Pursuing Connectivity in Cardio-Oncology Care-The Future of Telemedicine and Artificial Intelligence in Providing Equity and Access to Rural Communities

The Digital Revolution in Medicine: Applications in Cardio-Oncology

PURPOSE OF REVIEW

A critical evaluation of contemporary literature regarding the role of big data, artificial intelligence, and digital technologies in precision cardio-oncology care and survivorship, emphasizing innovative and groundbreaking endeavors.

RECENT FINDINGS

Artificial intelligence (AI) algorithm models can automate the risk assessment process and augment current subjective clinical decision tools. AI, particularly machine learning (ML), can identify medically significant patterns in large data sets. Machine learning in cardio-oncology care has great potential in screening, diagnosis, monitoring, and managing cancer therapy-related cardiovascular complications. To this end, large-scale imaging data and clinical information are being leveraged in training efficient AI algorithms that may lead to effective clinical tools for caring for this vulnerable population. Telemedicine may benefit cardio-oncology patients by enhancing healthcare delivery through lowering costs, improving quality, and personalizing care. Similarly, the utilization of wearable biosensors and mobile health technology for remote monitoring holds the potential to improve cardio-oncology outcomes through early intervention and deeper clinical insight. Investigations are ongoing regarding the application of digital health tools such as telemedicine and remote monitoring devices in enhancing the functional status and recovery of cancer patients, particularly those with limited access to centralized services, by increasing physical activity levels and providing access to rehabilitation services.

SUMMARY

In recent years, advances in cancer survival have increased the prevalence of patients experiencing cancer therapy-related cardiovascular complications. Traditional cardio-oncology risk categorization largely relies on basic clinical features and physician assessment, necessitating advancements in machine learning to create objective prediction models using diverse data sources. Healthcare disparities may be perpetuated through AI algorithms in digital health technologies. In turn, this may have a detrimental effect on minority populations by limiting resource allocation. Several AI-powered innovative health tools could be leveraged to bridge the digital divide and improve access to equitable care.

Racial and Ethnic Disparities in Cardio-Oncology Care

PURPOSE OF REVIEW

This review examines racial, ethnic, and socioeconomic disparities in cardio-oncology care, evaluating current evidence and proposing evidence-based strategies to address inequities in cardiovascular care for cancer patients.

RECENT FINDINGS

Significant disparities exist in cardio-oncology outcomes and access across populations. Racial and ethnic minoritized groups face higher cardiovascular mortality and increased cardiotoxicity risks during cancer treatment. These populations also preset with more advanced-stage cancer diagnoses and increased burden of cardiovascular risk factors. Social vulnerability indices strongly correlate with worse outcomes, while geographic location and environmental factors create additional risks. Rural populations particularly struggle with access to specialized care and clinical trials. Multiple factors contribute to disparities in cardio-oncology, including social determinants of health, disproportionate burden of cardiovascular risk factors, barriers to access, and environmental exposures. Key solutions include expanding access to subspecialty care, creation of collaborations between academic centers and community hospitals, particularly those in underserved communities, enhancing community engagement and public health education, improving clinical trial representation, increasing workforce diversity, and enhancing cultural competency. These findings emphasize the need for systematic healthcare delivery changes and resource allocation to achieve equitable cardio-oncology care for all populations.

Applications, challenges and future directions of artificial intelligence in cardio-oncology

BACKGROUND

The management of cardiotoxicity related to cancer therapies has emerged as a significant clinical challenge, prompting the rapid growth of cardio-oncology. As cancer treatments become more complex, there is an increasing need to enhance diagnostic and therapeutic strategies for managing their cardiovascular side effects.

OBJECTIVE

This review investigates the potential of artificial intelligence (AI) to revolutionize cardio-oncology by integrating diverse data sources to address the challenges of cardiotoxicity management.

METHODS

We explore applications of AI in cardio-oncology, focusing on its ability to leverage multiple data sources, including electronic health records, electrocardiograms, imaging modalities, wearable sensors, and circulating serum biomarkers.

RESULTS

AI has demonstrated significant potential in improving risk stratification and longitudinal monitoring of cardiotoxicity. By optimizing the use of electrocardiograms, non-invasive imaging, and circulating biomarkers, AI facilitates earlier detection, better prediction of outcomes, and more personalized therapeutic interventions. These advancements are poised to enhance patient outcomes and streamline clinical decision-making.

CONCLUSIONS

AI represents a transformative opportunity in cardio-oncology by advancing diagnostic and therapeutic capabilities. However, successful implementation requires addressing practical challenges such as data integration, model interpretability, and clinician training. Continued collaboration between clinicians and AI developers will be essential to fully integrate AI into routine clinical workflows.

AI and Smart Devices in Cardio-Oncology: Advancements in Cardiotoxicity Prediction and Cardiovascular Monitoring

The increasing prevalence of cardiovascular complications in cancer patients due to cardiotoxic treatments has necessitated advanced monitoring and predictive solutions. Cardio-oncology is an evolving interdisciplinary field that addresses these challenges by integrating artificial intelligence (AI) and smart cardiac devices. This comprehensive review explores the integration of artificial intelligence (AI) and smart cardiac devices in cardio-oncology, highlighting their role in improving cardiovascular risk assessment and the early detection and real-time monitoring of cardiotoxicity. AI-driven techniques, including machine learning (ML) and deep learning (DL), enhance risk stratification, optimize treatment decisions, and support personalized care for oncology patients at cardiovascular risk. Wearable ECG patches, biosensors, and AI-integrated implantable devices enable continuous cardiac surveillance and predictive analytics. While these advancements offer significant potential, challenges such as data standardization, regulatory approvals, and equitable access must be addressed. Further research, clinical validation, and multidisciplinary collaboration are essential to fully integrate AI-driven solutions into cardio-oncology practices and improve patient outcomes.

Building Better Medicine: Translational Justice and the Quest for Equity in US Healthcare

Despite considerable scientific progress and the evolution of regulatory pathways to ensure safety and efficacy, US healthcare continues to see increasing health disparities. This suggests that clinical translation in of itself cannot be the only measure of its own success, especially when the most marginalized patients, are neglected in the development and implementation of medical innovations. This raises the question of whether a system that is narrowly focused on technical achievement can meet the moral obligations of medicine and public health. We argue that traditional technocratic standards are failing to integrate normative considerations into biomedical translation. What is needed is a translational domain that moves beyond safety and efficacy toward anticipating how proposed technologies will be effective in society as it exists. We propose an additional metric of success: translational justice.

Cardiovascular Health in Breast Cancer: Survivorship Care

Improved screening and treatment have increased breast cancer survival rates, with over 7.8 million women surviving 5 years post-diagnosis globally. However, survivors face heightened cardiovascular morbidity and mortality due to cancer treatment and patient related risk factors. Cardio-oncology has emerged as a discipline to manage cardiovascular health in patients throughout and following cancer treatment. This review focuses on strategies to optimize cardiovascular health in breast cancer survivors, aligning with ASCO's survivorship principles. Key strategies include risk stratification, primary prevention, lifestyle interventions, pharmacologic management, appropriate cardiovascular monitoring, and tailored exercise programs. Effective cardio-oncology care hinges on collaboration between specialists and patients, underscoring the significance of shared-care models and telemedicine options in survivorship management.

Addressing health service equity through telehealth: A systematic review of reviews

Objective

To synthesize existing reviews on the impact of telehealth programs on health service equity in non-urban areas, focusing on six dimensions of access: accessibility, availability, acceptability, affordability, adequacy, and awareness.

Methods

We included systematic and non-systematic reviews published from 2012 to 2023 on telehealth interventions in rural or remote settings. Content was mapped to the six dimensions, and coverage within each dimension was rated based on predefined criteria.

Results

A total of 42 reviews (43% systematic) were identified. Most reviews (90.5%) addressed at least one dimension, yet comprehensive coverage was rare. Acceptability had the highest number of "good" ratings (24%), while awareness was the least explored. Gaps included digital literacy, infrastructure challenges, and cultural barriers-factors critical to equitable telehealth access. Cost-effectiveness analyses were also limited, leaving affordability underexamined.

Conclusion

Telehealth shows promise for improving healthcare access in non-urban regions. However, existing reviews often provide incomplete assessments across the six dimensions. This suggests a need for clearer, more robust evaluation frameworks to ensure more comprehensive reporting of equity impacts in telehealth research.

Healthcare Transformation: Artificial Intelligence Is the Dire Imperative of the Day

At present, healthcare systems around the world are confronted with unprecedented challenges caused by aging demographics, increasing chronic diseases, and resource challenges. In this scenario, artificial intelligence (AI) emerges as a disruptive technology that can provide solutions to these complicated problems. This review article outlines the vital role played by AI in altering the health landscape. The constant demand for effective and accessible healthcare demands the use of new solutions. AI can be described as an important imperative, enabling advancements in many areas of the delivery of healthcare. This review article explores the possibilities of use of AI to aid in the field of healthcare assistants, diagnosing, disease prediction, and personalized treatment and the discovery of drugs, telemedicine and remote monitoring of patients, robotic-assisted procedures imaging for pathology and radiology analysis, and the analysis of genomic data. By analyzing the existing research and cases, we explain how AI-driven technology can optimize processes in healthcare, improve diagnosis accuracy, improve the quality of treatment, and simplify administrative tasks. By highlighting the most successful AI applications and laying out possible future developments, the review article will provide insight for healthcare professionals, policymakers, researchers, and other stakeholders in harnessing the power of AI to transform healthcare delivery and enhance the quality of care for patients.

Leveraging the Academic Artificial Intelligence Silecosystem to Advance the Community Oncology Enterprise

Over the last 75 years, artificial intelligence has evolved from a theoretical concept and novel paradigm describing the role that computers might play in our society to a tool with which we daily engage. In this review, we describe AI in terms of its constituent elements, the synthesis of which we refer to as the AI Silecosystem. Herein, we provide an historical perspective of the evolution of the AI Silecosystem, conceptualized and summarized as a Kuhnian paradigm. This manuscript focuses on the role that the AI Silecosystem plays in oncology and its emerging importance in the care of the community oncology patient. We observe that this important role arises out of a unique alliance between the academic oncology enterprise and community oncology practices. We provide evidence of this alliance by illustrating the practical establishment of the AI Silecosystem at the City of Hope Comprehensive Cancer Center and its team utilization by community oncology providers.

Inequity in care delivery in cardio-oncology: dissecting disparities in underrepresented populations

It is well known that patients with cancer have a significantly higher cardiovascular mortality risk than the general population. Cardio-oncology has emerged to focus on these issues including risk reduction, detection, monitoring, and treatment of cardiovascular disease or complications in patients with cancer. The rapid advances in early detection and drug development in oncology, along with socioeconomic differences, racial inequities, lack of support, and barriers to accessing quality medical care, have created disparities in various marginalized populations. In this review, we will discuss the factors contributing to disparities in cardio-oncologic care in distinct populations, including Hispanic/Latinx, Black, Asian and Pacific Islander, indigenous populations, sex and gender minorities, and immigrants. Some factors that contribute to differences in outcomes in cardio-oncology include the prevalence of cancer screening rates, genetic cardiac/oncologic risk factors, cultural stressors, tobacco exposure rates, and physical inactivity. We will also discuss the barriers to cardio-oncologic care in these communities from the racial and socioeconomic context. Appropriate and timely cardiovascular and cancer care in minority groups is a critical component in addressing these disparities, and there need to be urgent efforts to address this widening gap.

Pros and cons of telemedicine: implications in cardiology and cardiovascular medicine

The COVID-19 pandemic has highlighted the vitalness of telehealth in our medical world, where considering a restructuring of healthcare services has become paramount. Indeed, in the context of this still ongoing pandemic, medical institutions must strive to improve telehealth technologies and implement solid future research directions in this growing field - to be able to persevere in meeting the needs of the patients. As long as no conclusive evidence exists regarding the fields where telemedicine is most worthwhile, healthcare systems will always keep the dread of wasting resources on developing ineffective programs. We gathered that telemedicine has been attributed a considerable attention in managing cardiac/cardiovascular conditions; nevertheless, further studies with solid designs are still needed to confirm its validity/utility within these specialties.