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Boucher A, Peters M, Jones GB. How Digital Solutions Might Provide a World of New Opportunities for Holistic and Empathic Support of Patients with Hidradenitis Suppurativa. Dermatol Ther (Heidelb) 2024:10.1007/s13555-024-01234-9. [PMID: 39042318 DOI: 10.1007/s13555-024-01234-9] [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: 04/18/2024] [Accepted: 07/08/2024] [Indexed: 07/24/2024] Open
Abstract
Hidradenitis suppurativa (HS) is a complex chronic relapsing inflammatory condition anchored in the hair follicle wherein painful abscesses, nodules, and tunnels form under the skin with the potential for intermittent pus drainage and tissue scarring. Current estimates of incidence are 1-4% globally with the disease three times more prevalent in women and higher rates among Black populations. Patients with HS are also more likely to suffer from depression, anxiety, and loneliness underscoring the need for carefully approached strategies on disease awareness and interventions. Delays in formal diagnosis, which have been estimated at 7-10 years on average, impede timely provision of optimal care. Despite best intent, when patients present at a physician's office, stigmas relating to physical appearance can be exacerbated by negative interactions experienced by patients. In addition to long wait times and the dearth of available HS expert dermatology professionals, patients perceive heightened physician focus on two of the HS flare risk factors (smoking and body mass index [BMI]) as negatively impacting their care. Given the need for continual, personal, and sensitive patient support, herein we advocate for re-examination of approach to care and the leveraging of highly personalized digital support solutions. New medications which can directly or indirectly control elements of the disease and its comorbidities are also entering the marketplace. Collectively, we posit that these new developments provide opportunity for a holistic approach for patients with HS, leading to long-term engagement and improved outcomes.
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Affiliation(s)
- Annie Boucher
- Novartis Pharma AG, Lichtstrasse 35, 4056, Basel, Switzerland
| | - Martin Peters
- Novartis Pharma AG, Lichtstrasse 35, 4056, Basel, Switzerland
| | - Graham B Jones
- Novartis Pharmaceuticals, 250 Massachusetts Avenue, Cambridge, MA, 02139, USA.
- Clinical and Translational Science Institute, Tufts University Medical Center, 800 Washington Street, Boston, MA, 02111, USA.
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Sheerah HA, AlSalamah S, Alsalamah SA, Lu CT, Arafa A, Zaatari E, Alhomod A, Pujari S, Labrique A. The Rise of Virtual Health Care: Transforming the Health Care Landscape in the Kingdom of Saudi Arabia: A Review Article. Telemed J E Health 2024. [PMID: 38984415 DOI: 10.1089/tmj.2024.0114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2024] Open
Abstract
BACKGROUND The rise of virtual healthcare underscores the transformative influence of digital technologies in reshaping the healthcare landscape. As technology advances and the global demand for accessible and convenient healthcare services escalates, the virtual healthcare sector is gaining unprecedented momentum. Saudi Arabia, with its ambitious Vision 2030 initiative, is actively embracing digital innovation in the healthcare sector. METHODS In this narrative review, we discussed the key drivers and prospects of virtual healthcare in Saudi Arabia, highlighting its potential to enhance healthcare accessibility, quality, and patient outcomes. We also summarized the role of the COVID-19 pandemic in the digital transformation of healthcare in the country. Healthcare services provided by Seha Virtual Hospital in Saudi Arabia, the world's largest and Middle East's first virtual hospital, were also described. Finally, we proposed a roadmap for the future development of virtual health in the country. RESULTS AND CONCLUSIONS The integration of virtual healthcare into the existing healthcare system can enhance patient experiences, improve outcomes, and contribute to the overall well-being of the population. However, careful planning, collaboration, and investment are essential to overcome the challenges and ensure the successful implementation and sustainability of virtual healthcare in the country.
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Affiliation(s)
- Haytham A Sheerah
- Ministry of Health, Office of the Vice Minister of Health, Riyadh, Saudi Arabia
| | - Shada AlSalamah
- Information Systems Department, College of Computer and Information Sciences, King Saud University, Riyadh, Saudi Arabia
- Department of Digital Health and Innovation, Science Division, World Health Organization, Geneva, Switzerland
| | - Sara A Alsalamah
- College of Computer and Information Sciences, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
- Department of Computer Science, Virginia Tech, Blacksburg, Virginia, USA
| | - Chang-Tien Lu
- Department of Computer Science, Virginia Tech, Blacksburg, Virginia, USA
| | - Ahmed Arafa
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan
- Department of Public Health and Community Medicine, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Ezzedine Zaatari
- Ministry of Health, Office of the Vice Minister of Health, Riyadh, Saudi Arabia
| | - Abdulaziz Alhomod
- Ministry of Health, SEHA Virtual Hospital, Riyadh, Saudi Arabia
- Emergency Medicine Administration, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Sameer Pujari
- Department of Digital Health and Innovation, Science Division, World Health Organization, Geneva, Switzerland
| | - Alain Labrique
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland,United States
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Karampinis E, Toli O, Georgopoulou KE, Kampra E, Spyridonidou C, Roussaki Schulze AV, Zafiriou E. Can Artificial Intelligence "Hold" a Dermoscope?-The Evaluation of an Artificial Intelligence Chatbot to Translate the Dermoscopic Language. Diagnostics (Basel) 2024; 14:1165. [PMID: 38893694 PMCID: PMC11171543 DOI: 10.3390/diagnostics14111165] [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: 04/20/2024] [Revised: 05/24/2024] [Accepted: 05/30/2024] [Indexed: 06/21/2024] Open
Abstract
This survey represents the first endeavor to assess the clarity of the dermoscopic language by a chatbot, unveiling insights into the interplay between dermatologists and AI systems within the complexity of the dermoscopic language. Given the complex, descriptive, and metaphorical aspects of the dermoscopic language, subjective interpretations often emerge. The survey evaluated the completeness and diagnostic efficacy of chatbot-generated reports, focusing on their role in facilitating accurate diagnoses and educational opportunities for novice dermatologists. A total of 30 participants were presented with hypothetical dermoscopic descriptions of skin lesions, including dermoscopic descriptions of skin cancers such as BCC, SCC, and melanoma, skin cancer mimickers such as actinic and seborrheic keratosis, dermatofibroma, and atypical nevus, and inflammatory dermatosis such as psoriasis and alopecia areata. Each description was accompanied by specific clinical information, and the participants were tasked with assessing the differential diagnosis list generated by the AI chatbot in its initial response. In each scenario, the chatbot generated an extensive list of potential differential diagnoses, exhibiting lower performance in cases of SCC and inflammatory dermatoses, albeit without statistical significance, suggesting that the participants were equally satisfied with the responses provided. Scores decreased notably when practical descriptions of dermoscopic signs were provided. Answers to BCC scenario scores in the diagnosis category (2.9 ± 0.4) were higher than those with SCC (2.6 ± 0.66, p = 0.005) and inflammatory dermatoses (2.6 ± 0.67, p = 0). Similarly, in the teaching tool usefulness category, BCC-based chatbot differential diagnosis received higher scores (2.9 ± 0.4) compared to SCC (2.6 ± 0.67, p = 0.001) and inflammatory dermatoses (2.4 ± 0.81, p = 0). The abovementioned results underscore dermatologists' familiarity with BCC dermoscopic images while highlighting the challenges associated with interpreting rigorous dermoscopic images. Moreover, by incorporating patient characteristics such as age, phototype, or immune state, the differential diagnosis list in each case was customized to include lesion types appropriate for each category, illustrating the AI's flexibility in evaluating diagnoses and highlighting its value as a resource for dermatologists.
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Affiliation(s)
- Emmanouil Karampinis
- Department of Dermatology, Faculty of Medicine, School of Health Sciences, University General Hospital of Larissa, University of Thessaly, 41110 Larissa, Greece; (E.K.); (A.-V.R.S.)
| | - Olga Toli
- Department of Dermatology, Oncoderm Center One Day Clinic, 45332 Ioannina, Greece;
| | | | - Elli Kampra
- Department of Dermatology, Faculty of Medicine, School of Health Sciences, University General Hospital of Larissa, University of Thessaly, 41110 Larissa, Greece; (E.K.); (A.-V.R.S.)
| | | | - Angeliki-Victoria Roussaki Schulze
- Department of Dermatology, Faculty of Medicine, School of Health Sciences, University General Hospital of Larissa, University of Thessaly, 41110 Larissa, Greece; (E.K.); (A.-V.R.S.)
| | - Efterpi Zafiriou
- Department of Dermatology, Faculty of Medicine, School of Health Sciences, University General Hospital of Larissa, University of Thessaly, 41110 Larissa, Greece; (E.K.); (A.-V.R.S.)
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Crovella S, Suleman M, Tricarico PM, Al-Khuzaei S, Moltrasio C, El Omri A, Marzano AV. Harnessing artificial intelligence for advancing early diagnosis in hidradenitis suppurativa. Ital J Dermatol Venerol 2024; 159:43-49. [PMID: 38345291 DOI: 10.23736/s2784-8671.23.07829-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
This perspective delves into the integration of artificial intelligence (AI) to enhance early diagnosis in hidradenitis suppurativa (HS). Despite significantly impacting Quality of Life, HS presents diagnostic challenges leading to treatment delays. We present a viewpoint on AI-powered clinical decision support system designed for HS, emphasizing the transformative potential of AI in dermatology. HS diagnosis, primarily reliant on clinical evaluation and visual inspection, often results in late-stage identification with substantial tissue damage. The incorporation of AI, utilizing machine learning and deep learning algorithms, addresses this challenge by excelling in image analysis. AI adeptly recognizes subtle patterns in skin lesions, providing objective and standardized analyses to mitigate subjectivity in traditional diagnostic approaches. The AI integration encompasses diverse datasets, including clinical records, images, biochemical and immunological data and OMICs data. AI algorithms enable nuanced comprehension, allowing for precise and customized diagnoses. We underscore AI's potential for continuous learning and adaptation, refining recommendations based on evolving data. Challenges in AI integration, such as data privacy, algorithm bias, and interpretability, are addressed, emphasizing the ethical considerations of responsible AI deployment, including transparency, human oversight, and striking a balance between automation and human intervention. From the dermatologists' standpoint, we illustrate how AI enhances diagnostic accuracy, treatment planning, and long-term follow-up in HS management. Dermatologists leverage AI to analyze clinical records, dermatological images, and various data types, facilitating a proactive and personalized approach. AI's dynamic nature supports continuous learning, refining diagnostic and treatment strategies, ultimately reshaping standards of care in dermatology.
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Affiliation(s)
- Sergio Crovella
- Laboratory of Animal Research Center (LARC), Qatar University, Doha, Qatar -
| | - Muhammad Suleman
- Laboratory of Animal Research Center (LARC), Qatar University, Doha, Qatar
| | | | - Safaa Al-Khuzaei
- Department of Dermatology and Venereology, Hamad Medical Corporation, Rumailah Hospital, Doha, Qatar
| | - Chiara Moltrasio
- Unit of Dermatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Abdelfatteh El Omri
- Surgical Research Section, Department of Surgery, Hamad Medical Corporation, Doha, Qatar
| | - Angelo V Marzano
- Unit of Dermatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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Cummins MR, Ong T, Ivanova J, Barrera JF, Wilczewski H, Soni H, Welch BM, Bunnell BE. Consensus Guidelines for Teledermatology: Scoping Review. JMIR DERMATOLOGY 2023; 6:e46121. [PMID: 37632944 PMCID: PMC10335147 DOI: 10.2196/46121] [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: 01/31/2023] [Revised: 04/05/2023] [Accepted: 04/23/2023] [Indexed: 08/28/2023] Open
Abstract
BACKGROUND Consensus guidelines and recommendations play an important role in fostering quality, safety, and best practices, as they represent an expert interpretation of the biomedical literature and its application to practice. However, it is unclear whether the recent collective experience of implementing telemedicine and the concurrent growth in the evidence base for teledermatology have resulted in more robust guidance. OBJECTIVE The objective of this review was to describe the extent and nature of currently available guidance, defined as consensus guidelines and recommendations available for telemedicine in dermatology, with guidance defined as consensus or evidence-based guidelines, protocols, or recommendations. METHODS We conducted a single-reviewer scoping review of the literature to assess the extent and nature of available guidance, consensus guidelines, or recommendations related to teledermatology. We limited the review to published material in English since 2013, reflecting approximately the past 10 years. We conducted the review in November and December of the year 2022. RESULTS We identified 839 potentially eligible publications, with 9 additional records identified through organizational websites. A total of 15 publications met the inclusion and exclusion criteria. The guidelines focused on varied topics and populations about dermatology and skin diseases. However, the most frequent focus was general dermatology (8/15, 53%). Approximately half of the telemedicine guidance described in the publications was specific to dermatology practice in the context of the COVID-19 pandemic. The publications were largely published in or after the year 2020 (13/15, 87%). Geographical origin spanned several different nations, including Australia, the United States, European countries, and India. CONCLUSIONS We found an increase in COVID-19-specific teledermatology guidance during 2020, in addition to general teledermatology guidance during the period of the study. Primary sources of general teledermatology guidance reported in the biomedical literature are the University of Queensland's Centre for Online Health and Australasian College of Dermatologists E-Health Committee, and the American Telemedicine Association. There is strong evidence of international engagement and interest. Despite the recent increase in research reports related to telemedicine, there is a relative lack of new guidance based on COVID-19 lessons and innovations. There is a need to review recent evidence and update existing recommendations. Additionally, there is a need for guidance that addresses emerging technologies.
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Affiliation(s)
- Mollie R Cummins
- College of Nursing, University of Utah, Salt Lake City, UT, United States
- Department of Biomedical Informatics, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT, United States
- Doxy.me, Inc, Rochester, NY, United States
| | - Triton Ong
- Doxy.me, Inc, Rochester, NY, United States
| | | | - Janelle F Barrera
- Doxy.me, Inc, Rochester, NY, United States
- Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, FL, United States
| | | | - Hiral Soni
- Doxy.me, Inc, Rochester, NY, United States
| | - Brandon M Welch
- Doxy.me, Inc, Rochester, NY, United States
- Biomedical Informatics Center, Public Health and Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Brian E Bunnell
- Doxy.me, Inc, Rochester, NY, United States
- Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, FL, United States
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The Challenge Arising from New Knowledge about Immune and Inflammatory Skin Diseases: Where We Are Today and Where We Are Going. Biomedicines 2022; 10:biomedicines10050950. [PMID: 35625686 PMCID: PMC9138773 DOI: 10.3390/biomedicines10050950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 04/12/2022] [Indexed: 11/16/2022] Open
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Al-Hazmi AM, Sheerah HA, Arafa A. Perspectives on Telemedicine during the Era of COVID-19; What Can Saudi Arabia Do? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10617. [PMID: 34682363 PMCID: PMC8535869 DOI: 10.3390/ijerph182010617] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 10/06/2021] [Accepted: 10/07/2021] [Indexed: 12/12/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has represented a challenge to medical practice in Saudi Arabia and worldwide. In contrary to the increasing numbers of COVID-19 patients, there was a limitation in the capacity of medical practices and access to healthcare. A growing body of evidence from healthcare settings in Saudi Arabia and worldwide has suggested a possible role for telemedicine in responding to this evolving need. Telemedicine can be used for triage, direct care, follow-up, and consultation. It could be delivered through synchronous, asynchronous, and mixed approaches. While telemedicine has several advantages, such as accessibility and cost-effectiveness, its diagnostic reliability should be further investigated. The Saudi Vision (2030) has drawn up a roadmap to invest in digital healthcare during the coming decade; however, some barriers related to using telemedicine in Saudi healthcare settings, including cultural issues and technical difficulties, should be openly discussed. In addition, before putting telemedicine in practice on a wide scale in Saudi Arabia, more efforts should be carried out to issue updated legislation and regulations, discuss and respond to ethical concerns, and ensure data security.
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Affiliation(s)
- Ali Mohsen Al-Hazmi
- Health Promotion and Health Education Research Chair, College of Medicine, King Saud University, Riyadh 11461, Saudi Arabia; (A.M.A.-H.); (A.A.)
- Department of Family & Community Medicine, College of Medicine, King Saud University, Riyadh 11461, Saudi Arabia
| | - Haytham A. Sheerah
- Health Promotion and Health Education Research Chair, College of Medicine, King Saud University, Riyadh 11461, Saudi Arabia; (A.M.A.-H.); (A.A.)
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita 564-8565, Japan
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
| | - Ahmed Arafa
- Health Promotion and Health Education Research Chair, College of Medicine, King Saud University, Riyadh 11461, Saudi Arabia; (A.M.A.-H.); (A.A.)
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
- Department of Public Health, Faculty of Medicine, Beni-Suef University, Beni-Suef 62511, Egypt
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Rosi E, Fastame MT, Scandagli I, Di Cesare A, Ricceri F, Pimpinelli N, Prignano F. Insights into the Pathogenesis of HS and Therapeutical Approaches. Biomedicines 2021; 9:1168. [PMID: 34572354 PMCID: PMC8467309 DOI: 10.3390/biomedicines9091168] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 08/31/2021] [Accepted: 09/01/2021] [Indexed: 12/13/2022] Open
Abstract
Hidradenitis suppurativa (HS) is a debilitating, chronic, (auto)inflammatory disease primarily affecting apocrine gland-rich areas of the body. Although pathogenic mechanisms responsible for HS have not yet been fully elucidated, it is a multifactorial process whose main target is the terminal follicle. The role of the inflammatory process (and consequently of cytokine milieu) and of several other factors (genetics, lifestyle, hormonal status, microbiome, innate and adaptive immune systems) involved in HS pathogenesis has been investigated (and often defined) over the years with a view to transferring research results from bench to bedside and describing a unique and universally accepted pathogenetic model. This review will update readers on recent advances in our understanding of HS pathogenesis and novel (potential) medical therapies for patients with moderate-to-severe HS.
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Affiliation(s)
| | | | | | | | | | | | - Francesca Prignano
- Department of Health Sciences, Section of Dermatology, University of Florence, 50125 Florence, Italy; (E.R.); (M.T.F.); (I.S.); (A.D.C.); (F.R.); (N.P.)
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Wake DT, Smith DM, Kazi S, Dunnenberger HM. Pharmacogenomic Clinical Decision Support: A Review, How-to Guide, and Future Vision. Clin Pharmacol Ther 2021; 112:44-57. [PMID: 34365648 PMCID: PMC9291515 DOI: 10.1002/cpt.2387] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 07/28/2021] [Indexed: 02/06/2023]
Abstract
Clinical decision support (CDS) is an essential part of any pharmacogenomics (PGx) implementation. Increasingly, institutions have implemented CDS tools in the clinical setting to bring PGx data into patient care, and several have published their experiences with these implementations. However, barriers remain that limit the ability of some programs to create CDS tools to fit their PGx needs. Therefore, the purpose of this review is to summarize the types, functions, and limitations of PGx CDS currently in practice. Then, we provide an approachable step‐by‐step how‐to guide with a case example to help implementers bring PGx to the front lines of care regardless of their setting. Particular focus is paid to the five “rights” of CDS as a core around designing PGx CDS tools. Finally, we conclude with a discussion of opportunities and areas of growth for PGx CDS.
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Affiliation(s)
- Dyson T Wake
- Mark R. Neaman Center for Personalized Medicine, NorthShore University HealthSystem, Evanston, Illinois, USA
| | - D Max Smith
- MedStar Health, Columbia, Maryland, USA.,Georgetown University Medical Center, Washington, DC, USA
| | - Sadaf Kazi
- Georgetown University Medical Center, Washington, DC, USA.,National Center for Human Factors in Healthcare, MedStar Health Research Institute Washington, Washington, DC, USA
| | - Henry M Dunnenberger
- Mark R. Neaman Center for Personalized Medicine, NorthShore University HealthSystem, Evanston, Illinois, USA
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