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Canaud B, Davenport A, Leray-Moragues H, Morena-Carrere M, Cristol JP, Kooman J, Kotanko P. Digital Health Support: Current Status and Future Development for Enhancing Dialysis Patient Care and Empowering Patients. Toxins (Basel) 2024; 16:211. [PMID: 38787063 PMCID: PMC11125858 DOI: 10.3390/toxins16050211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 04/18/2024] [Accepted: 04/27/2024] [Indexed: 05/25/2024] Open
Abstract
Chronic kidney disease poses a growing global health concern, as an increasing number of patients progress to end-stage kidney disease requiring kidney replacement therapy, presenting various challenges including shortage of care givers and cost-related issues. In this narrative essay, we explore innovative strategies based on in-depth literature analysis that may help healthcare systems face these challenges, with a focus on digital health technologies (DHTs), to enhance removal and ensure better control of broader spectrum of uremic toxins, to optimize resources, improve care and outcomes, and empower patients. Therefore, alternative strategies, such as self-care dialysis, home-based dialysis with the support of teledialysis, need to be developed. Managing ESKD requires an improvement in patient management, emphasizing patient education, caregiver knowledge, and robust digital support systems. The solution involves leveraging DHTs to automate HD, implement automated algorithm-driven controlled HD, remotely monitor patients, provide health education, and enable caregivers with data-driven decision-making. These technologies, including artificial intelligence, aim to enhance care quality, reduce practice variations, and improve treatment outcomes whilst supporting personalized kidney replacement therapy. This narrative essay offers an update on currently available digital health technologies used in the management of HD patients and envisions future technologies that, through digital solutions, potentially empower patients and will more effectively support their HD treatments.
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Affiliation(s)
- Bernard Canaud
- School of Medicine, Montpellier University, 9 Rue des Carmelites, 34090 Montpellier, France
- Fondation Charles Mion, AIDER-SANTE, 34000 Montpellier, France; (H.L.-M.)
- MTX Consulting International, 34090 Montpellier, France
| | - Andrew Davenport
- UCL Department of Renal Medicine, University College London, London WC1E 6BT, UK;
| | | | - Marion Morena-Carrere
- PhyMedExp, Department of Biochemistry and Hormonology, INSERM, CNRS, University Hospital Center of Montpellier, University of Montpellier, 34000 Montpellier, France;
| | - Jean Paul Cristol
- Fondation Charles Mion, AIDER-SANTE, 34000 Montpellier, France; (H.L.-M.)
- PhyMedExp, Department of Biochemistry and Hormonology, INSERM, CNRS, University Hospital Center of Montpellier, University of Montpellier, 34000 Montpellier, France;
| | - Jeroen Kooman
- Department of Internal Medicine, Division of Nephrology, Maastricht University Medical Center, 6202 AZ Maastricht, The Netherlands
| | - Peter Kotanko
- Renal Research Institute, Icahn University, New York, NY 10065, USA;
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Bekbolatova M, Mayer J, Ong CW, Toma M. Transformative Potential of AI in Healthcare: Definitions, Applications, and Navigating the Ethical Landscape and Public Perspectives. Healthcare (Basel) 2024; 12:125. [PMID: 38255014 PMCID: PMC10815906 DOI: 10.3390/healthcare12020125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/27/2023] [Accepted: 01/02/2024] [Indexed: 01/24/2024] Open
Abstract
Artificial intelligence (AI) has emerged as a crucial tool in healthcare with the primary aim of improving patient outcomes and optimizing healthcare delivery. By harnessing machine learning algorithms, natural language processing, and computer vision, AI enables the analysis of complex medical data. The integration of AI into healthcare systems aims to support clinicians, personalize patient care, and enhance population health, all while addressing the challenges posed by rising costs and limited resources. As a subdivision of computer science, AI focuses on the development of advanced algorithms capable of performing complex tasks that were once reliant on human intelligence. The ultimate goal is to achieve human-level performance with improved efficiency and accuracy in problem-solving and task execution, thereby reducing the need for human intervention. Various industries, including engineering, media/entertainment, finance, and education, have already reaped significant benefits by incorporating AI systems into their operations. Notably, the healthcare sector has witnessed rapid growth in the utilization of AI technology. Nevertheless, there remains untapped potential for AI to truly revolutionize the industry. It is important to note that despite concerns about job displacement, AI in healthcare should not be viewed as a threat to human workers. Instead, AI systems are designed to augment and support healthcare professionals, freeing up their time to focus on more complex and critical tasks. By automating routine and repetitive tasks, AI can alleviate the burden on healthcare professionals, allowing them to dedicate more attention to patient care and meaningful interactions. However, legal and ethical challenges must be addressed when embracing AI technology in medicine, alongside comprehensive public education to ensure widespread acceptance.
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Affiliation(s)
- Molly Bekbolatova
- Department of Osteopathic Manipulative Medicine, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY 11568, USA; (M.B.); (J.M.)
| | - Jonathan Mayer
- Department of Osteopathic Manipulative Medicine, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY 11568, USA; (M.B.); (J.M.)
| | - Chi Wei Ong
- School of Chemistry, Chemical Engineering, and Biotechnology, Nanyang Technological University, 62 Nanyang Drive, Singapore 637459, Singapore
| | - Milan Toma
- Department of Osteopathic Manipulative Medicine, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY 11568, USA; (M.B.); (J.M.)
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Savoia M, Tripepi G, Goethel-Paal B, Baró Salvador ME, Ponce P, Voiculescu D, Pachmann M, Jirka T, Koc SK, Marcinkowski W, Cioffi M, Neri L, Usvyat L, Hymes JL, Maddux FW, Zoccali C, Stuard S. European Nephrologists' Attitudes toward the Application of Artificial Intelligence in Clinical Practice: A Comprehensive Survey. Blood Purif 2023; 53:80-87. [PMID: 38008072 PMCID: PMC10836740 DOI: 10.1159/000534604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 10/12/2023] [Indexed: 11/28/2023]
Abstract
INTRODUCTION The rapid advancement of artificial intelligence and big data analytics, including descriptive, diagnostic, predictive, and prescriptive analytics, has the potential to revolutionize many areas of medicine, including nephrology and dialysis. Artificial intelligence and big data analytics can be used to analyze large amounts of patient medical records, including laboratory results and imaging studies, to improve the accuracy of diagnosis, enhance early detection, identify patterns and trends, and personalize treatment plans for patients with kidney disease. Additionally, artificial intelligence and big data analytics can be used to identify patients' treatment who are not receiving adequate care, highlighting care inefficiencies in the dialysis provider, optimizing patient outcomes, reducing healthcare costs, and consequently creating values for all the involved stakeholders. OBJECTIVES We present the results of a comprehensive survey aimed at exploring the attitudes of European physicians from eight countries working within a major hemodialysis network (Fresenius Medical Care NephroCare) toward the application of artificial intelligence in clinical practice. METHODS An electronic survey on the implementation of artificial intelligence in hemodialysis clinics was distributed to 1,067 physicians. Of the 1,067 individuals invited to participate in the study, 404 (37.9%) professionals agreed to participate in the survey. RESULTS The survey showed that a substantial proportion of respondents believe that artificial intelligence has the potential to support physicians in reducing medical malpractice or mistakes. CONCLUSION While artificial intelligence's potential benefits are recognized in reducing medical errors and improving decision-making, concerns about treatment plan consistency, personalization, privacy, and the human aspects of patient care persist. Addressing these concerns will be crucial for successfully integrating artificial intelligence solutions in nephrology practice.
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Affiliation(s)
- Matteo Savoia
- Fresenius Medical Care, Global Medical Office, Bad Homburg, Germany
| | - Giovanni Tripepi
- Clinical Epidemiology of Renal Diseases and Hypertension Unit, Consiglio Nazionale delle Ricerche Institute of Clinical Physiology, Reggio Calabria, Italy
| | | | | | - Pedro Ponce
- Fresenius Medical Care, Global Medical Office, Lisbon, Portugal
| | | | - Martin Pachmann
- Fresenius Medical Care, Global Medical Office, Bad Homburg, Germany
| | - Tomas Jirka
- Fresenius Medical Care, Global Medical Office, Praha, Czechia
| | | | | | - Mario Cioffi
- Fresenius Medical Care, Global Medical Office, Naples, Italy
| | - Luca Neri
- Fresenius Medical Care, Global Medical Office, Bad Homburg, Germany
| | - Len Usvyat
- Fresenius Medical Care, Global Medical Office, Waltham, Massachusetts, USA
| | - Jeffrey L Hymes
- Fresenius Medical Care, Global Medical Office, Waltham, Massachusetts, USA
| | - Franklin W Maddux
- Fresenius Medical Care, Global Medical Office, Waltham, Massachusetts, USA
| | - Carmine Zoccali
- Institute of Biology and Molecular Genetics (BIOGEM), Ariano Irpino, Italy
- Associazione Ipertensione Nefrologia e Trapianto Renale (IPNET), Reggio Calabria, Italy
| | - Stefano Stuard
- Fresenius Medical Care, Global Medical Office, Bad Homburg, Germany
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