[Decision support systems, assistance systems and telemedicine in epileptology]

Artificial intelligence in clinical decision support systems for oncology

Artificial intelligence (AI) has been widely used in various medical fields, such as image diagnosis, pathological classification, selection of treatment schemes, and prognosis analysis. Especially in the image-aided diagnosis of tumors, the cooperation of human-computer interactions has become mature. However, the ethics of the application of AI as an emerging technology in clinical decision-making have not been fully supported, so the clinical decision support system (CDSS) based on AI technology has not fully realized human-computer interactions in clinical practice as the image-aided diagnosis system. The CDSS was currently used and promoted worldwide including Watson for Oncology, Chinese society of clinical oncology-artificial intelligence (CSCO AI) and so on. This paper summarized the applications and clarified the principle of AI in CDSS, analyzed the difficulties of AI in oncology decisions, and provided a reference scheme for the application of AI in oncology decisions in the future.

Mobile Applications for Epilepsy: Where Are We? Where Should We Go? A Systematic Review

The development of mobile health for epilepsy has grown in the last years, bringing new applications (apps) to the market and improving already existing ones. In this systematic review, we analyse the scope of mobile apps for seizure detection and epilepsy self-management, with two research questions in mind: what are the characteristics of current solutions and do they meet users’ requirements? What should be considered when designing mobile health for epilepsy? We used PRISMA methodology to search within App Store and Google Play Store from February to April of 2021, reaching 55 potential apps. A more thorough analysis regarding particular features was performed on 26 of those apps. The content of these apps was evaluated in five categories, regarding if there was personalisable content; features related to medication management; what aspects of seizure log were present; what type of communication prevailed; and if there was any content related to seizure alarm or seizure action plans. Moreover, the 26 apps were evaluated through using MARS by six raters, including two neurologists. The analysis of MARS categories was performed for the top and bottom apps, to understand the core differences. Overall, the lowest MARS scores were related to engagement and information, which play a big part in long-term use, and previous studies raised the concern of assuring continuous use, especially in younger audiences. With that in mind, we identified conceptual improvement points, which were divided in three main topics: customisation, simplicity and healthcare connection. Moreover, we summarised some ideas to improve m-health apps catered around long-term adherence. We hope this work contributes to a better understanding of the current scope in mobile epilepsy management, endorsing healthcare professionals and developers to provide off-the-shelf solutions that engage patients and allows them to better manage their condition.

Forschung und Entwicklung telemedizinischer Anwendungen und mobiler Gesundheitstechnologien bei Epilepsie

Hintergrund

Telemedizin und mobile Gesundheitstechnologien finden auch in der Epileptologie zunehmend Anwendung. Die Umfrage erfasst die praktische Nutzung dieser Anwendungen sowie wissenschaftliche Aktivitäten in diesem Bereich in deutschsprachigen Epilepsiezentren, Epilepsieambulanzen und Epilepsieschwerpunktpraxen.

Methoden

Online Umfrage unter den Mitgliedern der Deutschen Gesellschaft für Epileptologie (DGfE).

Ergebnisse

Es haben 35 Personen von 31 verschiedenen Einrichtungen an der Umfrage teilgenommen; 86 % der Umfrageteilnehmer nutzen telemedizinische Anwendungen (v. a. Patient-zu-Arzt-Anwendungen: [Video-]Telefonsprechstunde), und jeweils 40 % nutzen in der Versorgung von Epilepsiepatienten bzw. empfehlen ihren Patienten mobile Gesundheitstechnologien. Als aktuelle Projekte wurden 5 Projekte zu telemedizinischen Arzt-zu-Arzt-Anwendungen an verschiedenen Standorten in Deutschland genannt und 4 Projekte zur automatisierten Anfallserkennung (3 unter der Nutzung von Wearables, 1 ohne Nutzung von Wearables).

Diskussion

Die Entwicklungen in der Epileptologie spiegeln die Entwicklung in vielen Bereichen des Gesundheitssystems wider, und so ist zu vermuten, dass der Einsatz von Telemedizin und mobilen Gesundheitstechnologien weiter zunehmen wird.