 4-day step count. The association between program engagement and health-related quality of life was assessed using KCCQ-OS tertiles. RESULTS We enrolled 231 patients, median age =59.5 years, 22% female, and elevated median KCCQ-OS=83.0 (interquartile range, 68-93). KCCQ-OS increase ≥5 points was not more prevalent for e-counseling, n=29 (29.6%) versus e-UC, n=32 (34.0%), P=0.51. E-Counseling versus e-UC increased total logon weeks (P=0.02), logon hours (P=0.001), and logons (P<0.001). Only e-counseling showed a positive association between 12-month KCCQ-OS tertile and logon weeks (P=0.04) and logon hours (P=0.004). E-Counseling increased CHF self-care behavior and diet but not 6-minute walk test or 4-day step count. CONCLUSIONS The primary KCCQ-OS end point was negative for this trial. Only e-counseling showed a positive association between program engagement and 12-month KCCQ-OS tertile, and it improved CHF self-care behavior and diet. Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT01864369.
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Affiliation(s)
- Robert P Nolan
- Cardiac eHealth and Behavioural Cardiology Research Unit, Peter Munk Cardiac Center (R.P.N.), University Health Network, Toronto, ON, Canada.,Faculty of Medicine (R.P.N., H.J.R., M.E.F., M.M.), University of Toronto, ON, Canada
| | - Heather J Ross
- Division of Cardiology, Peter Munk Cardiac Center (H.J.R., M.E.F., M.M.), University Health Network, Toronto, ON, Canada.,Faculty of Medicine (R.P.N., H.J.R., M.E.F., M.M.), University of Toronto, ON, Canada
| | - Michael E Farkouh
- Division of Cardiology, Peter Munk Cardiac Center (H.J.R., M.E.F., M.M.), University Health Network, Toronto, ON, Canada.,Faculty of Medicine (R.P.N., H.J.R., M.E.F., M.M.), University of Toronto, ON, Canada
| | - Ella Huszti
- Theta Institute (E.H.), University Health Network, Toronto, ON, Canada
| | - Sammy Chan
- Faculty of Medicine (S.C., M.T.), University of British Columbia, Vancouver, Canada.,Department of Cardiology, St Paul's Hospital, Vancouver, BC, Canada (S.C., M.T.)
| | - Mustafa Toma
- Faculty of Medicine (S.C., M.T.), University of British Columbia, Vancouver, Canada.,Department of Cardiology, St Paul's Hospital, Vancouver, BC, Canada (S.C., M.T.)
| | - Bianca D'Antono
- Centre de Recherche, Institut de Cardiologie de Montréal, QC, Canada (B.D., M.W.).,Département de Psychologie (B.D.).,Université de Montréal, QC, Canada (B.D.)
| | - Michel White
- Centre de Recherche, Institut de Cardiologie de Montréal, QC, Canada (B.D., M.W.)
| | - Scott Thomas
- Faculty of Kinesiology and Physical Education (S.T.), University of Toronto, ON, Canada
| | - Susan I Barr
- Department of Food, Nutrition, and Health (S.I.B.), University of British Columbia, Vancouver, Canada
| | | | - Michael McDonald
- Division of Cardiology, Peter Munk Cardiac Center (H.J.R., M.E.F., M.M.), University Health Network, Toronto, ON, Canada.,Faculty of Medicine (R.P.N., H.J.R., M.E.F., M.M.), University of Toronto, ON, Canada
| | - Shelley Zieroth
- Faculty of Medicine, University of Manitoba, Winnipeg, Canada (S.Z.)
| | - Debra Isaac
- Cardiac Transplant Clinic, Libin Cardiovascular Institute of Alberta, Calgary, Canada (D.I.)
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Farwati M, Riaz H, Tang WHW. Digital Health Applications in Heart Failure: a Critical Appraisal of Literature. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2021; 23:12. [PMID: 33488049 PMCID: PMC7812033 DOI: 10.1007/s11936-020-00885-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/11/2020] [Indexed: 12/05/2022]
Abstract
Purpose of the review Despite advancements in the diagnostic and therapeutic armamentarium, heart failure (HF) remains a major public health concern in the USA and worldwide. Digital health applications hold promise to bridge this gap and improve HF care. This review will provide the reader with a concise overview of the current digital health applications in HF, the main challenges to its use, and discuss the future of digital health for promoting care for HF patients. Recent findings Emerging evidence continues to support the potential role of digital health across the continuum of HF disease process including primary prevention, early detection, disease management, and reducing associated morbidity. There is also increasing emphasis on the need to pursue rigorous investigations to validate these promising claims, with some successful stories that have changed clinical practices. Summary Digital health technologies have emerged as potentially useful tools to complement HF care in both research and clinical realms. As digital technologies continue to play an increasing role in transforming healthcare delivery, creating the framework for its effective use would be necessary to ensure that digital health applications consistently improve outcomes and enhance care for HF patients.
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Affiliation(s)
- Medhat Farwati
- Department of Cardiovascular Medicine, Heart Vascular and Thoracic Institute, Cleveland Clinic, 9500 Euclid Avenue, Desk J3-4, Cleveland, OH 44195 USA
| | - Haris Riaz
- Department of Cardiovascular Medicine, Heart Vascular and Thoracic Institute, Cleveland Clinic, 9500 Euclid Avenue, Desk J3-4, Cleveland, OH 44195 USA
| | - W H Wilson Tang
- Department of Cardiovascular Medicine, Heart Vascular and Thoracic Institute, Cleveland Clinic, 9500 Euclid Avenue, Desk J3-4, Cleveland, OH 44195 USA
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38
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Finocchiaro G, Sinagra G, Papadakis M, Carr-White G, Pantazis A, Sharma S, Olivotto I, Rapezzi C. The labyrinth of nomenclature in Cardiology. Eternal dilemmas and new challenges on the horizon in the personalized medicine era. Eur J Heart Fail 2021; 23:1062-1067. [PMID: 33377243 DOI: 10.1002/ejhf.2088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Revised: 12/23/2020] [Accepted: 12/24/2020] [Indexed: 12/22/2022] Open
Affiliation(s)
- Gherardo Finocchiaro
- Cardiothoracic Centre, Guy's and St Thomas' Hospital, London, UK.,King's College London, London, UK
| | | | - Michael Papadakis
- Cardiology Clinical and Academic Group, St George's, University of London, London and St George's University Hospital NHS Foundation Trust, London, UK
| | - Gerald Carr-White
- Cardiothoracic Centre, Guy's and St Thomas' Hospital, London, UK.,King's College London, London, UK
| | | | - Sanjay Sharma
- Cardiology Clinical and Academic Group, St George's, University of London, London and St George's University Hospital NHS Foundation Trust, London, UK
| | - Iacopo Olivotto
- Cardiomyopathy Unit, Careggi University Hospital, Florence, Italy
| | - Claudio Rapezzi
- Centro Cardiologico Universitario di Ferrara, University of Ferrara, Ferrara, Italy.,Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy
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39
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Islam SMS, Maddison R. Digital health approaches for cardiovascular diseases prevention and management: lessons from preliminary studies. Mhealth 2021; 7:41. [PMID: 34345618 PMCID: PMC8326947 DOI: 10.21037/mhealth-2020-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 08/28/2020] [Indexed: 11/06/2022] Open
Affiliation(s)
| | - Ralph Maddison
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
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40
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Meinhart F, Stütz T, Sareban M, Kulnik ST, Niebauer J. Mobile Technologies to Promote Physical Activity during Cardiac Rehabilitation: A Scoping Review. SENSORS 2020; 21:s21010065. [PMID: 33374322 PMCID: PMC7795145 DOI: 10.3390/s21010065] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 12/17/2020] [Accepted: 12/18/2020] [Indexed: 12/21/2022]
Abstract
Promoting regular physical activity (PA) and improving exercise capacity are the primary goals of cardiac rehabilitation (CR). Mobile technologies (mTechs) like smartphones, smartwatches, and fitness trackers might help patients in reaching these goals. This review aimed to scope current scientific literature on mTechs in CR to assess the impact on patients’ exercise capacity and to identify gaps and future directions for research. PubMed, CENTRAL, and CDSR were systematically searched for randomized controlled trials (RCTs). These RCTs had to utilize mTechs to objectively monitor and promote PA of patients during or following CR, aim at improvements in exercise capacity, and be published between December 2014 and December 2019. A total of 964 publications were identified, and 13 studies met all inclusion criteria. Home-based CR with mTechs vs. outpatient CR without mTechs and outpatient CR with mTechs vs. outpatient CR without mTechs did not lead to statistically significant differences in exercise capacity. In contrast, outpatient CR followed by home-based CR with mTechs led to significant improvement in exercise capacity as compared to outpatient CR without further formal CR. Supplying patients with mTechs may improve exercise capacity. To ensure that usage of and compliance with mTechs is optimal, a concentrated effort of CR staff has to be achieved. The COVID-19 pandemic has led to an unprecedented lack of patient support while away from institutional CR. Even though mTechs lend themselves as suitable assistants, evidence is lacking that they can fill this gap.
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Affiliation(s)
- Florian Meinhart
- Ludwig Boltzmann Institute for Digital Health and Prevention, 5020 Salzburg, Austria; (F.M.); (T.S.); (M.S.); (S.T.K.)
- Salzburg Research Forschungsgesellschaft mbH, 5020 Salzburg, Austria
| | - Thomas Stütz
- Ludwig Boltzmann Institute for Digital Health and Prevention, 5020 Salzburg, Austria; (F.M.); (T.S.); (M.S.); (S.T.K.)
- Department of MultiMediaTechnology, Salzburg University of Applied Sciences, 5412 Puch/Salzburg, Austria
| | - Mahdi Sareban
- Ludwig Boltzmann Institute for Digital Health and Prevention, 5020 Salzburg, Austria; (F.M.); (T.S.); (M.S.); (S.T.K.)
- University Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, 5020 Salzburg, Austria
| | - Stefan Tino Kulnik
- Ludwig Boltzmann Institute for Digital Health and Prevention, 5020 Salzburg, Austria; (F.M.); (T.S.); (M.S.); (S.T.K.)
- Faculty of Health, Social Care and Education, Kingston University & St George’s, University of London, London SW17 0RE, UK
| | - Josef Niebauer
- Ludwig Boltzmann Institute for Digital Health and Prevention, 5020 Salzburg, Austria; (F.M.); (T.S.); (M.S.); (S.T.K.)
- University Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, 5020 Salzburg, Austria
- Correspondence: ; Tel.: +43-(0)-57-2552-3200
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41
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Krishnaswami A, Beavers C, Dorsch MP, Dodson JA, Masterson Creber R, Kitsiou S, Goyal P, Maurer MS, Wenger NK, Croy DS, Alexander KP, Batsis JA, Turakhia MP, Forman DE, Bernacki GM, Kirkpatrick JN, Orr NM, Peterson ED, Rich MW, Freeman AM, Bhavnani SP. Gerotechnology for Older Adults With Cardiovascular Diseases: JACC State-of-the-Art Review. J Am Coll Cardiol 2020; 76:2650-2670. [PMID: 33243384 PMCID: PMC10436190 DOI: 10.1016/j.jacc.2020.09.606] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/18/2020] [Accepted: 09/21/2020] [Indexed: 12/19/2022]
Abstract
The growing population of older adults (age ≥65 years) is expected to lead to higher rates of cardiovascular disease. The expansion of digital health (encompassing telehealth, telemedicine, mobile health, and remote patient monitoring), Internet access, and cellular technologies provides an opportunity to enhance patient care and improve health outcomes-opportunities that are particularly relevant during the current coronavirus disease-2019 pandemic. Insufficient dexterity, visual impairment, and cognitive dysfunction, found commonly in older adults should be taken into consideration in the development and utilization of existing technologies. If not implemented strategically and appropriately, these can lead to inequities propagating digital divides among older adults, across disease severities and socioeconomic distributions. A systematic approach, therefore, is needed to study and implement digital health strategies in older adults. This review will focus on current knowledge of the benefits, barriers, and use of digital health in older adults for cardiovascular disease management.
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Affiliation(s)
- Ashok Krishnaswami
- Division of Cardiology, Kaiser Permanente Medical Center, San Jose, California.
| | - Craig Beavers
- Division of Pharmacy, University of Kentucky, Lexington, Kentucky
| | - Michael P Dorsch
- College of Pharmacy, University of Michigan, Ann Arbor, Michigan
| | - John A Dodson
- NYU Langone Health, NYU Grossman School of Medicine, New York, New York
| | - Ruth Masterson Creber
- Weill Cornell Medicine, Department of Population Health Sciences, Division of Health Informatics, New York, New York
| | - Spyros Kitsiou
- Department of Biomedical and Health Information Sciences, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, Illinois
| | - Parag Goyal
- Department of Medicine, Weill Cornell Medicine, New York, New York
| | - Mathew S Maurer
- Division of Cardiology, Columbia University Medical Center, New York, New York
| | - Nanette K Wenger
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | | | - Karen P Alexander
- Division of Cardiology, Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
| | - John A Batsis
- Department of Medicine, Geisel School of Medicine and The Dartmouth Institute for Health Policy & Clinical Practice, Dartmouth College and Dartmouth-Hitchcock, Lebanon, New Hampshire; Division of Geriatric Medicine, School of Medicine, Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill. Chapel Hill, North Carolina
| | - Mintu P Turakhia
- Center for Digital Health, Stanford University, Stanford, California; Palo Alto Veterans Administration Health Care System, Palo Alto, California
| | - Daniel E Forman
- Division of Geriatric Cardiology, University of Pittsburgh, Geriatric Research, Education and Clinical Center; VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
| | - Gwen M Bernacki
- Cardiovascular Division, Department of Medicine, Cambia Palliative Care Center of Excellence, University of Washington, Seattle, Washington
| | - James N Kirkpatrick
- Cardiovascular Division, Department of Medicine, Department of Bioethics and Humanities, University of Washington, Seattle, Washington
| | - Nicole M Orr
- Post-Acute Cardiology Care, LCC, Darien, Connecticut; Division of Cardiology, Tufts Medical Center, Boston, Massachusetts
| | - Eric D Peterson
- Division of Cardiology, Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
| | - Michael W Rich
- Cardiovascular Division, Washington University, St. Louis, Missouri
| | - Andrew M Freeman
- Division of Cardiology, Department of Medicine, National Jewish Health, Denver, Colorado
| | - Sanjeev P Bhavnani
- Prebys Cardiovascular Institute, Scripps Clinic & Research Foundation, San Diego, California
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42
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Mazza A, Paneroni M. Gym space in the era of digital cardiovascular rehabilitation: Often overlooked but critically important. Eur J Prev Cardiol 2020; 27:2059-2062. [DOI: 10.1177/2047487319869576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Antonio Mazza
- Department of Cardiac Rehabilitation, Istituti Clinici Scientifici Maugeri IRCCS, Institute of Pavia, Italy
| | - Mara Paneroni
- Department of Pneumology Rehabilitation, Istituti Clinici Scientifici Maugeri IRCCS, Institute of Lumezzane (BS), Italy
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43
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DeVore AD, Wosik J, Hernandez AF. The Future of Wearables in Heart Failure Patients. JACC-HEART FAILURE 2020; 7:922-932. [PMID: 31672308 DOI: 10.1016/j.jchf.2019.08.008] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 08/07/2019] [Accepted: 08/14/2019] [Indexed: 01/28/2023]
Abstract
The adoption of mobile health (mHealth) devices is creating a unique opportunity to improve heart failure (HF) care. The rise of mHealth is driven by multiple factors including consumerism, policy changes in health care, and innovations in technology. Wearable health devices are one aspect of mHealth that may improve the delivery of HF care by allowing for medical data collection outside of a clinician's office or hospital. Wearable devices are externally applied and capture functional or physiological data in order to monitor and improve patients' health. Most wearable sensors capture data continuously and may be incorporated into accessories (e.g., a watch or clothing) or may be applied as a cutaneous patch. Wearable devices are often paired with another device, such as a smartphone, to collect, interpret, or transmit data. This study assessed the potential applications of wearable devices in HF care, summarizes available data for wearables, and discusses the future of wearables for improving the health of patients with HF.
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Affiliation(s)
- Adam D DeVore
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina; Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina.
| | - Jedrek Wosik
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina
| | - Adrian F Hernandez
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina
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44
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Melstrom LG, Rodin AS, Rossi LA, Fu P, Fong Y, Sun V. Patient generated health data and electronic health record integration in oncologic surgery: A call for artificial intelligence and machine learning. J Surg Oncol 2020; 123:52-60. [PMID: 32974930 DOI: 10.1002/jso.26232] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 09/11/2020] [Indexed: 12/16/2022]
Abstract
In this review, we aim to assess the current state of science in relation to the integration of patient-generated health data (PGHD) and patient-reported outcomes (PROs) into routine clinical care with a focus on surgical oncology populations. We will also describe the critical role of artificial intelligence and machine-learning methodology in the efficient translation of PGHD, PROs, and traditional outcome measures into meaningful patient care models.
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Affiliation(s)
- Laleh G Melstrom
- Department of Surgery, City of Hope National Medical Center, Duarte, California, USA
| | - Andrei S Rodin
- Department of Computational and Quantitative Medicine, Beckman Research Institute, City of Hope National Medical Center, Duarte, California, USA
| | - Lorenzo A Rossi
- Applied AI and Data Science Department, City of Hope National Medical Center, Duarte, California, USA
| | - Paul Fu
- Department of Pediatrics, City of Hope National Medical Center, Duarte, California, USA
| | - Yuman Fong
- Department of Surgery, City of Hope National Medical Center, Duarte, California, USA
| | - Virginia Sun
- Department of Surgery, City of Hope National Medical Center, Duarte, California, USA.,Department of Population Sciences, City of Hope National Medical Center, Duarte, California, USA
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45
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Constantine A, Barradas-Pires A, Dimopoulos K. Modifiable risk factors in congenital heart disease: Education, transition, digital health and choice architecture. Eur J Prev Cardiol 2020; 27:1074-1076. [PMID: 31480874 DOI: 10.1177/2047487319874146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Andrew Constantine
- The Adult Congenital Heart Centre and National Centre for Pulmonary Hypertension, Royal Brompton Hospital, London, UK.,The National Heart and Lung Institute, Imperial College London, UK
| | - Ana Barradas-Pires
- The Adult Congenital Heart Centre and National Centre for Pulmonary Hypertension, Royal Brompton Hospital, London, UK.,The National Heart and Lung Institute, Imperial College London, UK
| | - Konstantinos Dimopoulos
- The Adult Congenital Heart Centre and National Centre for Pulmonary Hypertension, Royal Brompton Hospital, London, UK.,The National Heart and Lung Institute, Imperial College London, UK
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46
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Cohoon TJ, Bhavnani SP. Toward precision health: applying artificial intelligence analytics to digital health biometric datasets. Per Med 2020; 17:307-316. [PMID: 32588726 DOI: 10.2217/pme-2019-0113] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The rapid development of digital health devices has enabled patients to engage in their care to an unprecedented degree and holds the possibility of significantly improving the diagnosis, treatment and monitoring of many medical conditions. Combined with the emergence of artificial intelligence algorithms, biometric datasets produced from these digital health devices present new opportunities to create precision-based, personalized approaches for healthcare delivery. For effective implementation of such innovations to patient care, clinicians will require an understanding of the types of datasets produced from digital health technologies; the types of analytic methods including feature selection, convolution neural networking, and deep learning that can be used to analyze digital data; and how the interpretation of these findings are best translated to patient care. In this perspective, we aim to provide the groundwork for clinicians to be able to apply artificial intelligence to this transformation of healthcare.
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Affiliation(s)
- Travis J Cohoon
- Department of Medicine, Scripps Clinic, San Diego, CA 92037, USA
| | - Sanjeev P Bhavnani
- Division of Cardiology, Healthcare Innovation & Practice Transformation Laboratory, Scripps Clinic, San Diego, CA 92037, USA
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47
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Guideline-concordant-phenotyping: Identifying patient indications for implantable cardioverter defibrillators from electronic health records. Int J Med Inform 2020; 138:104138. [DOI: 10.1016/j.ijmedinf.2020.104138] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 02/25/2020] [Accepted: 03/28/2020] [Indexed: 12/11/2022]
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Stogios N, Kaur B, Huszti E, Vasanthan J, Nolan RP. Advancing Digital Health Interventions as a Clinically Applied Science for Blood Pressure Reduction: A Systematic Review and Meta-analysis. Can J Cardiol 2020; 36:764-774. [DOI: 10.1016/j.cjca.2019.11.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 10/24/2019] [Accepted: 11/10/2019] [Indexed: 01/29/2023] Open
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Wolk S, Kleemann M, Reeps C. [Artificial intelligence in vascular surgery and vascular medicine]. Chirurg 2020; 91:195-200. [PMID: 32060576 DOI: 10.1007/s00104-020-01143-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
New digital technologies will also gain in importance in vascular surgery. There is a wide field of potential applications. Simulation-based training of endovascular procedures can lead to improvement in procedure-specific parameters and reduce fluoroscopy and procedural times. The use of intraoperative image-guided navigation and robotics also enables a reduction of the radiation dose. Artificial intelligence can be used for risk stratification and individualization of treatment approaches. Health apps can be used to improve the follow-up care of patients.
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Affiliation(s)
- S Wolk
- Gefäß- und Endovaskuläre Chirurgie, Klinik und Poliklinik für Visceral‑, Thorax- und Gefäßchirurgie, Universitätsklinikum Carl Gustav Carus Dresden, TU Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
| | - M Kleemann
- Gefäß- und Endovaskuläre Chirurgie, Klinik für Chirurgie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland
| | - C Reeps
- Gefäß- und Endovaskuläre Chirurgie, Klinik und Poliklinik für Visceral‑, Thorax- und Gefäßchirurgie, Universitätsklinikum Carl Gustav Carus Dresden, TU Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.
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Fleurence RL, Blake K, Shuren J. The Future of Registries in the Era of Real-world Evidence for Medical Devices. JAMA Cardiol 2020; 4:197-198. [PMID: 30785595 DOI: 10.1001/jamacardio.2018.4933] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Rachael L Fleurence
- National Evaluation System for Health Technology, Medical Device Innovation Consortium, Arlington, Virginia
| | | | - Jeffrey Shuren
- US Food and Drug Administration, Silver Spring, Maryland
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