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Mei DA, Imberti JF, Vitolo M, Bonini N, Casali E, Osoro L, Casado-Arroyo R, Boriani G. Economic Evaluations in Electrophysiology in the Last 15 Years: A Systematic Review of the Literature. Rev Cardiovasc Med 2025; 26:36206. [PMID: 40351680 PMCID: PMC12059752 DOI: 10.31083/rcm36206] [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: 12/05/2024] [Revised: 01/26/2025] [Accepted: 02/24/2025] [Indexed: 05/14/2025] Open
Abstract
Background Electrophysiology (EP) procedures, including cardiac implantable electronic devices (CIEDs) and ablations, are widely used to manage arrhythmias and heart failure. These interventions, though effective, require substantial resources, prompting the need for systematic economic evaluations to inform healthcare decision-making. Methods A systematic review of studies from 2007 to 2024 was conducted in two phases. Phase one assessed trends in economic evaluations of EP procedures, analyzing 129 studies across regions and timeframes. Phase two focused on cost-effectiveness analyses of implantable cardioverter defibrillators (ICDs), cardiac resynchronization therapy defibrillators (CRT-Ds), and atrial fibrillation (AF) ablation, examining outcomes like quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs), while identifying factors influencing economic results. Results EP procedures generally demonstrated favorable cost-effectiveness, particularly in high-income regions. Studies on ICDs and CRT-Ds consistently supported their economic value for patients with arrhythmias or heart failure, while AF ablation showed potential for long-term benefits, particularly when compared to medical therapies. However, results varied by region, reflecting differences in healthcare systems, costs, and patient populations. Conclusions The review highlights the overall cost-effectiveness of EP procedures in many settings but underscores the need for tailored economic evaluations in low- and middle-income countries. Simplified methodologies and greater attention to regional contexts are recommended to guide resource allocation and policy development globally.
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Affiliation(s)
- Davide Antonio Mei
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41121 Modena, Italy
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41121 Modena, Italy
- Advocacy, Quality Improvement and Health Economics (AQIHEC) Committee, EHRA, 06903 Sophia Antipolis, France
| | - Jacopo Francesco Imberti
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41121 Modena, Italy
| | - Marco Vitolo
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41121 Modena, Italy
| | - Niccolò Bonini
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41121 Modena, Italy
| | - Edoardo Casali
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41121 Modena, Italy
| | - Lucia Osoro
- Advocacy, Quality Improvement and Health Economics (AQIHEC) Committee, EHRA, 06903 Sophia Antipolis, France
- Department of Cardiology, H.U.B.-Hôpital Erasme, Université Libre de Bruxelles, 1070 Bruxelles, Belgium
| | - Ruben Casado-Arroyo
- Advocacy, Quality Improvement and Health Economics (AQIHEC) Committee, EHRA, 06903 Sophia Antipolis, France
- Department of Cardiology, H.U.B.-Hôpital Erasme, Université Libre de Bruxelles, 1070 Bruxelles, Belgium
| | - Giuseppe Boriani
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41121 Modena, Italy
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Goel I, Bhaskar Y, Kumar N, Singh S, Amanullah M, Dhar R, Karmakar S. Role of AI in empowering and redefining the oncology care landscape: perspective from a developing nation. Front Digit Health 2025; 7:1550407. [PMID: 40103737 PMCID: PMC11913822 DOI: 10.3389/fdgth.2025.1550407] [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: 12/23/2024] [Accepted: 02/17/2025] [Indexed: 03/20/2025] Open
Abstract
Early diagnosis and accurate prognosis play a pivotal role in the clinical management of cancer and in preventing cancer-related mortalities. The burgeoning population of Asia in general and South Asian countries like India in particular pose significant challenges to the healthcare system. Regrettably, the demand for healthcare services in India far exceeds the available resources, resulting in overcrowded hospitals, prolonged wait times, and inadequate facilities. The scarcity of trained manpower in rural settings, lack of awareness and low penetrance of screening programs further compounded the problem. Artificial Intelligence (AI), driven by advancements in machine learning, deep learning, and natural language processing, can profoundly transform the underlying shortcomings in the healthcare industry, more for populous nations like India. With about 1.4 million cancer cases reported annually and 0.9 million deaths, India has a significant cancer burden that surpassed several nations. Further, India's diverse and large ethnic population is a data goldmine for healthcare research. Under these circumstances, AI-assisted technology, coupled with digital health solutions, could support effective oncology care and reduce the economic burden of GDP loss in terms of years of potential productive life lost (YPPLL) due to India's stupendous cancer burden. This review explores different aspects of cancer management, such as prevention, diagnosis, precision treatment, prognosis, and drug discovery, where AI has demonstrated promising clinical results. By harnessing the capabilities of AI in oncology research, healthcare professionals can enhance their ability to diagnose cancers at earlier stages, leading to more effective treatments and improved patient outcomes. With continued research and development, AI and digital health can play a transformative role in mitigating the challenges posed by the growing population and advancing the fight against cancer in India. Moreover, AI-driven technologies can assist in tailoring personalized treatment plans, optimizing therapeutic strategies, and supporting oncologists in making well-informed decisions. However, it is essential to ensure responsible implementation and address potential ethical and privacy concerns associated with using AI in healthcare.
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Affiliation(s)
- Isha Goel
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), New Delhi, India
- Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Yogendra Bhaskar
- ICMR Computational Genomics Centre, Indian Council of Medical Research (ICMR), New Delhi, India
| | - Nand Kumar
- Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Sunil Singh
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Mohammed Amanullah
- Department of Clinical Biochemistry, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Ruby Dhar
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Subhradip Karmakar
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), New Delhi, India
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Gardner DSL, Saboo B, Kesavadev J, Mustafa N, Villa M, Mahoney E, Bajpai S. Digital Health Technology in Diabetes Management in the Asia-Pacific Region: A Narrative Review of the Current Scenario and Future Outlook. Diabetes Ther 2025; 16:349-369. [PMID: 39928223 PMCID: PMC11868478 DOI: 10.1007/s13300-025-01692-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 01/13/2025] [Indexed: 02/11/2025] Open
Abstract
Diabetes is a growing global health concern with a high prevalence in the Asian and Western Pacific regions. Effective diabetes management mainly relies on self-care practices. However, glycemic control remains poor, especially in developing nations where healthcare access is limited. Low physician density and minimal healthcare funding exacerbate the challenges faced by people with diabetes in Asia. Digital health technologies offer promising solutions to bridge these gaps. These technologies enhance patient engagement, improve medication adherence, and promote healthier lifestyles. Mobile apps provide tools for self-management, such as monitoring physical activity and dietary intake, while telemedicine platforms and electronic medical records facilitate patient data management and remote consultations. Despite the advantages provided by digital health technologies in managing diabetes, barriers to their adoption include infrastructure limitations, regulatory challenges, and issues with data security. Some Asian countries have made major strides in the adoption of digital health tools with national strategies and regulatory bodies to manage digital health options; however, disparities in digital health readiness persist. Effective implementation of these technologies requires addressing these barriers, including enhancing infrastructure, improving app usability, and ensuring regulatory compliance. While digital health solutions present significant opportunities, their impact depends on overcoming current challenges and ensuring equitable access and effective use in managing diabetes. Future directions should focus on prioritizing app acceptance and efficacy, as well as integrating machine learning and artificial intelligence-powered digital solutions.
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Affiliation(s)
- Daphne S L Gardner
- Department of Endocrinology, Singapore General Hospital, Singapore, Singapore.
| | - Banshi Saboo
- Diabetes Care & Hormone Clinic, Ahmedabad, India
| | | | - Norlaila Mustafa
- Department of Medicine, Universiti Kebangsaan Malaysia, Selangor, Malaysia
| | - Michael Villa
- Department of Endocrinology, St. Luke's Medical Center-Global City, Metro Manila, Philippines
| | - Edward Mahoney
- Embecta (formerly BD Diabetes Care), Parsippany, NJ, USA
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Tian H, Zhang K, Zhang J, Shi J, Qiu H, Hou N, Han F, Kan C, Sun X. Revolutionizing public health through digital health technology. PSYCHOL HEALTH MED 2025:1-16. [PMID: 39864819 DOI: 10.1080/13548506.2025.2458254] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Accepted: 01/20/2025] [Indexed: 01/28/2025]
Abstract
The aging population and increasing chronic diseases strain public health systems. Advancements in digital health promise to tackle these challenges and enhance public health outcomes. Digital health integrates digital health technology (DHT) across healthcare, including smart consumer devices. This article examines the application of DHT in public health and its significant impact on revolutionizing the field. Historically, DHT has not only enhanced the efficiency of disease prevention, diagnosis, and treatment but also facilitated the equitable distribution of global health resources. Looking ahead, DHT holds vast potential in areas such as personalized medicine, telemedicine, and intelligent health management. However, it also encounters challenges such as ethics, privacy, and data security. To further advance DHT, concerted efforts are essential, including policy support, investment in research and development, involvement of medical institutions, and improvement of public digital health literacy.
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Affiliation(s)
- Hongzhan Tian
- Department of Endocrinology and Metabolism, Clinical Research Center, Affiliated Hospital of Shandong Second Medical University, Weifang, China
| | - Kexin Zhang
- Department of Endocrinology and Metabolism, Clinical Research Center, Affiliated Hospital of Shandong Second Medical University, Weifang, China
| | - Jingwen Zhang
- Department of Endocrinology and Metabolism, Clinical Research Center, Affiliated Hospital of Shandong Second Medical University, Weifang, China
| | - Junfeng Shi
- Department of Endocrinology and Metabolism, Clinical Research Center, Affiliated Hospital of Shandong Second Medical University, Weifang, China
| | - Hongyan Qiu
- Department of Endocrinology and Metabolism, Clinical Research Center, Affiliated Hospital of Shandong Second Medical University, Weifang, China
| | - Ningning Hou
- Department of Endocrinology and Metabolism, Clinical Research Center, Affiliated Hospital of Shandong Second Medical University, Weifang, China
| | - Fang Han
- Department of Pathology, Affiliated Hospital of Shandong Second Medical University, Weifang, China
| | - Chengxia Kan
- Department of Endocrinology and Metabolism, Clinical Research Center, Affiliated Hospital of Shandong Second Medical University, Weifang, China
| | - Xiaodong Sun
- Department of Endocrinology and Metabolism, Clinical Research Center, Affiliated Hospital of Shandong Second Medical University, Weifang, China
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Rana RK, Kapoor N, Kumar D, Verma M, Taneja G. Digital Health Revolution in India: Transforming Health and Medicine. Indian J Community Med 2024; 49:S205-S209. [PMID: 40124867 PMCID: PMC11927824 DOI: 10.4103/ijcm.ijcm_803_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2024] [Accepted: 11/27/2024] [Indexed: 03/25/2025] Open
Abstract
Digital innovation and its integration in various parts of lifestyle are inevitable as humans have started to evolve over time. Its integration in our health and various systems is irrefutable. In this position paper, we explore the various aspects of this important component of technology, discuss its evolution over time, discuss the various existing modalities, highlight the regulatory frameworks in India, and elaborate on the different ways it can be integrated in our country's future health plans. We believe digital health is here to stay and play important role in shaping our lives in terms of our accessibility and other interactions related to health.
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Affiliation(s)
| | | | - Dewesh Kumar
- Department of PSM, RIMS, Ranchi, Jharkhand, India
| | - Madhur Verma
- Department of CFM, AIIMS, Bhatinda, Punjab, India
| | - Gunjan Taneja
- Public Health Specialist, Noida, Uttar Pradesh, India
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Kim HW, Choi J, Kim JS, Son YJ. Exploring Research Trends on Digital Health in Nursing Science in Korea: A Topic Modeling Approach. ANS Adv Nurs Sci 2024; 47:370-384. [PMID: 39401160 DOI: 10.1097/ans.0000000000000543] [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] [Indexed: 05/27/2025]
Abstract
Digital health technology is utilized in contemporary nursing practice and education. This review explored the scope of digital health applications and major trends in nursing research involving digital health in Korea using topic modeling. Our analysis of data using the Latent Dirichlet Allocation model identified four distinct research topics: nursing education using digital technologies (35.17%), hospital-based nursing practice using digital technologies (19.88%), digital technologies for health education (25.75%), and development of digital technologies to support self-management of chronic conditions (19.20%). Our findings reveal trends, current issues, and gaps in digital health nursing research.
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Affiliation(s)
- Hae Won Kim
- Author Affiliations: Seoul National University College of Nursing, Seoul, South Korea (Dr Kim); Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Yonsei University Institute for Innovation in Digital Healthcare, Seoul, South Korea (Dr Choi); and Chung-Ang University Red Cross College of Nursing, Seoul, South Korea (Drs Kim and Son)
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Wu Y, Wang X, Zhou M, Huang Z, Liu L, Cong L. Application of eHealth Tools in Anticoagulation Management After Cardiac Valve Replacement: Scoping Review Coupled With Bibliometric Analysis. JMIR Mhealth Uhealth 2024; 12:e48716. [PMID: 38180783 PMCID: PMC10799280 DOI: 10.2196/48716] [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: 05/05/2023] [Revised: 07/20/2023] [Accepted: 12/07/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Anticoagulation management can effectively prevent complications in patients undergoing cardiac valve replacement (CVR). The emergence of eHealth tools provides new prospects for the management of long-term anticoagulants. However, there is no comprehensive summary of the application of eHealth tools in anticoagulation management after CVR. OBJECTIVE Our objective is to clarify the current state, trends, benefits, and challenges of using eHealth tools in the anticoagulation management of patients after CVR and provide future directions and recommendations for development in this field. METHODS This scoping review follows the 5-step framework developed by Arksey and O'Malley. We searched 5 databases such as PubMed, MEDLINE, Web of Science, CINAHL, and Embase using keywords such as "eHealth," "anticoagulation," and "valve replacement." We included papers on the practical application of eHealth tools and excluded papers describing the underlying mechanisms for developing eHealth tools. The search time ranged from the database inception to March 1, 2023. The study findings were reported according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). Additionally, VOSviewer (version 1.6.18) was used to construct visualization maps of countries, institutions, authors, and keywords to investigate the internal relations of included literature and to explore research hotspots and frontiers. RESULTS This study included 25 studies that fulfilled the criteria. There were 27,050 participants in total, with the sample size of the included studies ranging from 49 to 13,219. The eHealth tools mainly include computer-based support systems, electronic health records, telemedicine platforms, and mobile apps. Compared to traditional anticoagulation management, eHealth tools can improve time in therapeutic range and life satisfaction. However, there is no significant impact observed in terms of economic benefits and anticoagulation-related complications. Bibliometric analysis suggests the potential for increased collaboration and opportunities among countries and academic institutions. Italy had the widest cooperative relationships. Machine learning and artificial intelligence are the popular research directions in anticoagulation management. CONCLUSIONS eHealth tools exhibit promise for clinical applications in anticoagulation management after CVR, with the potential to enhance postoperative rehabilitation. Further high-quality research is needed to explore the economic benefits of eHealth tools in long-term anticoagulant therapy and the potential to reduce the occurrence of adverse events.
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Affiliation(s)
- Ying Wu
- Center for Moral Culture, Hunan Normal University, Changsha, China
- School of Medicine, Hunan Normal University, Changsha, China
| | - Xiaohui Wang
- School of Medicine, Hunan Normal University, Changsha, China
| | - Mengyao Zhou
- School of Medicine, Hunan Normal University, Changsha, China
| | - Zhuoer Huang
- School of Medicine, Hunan Normal University, Changsha, China
| | - Lijuan Liu
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, Changsha, China
| | - Li Cong
- School of Medicine, Hunan Normal University, Changsha, China
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