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Hirten RP. Forging a Career in Digital Health Research. Gastroenterology 2024:S0016-5085(24)05218-1. [PMID: 39033864 DOI: 10.1053/j.gastro.2024.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 07/07/2024] [Accepted: 07/15/2024] [Indexed: 07/23/2024]
Affiliation(s)
- Robert P Hirten
- The Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York; The Hasso Plattner Institute for Digital Health at the Mount Sinai, New York, New York; Windreich Department of Artificial Intelligence and Human Health, Icahn School of Medicine at Mount Sinai, New York, New York.
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2
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Srichan C, Danvirutai P, Boonsim N, Namvong A, Surawanitkun C, Ritsongmuang C, Siritaratiwat A, Anutrakulchai S. Non-Invasive Sensors Integration for NCDs with AIoT Based Telemedicine System. SENSORS (BASEL, SWITZERLAND) 2024; 24:4431. [PMID: 39065830 PMCID: PMC11281239 DOI: 10.3390/s24144431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 06/30/2024] [Accepted: 07/06/2024] [Indexed: 07/28/2024]
Abstract
Thailand's hospitals face overcrowding, particularly with non-communicable disease (NCD) patients, due to a doctor shortage and an aging population. Most literature showed implementation merely on web or mobile application to teleconsult with physicians. Instead, in this work, we developed and implemented a telemedicine health kiosk system embedded with non-invasive biosensors and time-series predictors to improve NCD indicators over an eight-month period. Two cohorts were randomly selected: a control group with usual care and a telemedicine-using group. The telemedicine-using group showed significant improvements in average fasting blood glucose (148 to 130 mg/dL) and systolic blood pressure (152 to 138 mmHg). Data mining with the Apriori algorithm revealed correlations between diseases, occupations, and environmental factors, informing public health policies. Communication between kiosks and servers used LoRa, 5G, and IEEE802.11, which are selected based on the distance and signal availability. The results support telemedicine kiosks as effective for NCD management, significantly improving key NCD indicators, average blood glucose, and blood pressure.
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Affiliation(s)
- Chavis Srichan
- Faculty of Engineering, Khon Kaen University, Khon Kaen 40002, Thailand;
| | - Pobporn Danvirutai
- Chronic Kidney Disease Prevention in Northeast Thailand, Khon Kaen University, Khon Kaen 40002, Thailand; (P.D.); (S.A.)
| | - Noppakun Boonsim
- Faculty of Interdisciplinary Studies, Khon Kaen University, Nong Khai Campus, Nong Khai 43000, Thailand; (N.B.); (A.N.); (C.S.)
| | - Ariya Namvong
- Faculty of Interdisciplinary Studies, Khon Kaen University, Nong Khai Campus, Nong Khai 43000, Thailand; (N.B.); (A.N.); (C.S.)
- Center of Multidisciplinary Innovation Network Talent (MINT Center), Department of Technology and Engineering, Faculty of Interdisciplinary Studies, Khon Kaen University, Nong Khai Campus, Nong Khai 43000, Thailand
| | - Chayada Surawanitkun
- Faculty of Interdisciplinary Studies, Khon Kaen University, Nong Khai Campus, Nong Khai 43000, Thailand; (N.B.); (A.N.); (C.S.)
- Center of Multidisciplinary Innovation Network Talent (MINT Center), Department of Technology and Engineering, Faculty of Interdisciplinary Studies, Khon Kaen University, Nong Khai Campus, Nong Khai 43000, Thailand
| | | | | | - Sirirat Anutrakulchai
- Chronic Kidney Disease Prevention in Northeast Thailand, Khon Kaen University, Khon Kaen 40002, Thailand; (P.D.); (S.A.)
- Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
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Bond A, Mccay K, Lal S. Artificial intelligence & clinical nutrition: What the future might have in store. Clin Nutr ESPEN 2023; 57:542-549. [PMID: 37739704 DOI: 10.1016/j.clnesp.2023.07.082] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 07/02/2023] [Accepted: 07/17/2023] [Indexed: 09/24/2023]
Abstract
Artificial Intelligence (AI) is a rapidly emerging technology in healthcare that has the potential to revolutionise clinical nutrition. AI can assist in analysing complex data, interpreting medical images, and providing personalised nutrition interventions for patients. Clinical nutrition is a critical aspect of patient care, and AI can help clinicians make more informed decisions regarding patients' nutritional requirements, disease prevention, and management. AI algorithms can analyse large datasets to identify novel associations between diet and disease outcomes, enabling clinicians to make evidence-based nutritional recommendations. AI-powered devices and applications can also assist in tracking dietary intake, providing feedback, and motivating patients towards healthier food choices. However, the adoption of AI in clinical nutrition raises several ethical and regulatory concerns, such as data privacy and bias. Further research is needed to assess the clinical effectiveness and safety of AI-powered nutrition interventions. In conclusion, AI has the potential to transform clinical nutrition, but its integration into clinical practice should be carefully monitored to ensure patient safety and benefit. This article discusses the current and future applications of AI in clinical nutrition and highlights its potential benefits.
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Affiliation(s)
- Ashley Bond
- Intestinal Failure Unit, Salford Royal Foundation Trust, UK; University of Manchester, Manchester, UK.
| | - Kevin Mccay
- Manchester Metropolitan University, Manchester, UK; Northern Care Alliance NHS Foundation Trust, Salford Royal Hospital, Salford, UK
| | - Simon Lal
- Intestinal Failure Unit, Salford Royal Foundation Trust, UK; University of Manchester, Manchester, UK
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Gravina AG, Pellegrino R, Durante T, Palladino G, D'Onofrio R, Mammone S, Arboretto G, Auletta S, Imperio G, Ventura A, Romeo M, Federico A. Telemedicine in inflammatory bowel diseases: A new brick in the medicine of the future? World J Methodol 2023; 13:194-209. [PMID: 37771865 PMCID: PMC10523254 DOI: 10.5662/wjm.v13.i4.194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 07/12/2023] [Accepted: 07/31/2023] [Indexed: 09/20/2023] Open
Abstract
Inflammatory bowel disease (IBD) is a chronic digestive disease that requires continuous monitoring by healthcare professionals to determine the appropriate therapy and monitor short-term and long-term complications. The progressive development of information technology has enabled healthcare personnel to deliver care services to patients remotely. Therefore, various applications of telemedicine in IBD management have evolved, including telemonitoring, teleconsulting, teleducation, telenursing, telenutrition, and telepathology. While evidence has been provided for some telemedicine applications, targeted studies are still required. This review summarises the major studies that have evaluated telemedicine and its application in the management of IBD.
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Affiliation(s)
| | - Raffaele Pellegrino
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | - Tommaso Durante
- Mental Health Department, “S. Pio” Hospital, Benevento 82100, Italy
| | - Giovanna Palladino
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | - Rossella D'Onofrio
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | - Simone Mammone
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | - Giusi Arboretto
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | - Salvatore Auletta
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | - Giuseppe Imperio
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | - Andrea Ventura
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | - Mario Romeo
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | - Alessandro Federico
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
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Plachta-Danielzik S, Grasskemper L, Schmidt K, Schreiber S, Bokemeyer B. Health Status, Quality of Life, Psychosocial Well-being, and Wearables Data of Patients With Active Ulcerative Colitis Receiving Filgotinib Therapy (FilgoColitis Study): Protocol for a Real-world Observational Study. JMIR Res Protoc 2023; 12:e42574. [PMID: 37155235 DOI: 10.2196/42574] [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: 09/12/2022] [Revised: 03/31/2023] [Accepted: 03/31/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND Filgotinib was approved in Germany for treating patients with moderate to severe active ulcerative colitis in November 2021. It represents a preferential Janus kinase 1 inhibitor. The FilgoColitis study began recruiting immediately after approval and aims to assess filgotinib effectiveness under real-world conditions with a particular focus on patient-reported outcomes (PROs). The novelty of the study design is the optional inclusion of 2 innovative wearables, which could provide a new layer of patient-derived data. OBJECTIVE The study investigates quality of life (QoL) and psychosocial well-being of patients with active ulcerative colitis during long-term exposure to filgotinib. PROs related to QoL and psychometric profiles (fatigue and depression) are collected alongside with disease activity symptom scores. We aim to evaluate physical activity patterns collected by wearables as an addition to traditional PROs, patient-reported health status, and QoL in different phases of disease activity. METHODS This is a prospective, single-arm, multicentric, noninterventional, observational study with a sample size of 250 patients. QoL is assessed with validated questionnaires: the Short Inflammatory Bowel Disease Questionnaire (sIBDQ) for the disease-specific QoL, the EQ-5D for the general QoL, and the fatigue questionnaire (Inflammatory Bowel Disease-Fatigue [IBD-F]). Physical activity data are collected from patients using wearables (SENS motion leg sensor [accelerometry] and smartwatch, GARMIN vívosmart 4). RESULTS The enrollment started in December 2021 and was still open at the date of submission. After 6 months of study initiation, 69 patients were enrolled. The study is expected to be completed in June 2026. CONCLUSIONS Real-world data for novel drugs are important to assess effectiveness outside of highly selected populations represented by randomized controlled trials. We examine whether patients' QoL and other PROs can be supplemented with physical activity patterns measured objectively. Use of wearables with newly defined outcomes represents an additional observational tool for monitoring disease activity in patients with inflammatory bowel disease. TRIAL REGISTRATION German Clinical Trials Register DRKS00027327; https://drks.de/search/en/trial/DRKS00027327. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/42574.
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Affiliation(s)
| | | | | | - Stefan Schreiber
- Clinic of General Internal Medicine I, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Bernd Bokemeyer
- Department Medicine I, University Hospital Schleswig Holstein, Campus Kiel, Kiel, Germany
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Sriraam N, Srinivasulu A, Prakash VS. Wireless CardioS framework for continuous ECG acquisition. J Med Eng Technol 2023; 47:201-216. [PMID: 37910047 DOI: 10.1080/03091902.2023.2267116] [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: 05/08/2023] [Accepted: 09/30/2023] [Indexed: 11/03/2023]
Abstract
A first-level textile-based electrocardiogram (ECG) monitoring system referred to as "CardioS" (cardiac sensor) for continuous health monitoring applications is proposed in this study to address the demand for resource-constrained environments. and the signal quality assessment of a wireless CardioS was studied. The CardioS consists of a Lead-I ECG signal recorded wirelessly using silver-plated nylon woven (Ag-NyW) dry textile electrodes to compare the results of wired wearable Ag-NyW textile electrode-based ECG acquisition system and CardioS. The effect of prolonged usage of Ag-NyW dry electrodes on electrode impedance was tested in the current work. In addition, electrode half-cell potential was measured to validate the range of Ag-NyW dry electrodes for ECG signal acquisition. Further, the quality of signals recorded by the proposed wireless CardioS framework was evaluated and compared with clinical disposable (Ag-AgCl Gel) electrodes. The signal quality was assessed in terms of mean magnitude coherence spectra, signal cross-correlation, signal-to-noise-band ratio (Sband/Nband), crest factor, low and high band powers and power spectral density. The experimental results showed that the impedance was increased by 2.5-54.6% after six weeks of continuous usage. This increased impedance was less than 1 MΩ/cm2, as reported in the literature. The half-cell potential of the Ag-NyW textile electrode obtained was 80 mV, sufficient to acquire the ECG signal from the human body. All the fidelity parameters measured by Ag-NyW textile electrodes were correlated with standard disposable electrodes. The cardiologists validated all the measurements and confirmed that the proposed framework exhibited good performance for ECG signal acquisition from the five healthy subjects. As a result of its low-cost architecture, the proposed CardioS framework can be used in resource-constrained environments for ECG monitoring.
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Affiliation(s)
- N Sriraam
- Center for Medical Electronics and Computing, MS Ramaiah Institute of Technology, Bangalore, India
- Department of Medical Electronics Engineering, MS Ramaiah Institute of Technology, Bangalore, India
| | | | - V S Prakash
- Department of Cardiology, M.S. Ramaiah Medical College and Hospitals, Bangalore, India
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Del Hoyo J, Millán M, Garrido-Marín A, Aguas M. Are we ready for telemonitoring inflammatory bowel disease? A review of advances, enablers, and barriers. World J Gastroenterol 2023; 29:1139-1156. [PMID: 36926667 PMCID: PMC10011957 DOI: 10.3748/wjg.v29.i7.1139] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 11/02/2022] [Accepted: 02/09/2023] [Indexed: 02/21/2023] Open
Abstract
This review summarizes the evidence about telemonitoring in patients with inflammatory bowel disease (IBD). To give an overview of the advances performed, as well as the enablers and barriers which favoured/hindered telemonitoring implementation. We performed a literature search in PubMed, EMBASE, MEDLINE, Cochrane Database, Web of Science and Conference Proceedings. Titles and abstracts published up to September 2022 were screened for a set of inclusion criteria: telemonitoring intervention, IBD as the main disease, and a primary study performed. Ninety-seven reports were selected for full review. Finally, 20 were included for data extraction and critical appraisal. Most studies used telemonitoring combined with tele-education, and programs evolved from home telemanagement systems towards web portals through mHealth applications. Web systems demonstrated patients’ acceptance, improvement in quality of life, disease activity and knowledge, with a good cost-effectiveness profile in the short-term. Initially, telemonitoring was almost restricted to ulcerative colitis, but new patient reported outcome measures, home-based tests and mobile devices favoured its expansion to different patients´ categories. However, technological and knowledge advances led to legal, ethical, economical and logistic issues. Standardization of remote healthcare is necessary, to improve the interoperability of systems as well as to address liability concerns and users´ preferences. Telemonitoring IBD is well accepted and improves clinical outcomes at a lower cost in the short-term. Funders, policymakers, providers, and patients need to align their interests to overcome the emerging barriers for its full implementation.
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Affiliation(s)
- Javier Del Hoyo
- Department of Gastroenterology, La Fe University and Polytechnic Hospital, Valencia 46026, Spain
| | - Mónica Millán
- Department of Surgery, La Fe University and Polytechnic Hospital, Valencia 46026, Spain
| | - Alejandro Garrido-Marín
- Department of Gastroenterology, La Fe University and Polytechnic Hospital, Valencia 46026, Spain
| | - Mariam Aguas
- Department of Gastroenterology, La Fe University and Polytechnic Hospital, Valencia 46026, Spain
- Health Research Institute La Fe, La Fe University and Polytechnic Hospital, Valencia 46026, Spain
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Escobar-Linero E, Muñoz-Saavedra L, Luna-Perejón F, Sevillano JL, Domínguez-Morales M. Wearable Health Devices for Diagnosis Support: Evolution and Future Tendencies. SENSORS (BASEL, SWITZERLAND) 2023; 23:1678. [PMID: 36772718 PMCID: PMC9920884 DOI: 10.3390/s23031678] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 01/18/2023] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
The use of wearable devices has increased substantially in recent years. This, together with the rise of telemedicine, has led to the use of these types of devices in the healthcare field. In this work, we carried out a detailed study on the use of these devices (regarding the general trends); we analyzed the research works and devices marketed in the last 10 years. This analysis extracted relevant information on the general trend of use, as well as more specific aspects, such as the use of sensors, communication technologies, and diseases. A comparison was made between the commercial and research aspects linked to wearables in the healthcare field, and upcoming trends were analyzed.
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Affiliation(s)
- Elena Escobar-Linero
- Architecture and Computer Technology Department, ETSII-EPS, University of Seville, 41004 Sevilla, Spain
- Robotics and Technology of Computers Laboratory, University of Seville, 41004 Sevilla, Spain
| | - Luis Muñoz-Saavedra
- Architecture and Computer Technology Department, ETSII-EPS, University of Seville, 41004 Sevilla, Spain
- Robotics and Technology of Computers Laboratory, University of Seville, 41004 Sevilla, Spain
| | - Francisco Luna-Perejón
- Architecture and Computer Technology Department, ETSII-EPS, University of Seville, 41004 Sevilla, Spain
- Robotics and Technology of Computers Laboratory, University of Seville, 41004 Sevilla, Spain
| | - José Luis Sevillano
- Architecture and Computer Technology Department, ETSII-EPS, University of Seville, 41004 Sevilla, Spain
- Robotics and Technology of Computers Laboratory, University of Seville, 41004 Sevilla, Spain
- Research Institute of Computer Engineering (I3US), University of Seville, 41004 Sevilla, Spain
| | - Manuel Domínguez-Morales
- Architecture and Computer Technology Department, ETSII-EPS, University of Seville, 41004 Sevilla, Spain
- Robotics and Technology of Computers Laboratory, University of Seville, 41004 Sevilla, Spain
- Research Institute of Computer Engineering (I3US), University of Seville, 41004 Sevilla, Spain
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Güney Coşkun M, Kolay E, Basaranoglu M. Telenutrition for the management of inflammatory bowel disease: Benefits, limits, and future perspectives. World J Clin Cases 2023; 11:308-315. [PMID: 36686349 PMCID: PMC9850965 DOI: 10.12998/wjcc.v11.i2.308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 11/24/2022] [Accepted: 12/21/2022] [Indexed: 01/12/2023] Open
Abstract
Patients with inflammatory bowel disease (IBD) require lifelong and personalized care by a multidisciplinary healthcare team. However, the traditional medical model is not ideal for patients who require continuous close monitoring and whose symptoms may dramatically worsen between regularly scheduled visits. Additionally, close dietary follow-up and monitoring of IBD in a traditional setting are challenging because of the disease complexity, high pressure on outpatient clinics with a small number of IBD specialist dietitians, and rising incidence. Given the significant burden of IBD, there is a need to develop effective dietary management strategies. The coronavirus disease 2019 pandemic caused an unprecedented shift from in-person care to delivering health care via technological remote devices. Traditional nutrition therapy and consultation can be provided by telenutrition through remote electronic communication applications that could greatly benefit patient care. Telenutrition might be useful, safe, and cost-effective compared with standard care. It is likely that virtual care for chronic diseases including IBD will continue in some form into the future. This review article summarizes the evidence about telenutrition applications in the management of IBD patients, and we gave an overview of the acceptance and impact of these interventions on health outcomes.
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Affiliation(s)
- Merve Güney Coşkun
- Department of Nutrition and Dietetics, Istanbul Medipol University, Faculty of Health Sciences, Istanbul 34810, Turkey
- Department of Nutrition and Dietetics, Institute of Health Sciences, Istanbul Medipol University, Istanbul 34810, Turkey
| | - Ezgi Kolay
- Dietitian, Independent Researcher, Istanbul 34000, Turkey
| | - Metin Basaranoglu
- Department of Gastroenterology, Bezmialem Vakif University Faculty of Medicine, Istanbul 34093, Turkey
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Telemedicine: A promising future for inflammatory bowel disease management. Ann Med Surg (Lond) 2022; 82:104684. [PMID: 36148081 PMCID: PMC9486437 DOI: 10.1016/j.amsu.2022.104684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 09/10/2022] [Indexed: 11/21/2022] Open
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Editorial: The future of inflammatory bowel disease management. Curr Opin Gastroenterol 2022; 38:319-320. [PMID: 35762690 DOI: 10.1097/mog.0000000000000856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
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