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Armoundas AA, Ahmad FS, Bennett DA, Chung MK, Davis LL, Dunn J, Narayan SM, Slotwiner DJ, Wiley KK, Khera R. Data Interoperability for Ambulatory Monitoring of Cardiovascular Disease: A Scientific Statement From the American Heart Association. CIRCULATION. GENOMIC AND PRECISION MEDICINE 2024; 17:e000095. [PMID: 38779844 DOI: 10.1161/hcg.0000000000000095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
Wearable devices are increasingly used by a growing portion of the population to track health and illnesses. The data emerging from these devices can potentially transform health care. This requires an interoperability framework that enables the deployment of platforms, sensors, devices, and software applications within diverse health systems, aiming to facilitate innovation in preventing and treating cardiovascular disease. However, the current data ecosystem includes several noninteroperable systems that inhibit such objectives. The design of clinically meaningful systems for accessing and incorporating these data into clinical workflows requires strategies to ensure the quality of data and clinical content and patient and caregiver accessibility. This scientific statement aims to address the best practices, gaps, and challenges pertaining to data interoperability in this area, with considerations for (1) data integration and the scope of measures, (2) application of these data into clinical approaches/strategies, and (3) regulatory/ethical/legal issues.
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Spadafora L, Comandini GL, Giordano S, Polimeni A, Perone F, Sabouret P, Leonetti M, Cacciatore S, Cacia M, Betti M, Bernardi M, Zimatore FR, Russo F, Iervolino A, Aulino G, Moscardelli A. Blockchain technology in Cardiovascular Medicine: a glance to the future? Results from a social media survey and future perspectives. Minerva Cardiol Angiol 2024; 72:1-10. [PMID: 37971710 DOI: 10.23736/s2724-5683.23.06457-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
The leverage of digital facilities in medicine for disease diagnosis, monitoring, and medical history recording has become increasingly pivotal. However, the advancement of these technologies poses a significant challenge regarding data privacy, given the highly sensitive nature of medical information. In this context, the application of Blockchain technology, a digital system where information is stored in blocks and each block is linked to the one before, has the potential to enhance existing technologies through its exceptional security and transparency. This paradigm is of particular importance in cardiovascular medicine, where the prevalence of chronic conditions leads to the need for secure remote monitoring, secure data storage and secure medical history updating. Indeed, digital support for chronic cardiovascular pathologies is getting more and more crucial. This paper lays its rationale in three primary aims: 1) to scrutinize the existing literature for tangible applications of blockchain technology in the field of cardiology; 2) to report results from a survey aimed at gauging the reception of blockchain technology within the cardiovascular community, conducted on social media; 3) to conceptualize a web application tailored specifically to cardiovascular care based on blockchain technology. We believe that Blockchain technology may contribute to a breakthrough in healthcare digitalization, especially in the field of cardiology; in this context, we hope that the present work may be inspiring for physicians and healthcare stakeholders.
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Affiliation(s)
- Luigi Spadafora
- Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University, Rome, Italy -
| | - Gian L Comandini
- Department of Engineering, Guglielmo Marconi University, Rome, Italy
- Department of Economics and Law, University of Macerata, Macerata, Italy
| | - Salvatore Giordano
- Division of Cardiology, Department of Medical and Surgical Sciences, Magna Græcia University, Catanzaro, Italy
| | - Alberto Polimeni
- Division of Cardiology, Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Cosenza, Italy
| | - Francesco Perone
- Cardiac Rehabilitation Unit, Villa delle Magnolie Rehabilitation Clinic, Castel Morrone, Caserta, Italy
| | - Pierre Sabouret
- Heart Institute and Action Group, Pitié-Salpétrière, Sorbonne University, Paris, France
- National College of French Cardiologists, Paris, France
| | | | - Stefano Cacciatore
- Department of Geriatrics, Orthopedics and Rheumatology, Sacred Heart Catholic University, Rome, Italy
| | - Michele Cacia
- Cardiology Unit, A.O.U. Renato Dulbecco, Catanzaro, Italy
- Department of Experimental and Clinical Medicine, Magna Græcia University, Catanzaro, Italy
| | - Matteo Betti
- Cardiovascular Section, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Centro Cardiologico Monzino IRCCS, Milan, Italy
| | - Marco Bernardi
- Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University, Rome, Italy
| | | | | | - Adelaide Iervolino
- Department of Clinical Medicine and Surgery, Federico II University Hospital, Naples, Italy
| | - Giovanni Aulino
- Section of Legal Medicine, Department of Health Surveillance and Bioethics, IRCCS A. Gemelli University Polyclinic Foundation, Sacred Heart Catholic University, Rome, Italy
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Martone AM, Parrini I, Ciciarello F, Galluzzo V, Cacciatore S, Massaro C, Giordano R, Giani T, Landi G, Gulizia MM, Colivicchi F, Gabrielli D, Oliva F, Zuccalà G. Recent Advances and Future Directions in Syncope Management: A Comprehensive Narrative Review. J Clin Med 2024; 13:727. [PMID: 38337421 PMCID: PMC10856004 DOI: 10.3390/jcm13030727] [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] [Received: 01/09/2024] [Revised: 01/21/2024] [Accepted: 01/25/2024] [Indexed: 02/12/2024] Open
Abstract
Syncope is a highly prevalent clinical condition characterized by a rapid, complete, and brief loss of consciousness, followed by full recovery caused by cerebral hypoperfusion. This symptom carries significance, as its potential underlying causes may involve the heart, blood pressure, or brain, leading to a spectrum of consequences, from sudden death to compromised quality of life. Various factors contribute to syncope, and adhering to a precise diagnostic pathway can enhance diagnostic accuracy and treatment effectiveness. A standardized initial assessment, risk stratification, and appropriate test identification facilitate determining the underlying cause in the majority of cases. New technologies, including artificial intelligence and smart devices, may have the potential to reshape syncope management into a proactive, personalized, and data-centric model, ultimately enhancing patient outcomes and quality of life. This review addresses key aspects of syncope management, including pathogenesis, current diagnostic testing options, treatments, and considerations in the geriatric population.
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Affiliation(s)
- Anna Maria Martone
- Fondazione Policlinico Universitario “A. Gemelli” IRCCS, L.go A. Gemelli 8, 00168 Rome, Italy; (A.M.M.); (F.C.); (V.G.); (G.L.); (G.Z.)
- Department of Geriatrics, Orthopedics, and Rheumatology, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168 Rome, Italy; (C.M.); (R.G.); (T.G.)
| | - Iris Parrini
- Department of Cardiology, Mauriziano Hospital, Largo Filippo Turati, 62, 10128 Turin, Italy
| | - Francesca Ciciarello
- Fondazione Policlinico Universitario “A. Gemelli” IRCCS, L.go A. Gemelli 8, 00168 Rome, Italy; (A.M.M.); (F.C.); (V.G.); (G.L.); (G.Z.)
| | - Vincenzo Galluzzo
- Fondazione Policlinico Universitario “A. Gemelli” IRCCS, L.go A. Gemelli 8, 00168 Rome, Italy; (A.M.M.); (F.C.); (V.G.); (G.L.); (G.Z.)
| | - Stefano Cacciatore
- Department of Geriatrics, Orthopedics, and Rheumatology, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168 Rome, Italy; (C.M.); (R.G.); (T.G.)
| | - Claudia Massaro
- Department of Geriatrics, Orthopedics, and Rheumatology, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168 Rome, Italy; (C.M.); (R.G.); (T.G.)
| | - Rossella Giordano
- Department of Geriatrics, Orthopedics, and Rheumatology, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168 Rome, Italy; (C.M.); (R.G.); (T.G.)
| | - Tommaso Giani
- Department of Geriatrics, Orthopedics, and Rheumatology, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168 Rome, Italy; (C.M.); (R.G.); (T.G.)
| | - Giovanni Landi
- Fondazione Policlinico Universitario “A. Gemelli” IRCCS, L.go A. Gemelli 8, 00168 Rome, Italy; (A.M.M.); (F.C.); (V.G.); (G.L.); (G.Z.)
| | | | - Furio Colivicchi
- Division of Cardiology, San Filippo Neri Hospital-ASL Roma 1, Via Giovanni Martinotti, 20, 00135 Rome, Italy;
| | - Domenico Gabrielli
- Department of Cardio-Thoracic and Vascular Medicine and Surgery, Division of Cardiology, S. Camillo-Forlanini Hospital, Circonvallazione Gianicolense, 87, 00152 Rome, Italy;
| | - Fabrizio Oliva
- “A. De Gasperis” Cardiovascular Department, Division of Cardiology, ASST Grande Ospedale Metropolitano Niguarda, Piazza dell’Ospedale Maggiore, 3, 20162 Milan, Italy;
| | - Giuseppe Zuccalà
- Fondazione Policlinico Universitario “A. Gemelli” IRCCS, L.go A. Gemelli 8, 00168 Rome, Italy; (A.M.M.); (F.C.); (V.G.); (G.L.); (G.Z.)
- Department of Geriatrics, Orthopedics, and Rheumatology, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168 Rome, Italy; (C.M.); (R.G.); (T.G.)
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Skalidis I, Muller O, Fournier S. CardioVerse: The cardiovascular medicine in the era of Metaverse. Trends Cardiovasc Med 2023; 33:471-476. [PMID: 35568263 DOI: 10.1016/j.tcm.2022.05.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/28/2022] [Accepted: 05/07/2022] [Indexed: 01/04/2023]
Abstract
The recent pandemic launched an acceleration in adopting telemedicine by cardiovascular health and triggered the flourishing of technological advancements, such as the metaverse, which is a novel interactive mix of digital worlds that leverages augmented reality with virtual reality. The CardioVerse represents a theoretical term for the embracement of the metaverse by cardiovascular medicine, encompassing the endless possibilities as well as the challenges that it holds and introduces new dimensions to disease education, prevention and diagnosis. Its applications are numerous, notably in enhancing medical visits, assisting cardiovascular interventions and reshaping the way medical education is provided. Although obstacles are expected in diverse domains such as security, technical, legislative and regulatory, the utilization of non-fungible tokens as a security asset for patient data appears as potential solution.
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Affiliation(s)
- Ioannis Skalidis
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland.; Faculty of Medicine, University of Crete, Crete, Greece.
| | - Olivier Muller
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Stephane Fournier
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
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Elvas LB, Nunes M, Ferreira JC, Dias MS, Rosário LB. AI-Driven Decision Support for Early Detection of Cardiac Events: Unveiling Patterns and Predicting Myocardial Ischemia. J Pers Med 2023; 13:1421. [PMID: 37763188 PMCID: PMC10533089 DOI: 10.3390/jpm13091421] [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] [Received: 08/30/2023] [Revised: 09/18/2023] [Accepted: 09/19/2023] [Indexed: 09/29/2023] Open
Abstract
Cardiovascular diseases (CVDs) account for a significant portion of global mortality, emphasizing the need for effective strategies. This study focuses on myocardial infarction, pulmonary thromboembolism, and aortic stenosis, aiming to empower medical practitioners with tools for informed decision making and timely interventions. Drawing from data at Hospital Santa Maria, our approach combines exploratory data analysis (EDA) and predictive machine learning (ML) models, guided by the Cross-Industry Standard Process for Data Mining (CRISP-DM) methodology. EDA reveals intricate patterns and relationships specific to cardiovascular diseases. ML models achieve accuracies above 80%, providing a 13 min window to predict myocardial ischemia incidents and intervene proactively. This paper presents a Proof of Concept for real-time data and predictive capabilities in enhancing medical strategies.
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Affiliation(s)
- Luís B. Elvas
- ISTAR, Instituto Universitário de Lisboa (ISCTE-IUL), 1649-026 Lisbon, Portugal; (M.N.); (J.C.F.); (M.S.D.)
- Inov Inesc Inovação—Instituto de Novas Tecnologias, 1000-029 Lisbon, Portugal
| | - Miguel Nunes
- ISTAR, Instituto Universitário de Lisboa (ISCTE-IUL), 1649-026 Lisbon, Portugal; (M.N.); (J.C.F.); (M.S.D.)
| | - Joao C. Ferreira
- ISTAR, Instituto Universitário de Lisboa (ISCTE-IUL), 1649-026 Lisbon, Portugal; (M.N.); (J.C.F.); (M.S.D.)
- Inov Inesc Inovação—Instituto de Novas Tecnologias, 1000-029 Lisbon, Portugal
| | - Miguel Sales Dias
- ISTAR, Instituto Universitário de Lisboa (ISCTE-IUL), 1649-026 Lisbon, Portugal; (M.N.); (J.C.F.); (M.S.D.)
| | - Luís Brás Rosário
- Faculty of Medicine, Lisbon University, Hospital Santa Maria/CHULN, CCUL, 1649-028 Lisbon, Portugal;
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Vandenberk B, Chew DS, Prasana D, Gupta S, Exner DV. Successes and challenges of artificial intelligence in cardiology. Front Digit Health 2023; 5:1201392. [PMID: 37448836 PMCID: PMC10336354 DOI: 10.3389/fdgth.2023.1201392] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023] Open
Abstract
In the past decades there has been a substantial evolution in data management and data processing techniques. New data architectures made analysis of big data feasible, healthcare is orienting towards personalized medicine with digital health initiatives, and artificial intelligence (AI) is becoming of increasing importance. Despite being a trendy research topic, only very few applications reach the stage where they are implemented in clinical practice. This review provides an overview of current methodologies and identifies clinical and organizational challenges for AI in healthcare.
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Affiliation(s)
- Bert Vandenberk
- Department of Cardiac Sciences, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium
| | - Derek S. Chew
- Department of Cardiac Sciences, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Dinesh Prasana
- Intelense Inc., Markham, ON, Canada
- IOT/AI- Caliber Interconnect Pvt Ltd., Coimbatore, India
| | | | - Derek V. Exner
- Department of Cardiac Sciences, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Ali S, Abdullah, Armand TPT, Athar A, Hussain A, Ali M, Yaseen M, Joo MI, Kim HC. Metaverse in Healthcare Integrated with Explainable AI and Blockchain: Enabling Immersiveness, Ensuring Trust, and Providing Patient Data Security. SENSORS (BASEL, SWITZERLAND) 2023; 23:565. [PMID: 36679361 PMCID: PMC9862285 DOI: 10.3390/s23020565] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 12/28/2022] [Accepted: 01/02/2023] [Indexed: 08/12/2023]
Abstract
Digitization and automation have always had an immense impact on healthcare. It embraces every new and advanced technology. Recently the world has witnessed the prominence of the metaverse which is an emerging technology in digital space. The metaverse has huge potential to provide a plethora of health services seamlessly to patients and medical professionals with an immersive experience. This paper proposes the amalgamation of artificial intelligence and blockchain in the metaverse to provide better, faster, and more secure healthcare facilities in digital space with a realistic experience. Our proposed architecture can be summarized as follows. It consists of three environments, namely the doctor's environment, the patient's environment, and the metaverse environment. The doctors and patients interact in a metaverse environment assisted by blockchain technology which ensures the safety, security, and privacy of data. The metaverse environment is the main part of our proposed architecture. The doctors, patients, and nurses enter this environment by registering on the blockchain and they are represented by avatars in the metaverse environment. All the consultation activities between the doctor and the patient will be recorded and the data, i.e., images, speech, text, videos, clinical data, etc., will be gathered, transferred, and stored on the blockchain. These data are used for disease prediction and diagnosis by explainable artificial intelligence (XAI) models. The GradCAM and LIME approaches of XAI provide logical reasoning for the prediction of diseases and ensure trust, explainability, interpretability, and transparency regarding the diagnosis and prediction of diseases. Blockchain technology provides data security for patients while enabling transparency, traceability, and immutability regarding their data. These features of blockchain ensure trust among the patients regarding their data. Consequently, this proposed architecture ensures transparency and trust regarding both the diagnosis of diseases and the data security of the patient. We also explored the building block technologies of the metaverse. Furthermore, we also investigated the advantages and challenges of a metaverse in healthcare.
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Affiliation(s)
- Sikandar Ali
- Department of Digital Anti-Aging Healthcare, Inje University, Gimhae 50834, Republic of Korea
| | - Abdullah
- Department of Digital Anti-Aging Healthcare, Inje University, Gimhae 50834, Republic of Korea
| | | | - Ali Athar
- Department of Digital Anti-Aging Healthcare, Inje University, Gimhae 50834, Republic of Korea
| | - Ali Hussain
- Department of Digital Anti-Aging Healthcare, Inje University, Gimhae 50834, Republic of Korea
| | - Maisam Ali
- Department of Digital Anti-Aging Healthcare, Inje University, Gimhae 50834, Republic of Korea
| | - Muhammad Yaseen
- Department of Digital Anti-Aging Healthcare, Inje University, Gimhae 50834, Republic of Korea
| | - Moon-Il Joo
- Department of Digital Anti-Aging Healthcare, Inje University, Gimhae 50834, Republic of Korea
| | - Hee-Cheol Kim
- Institute of Digital Anti-Aging Healthcare, College of AI Convergence, u-AHRC, Inje University, Gimhae 50834, Republic of Korea
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The Metaverse: A New Challenge for the Healthcare System: A Scoping Review. J Funct Morphol Kinesiol 2022; 7:jfmk7030063. [PMID: 36135421 PMCID: PMC9501644 DOI: 10.3390/jfmk7030063] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/19/2022] [Accepted: 08/24/2022] [Indexed: 02/05/2023] Open
Abstract
(1) Background: The metaverse is now a reality, and it interests the scientific community, the educational setting, and medical care. Considering the number of people in front of screens, especially children and adolescents, the metaverse could and should become a place of health promotion. Consequently, the objective of the present study was to review the current literature to detect articles that connected the metaverse with prevention and treatment, education and training, and research setting. (2) Methods: Articles were searched on Pubmed, Web of Science, and Scopus, including English-written papers published until 12 August 2022. They were screened against the eligibility criteria and discussed narratively. (3) Results: The literature published is poor; only 21 articles were included, and 11 of them were added in a second moment. These articles were mainly reviews of the literature or editorials. The aspects related to this virtual world in terms of health prevention and the treatment of clinical conditions, education and training, and research have been narratively discussed. (4) Conclusions: The metaverse could be considered a useful instrument to arrive easily and quickly to the population. Given its importance, today, different studies and investments are required to develop proper health promotion programs that are feasible and valid in the metaverse.
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Nattel S. Digital Technologies: Revolutionizing Cardiovascular Medicine and Reshaping the World. Can J Cardiol 2021; 38:142-144. [PMID: 34954008 DOI: 10.1016/j.cjca.2021.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 12/19/2021] [Indexed: 11/26/2022] Open
Affiliation(s)
- Stanley Nattel
- Department of Medicine and Research Center, Montreal Heart Institute and Université de Montréal, Montreal, Quebec, Canada; Institute of Pharmacology, West German Heart and Vascular Center, University Duisburg-Essen, Germany; IHU LIRYC and Fondation Bordeaux Université, Bordeaux, France.
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