The Value of Delaying Alzheimer's Disease Onset

Alzheimer's disease (AD) extracts a heavy societal toll. The value of medical advances that delay onset of AD could be significant. Using data from nationally representative samples from the Health and Retirement Study (1998-2008) and Aging Demographics and Memory Study (2001-2009), we estimate the prevalence and incidence of AD and the formal and informal health care costs associated with it. We use microsimulation to project future prevalence and costs of AD under different treatment scenarios. We find from 2010 to 2050, the number of individuals ages 70+ with AD increases 153%, from 3.6 to 9.1 million, and annual costs increase from $307 billion ($181B formal, $126B informal costs) to $1.5 trillion. 2010 annual per person costs were $71,303 and double by 2050. Medicare and Medicaid are paying 75% of formal costs. Medical advances that delay onset of AD for 5 years result in 41% lower prevalence and 40% lower cost of AD in 2050. For one cohort of older individuals, who would go on to acquire AD, a 5-year delay leads to 2.7 additional life years (about 5 AD-free), slightly higher formal care costs due to longer life but lower informal care costs for a total value of $511,208 per person. We find Medical advances delaying onset of AD generate significant economic and longevity benefits. The findings inform clinicians, policymakers, businesses and the public about the value of prevention, diagnosis, and treatment of AD.

Innovative Practice, Clinical Research, and the Ethical Advancement of Medicine

Innovative practice occurs when a clinician provides something new, untested, or nonstandard to a patient in the course of clinical care, rather than as part of a research study. Commentators have noted that patients engaged in innovative practice are at significant risk of suffering harm, exploitation, or autonomy violations. By creating a pathway for harmful or nonbeneficial interventions to spread within medical practice without being subjected to rigorous scientific evaluation, innovative practice poses similar risks to the wider community of patients and society as a whole. Given these concerns, how should we control and oversee innovative practice, and in particular, how should we coordinate innovative practice and clinical research? In this article, I argue that an ethical approach overseeing innovative practice must encourage the early transition to rigorous clinical research without delaying or deferring the development of beneficial innovations or violating the autonomy rights of clinicians and their patients.

Health and Health Care of Medicare Beneficiaries in 2030

On Medicare's 50th anniversary, we use the Future Elderly Model (FEM) - a microsimulation model of health and economic outcomes for older Americans - to generate a snapshot of changing Medicare demographics and spending between 2010 and 2030. During this period, the baby boomers, who began turning 65 and aging into Medicare in 2011, will drive Medicare demographic changes, swelling the estimated US population aged 65 or older from 39.7 million to 67.0 million. Among the risks for Medicare sustainability, the size of the elderly population in the future likely will have the highest impact on spending but is easiest to forecast. Population health and the proportion of the future elderly with disabilities are more uncertain, though tools such as the FEM can provide reasonable forecasts to guide policymakers. Finally, medical technology breakthroughs and their effect on longevity are most uncertain and perhaps riskiest. Policymakers will need to keep these risks in mind if Medicare is to be sustained for another 50 years. Policymakers may also want to monitor the equity of Medicare financing amid signs that the program's progressivity is declining, resulting in higher-income people benefiting relatively more from Medicare than lower-income people.

Health consumers and stem cell therapy innovation: markets, models and regulation

Global health consumer demand for stem cell therapies is vibrant, but the supply of treatments from the conventional science-based model of innovation is small and unlikely to increase in the near future. At the same time, several models of medical innovation have emerged that can respond to the demand, often employing a transnational value chain to deliver the product. Much of the commentary has approached the issue from a supply side perspective, demonstrating the extent to which national and transnational regulation fails to impose what are regarded as appropriate standards on the 'illicit' supply of stem cell therapies characterized by little data and poor outcomes. By contrast, this article presents a political economic analysis with a strong demand side perspective, arguing that the problem of what is termed 'stem cell tourism' is embedded in the demand-supply relationship of the health consumer market and its engagement with different types of stem cell therapy innovation. To be meaningful, discussions of regulation must recognize that analysis or risk being sidelined by a market, which ignores their often wishful thinking.

Administration of oral medication by parents at home

AIMS AND OBJECTIVE

The objective of this study was to determine parents' experiences and problems with administering medication to their children at home.

BACKGROUND

Parents' experiences and access to information for the treatment of their children's illnesses at home is necessary for their children's safety.

DESIGN

A descriptive cross-sectional study.

METHODS

Four hundred parents from children's hospital outpatient clinics were included. A questionnaire was used to determine parents' experiences and problems with administering medication to their children at home. Descriptive statistical analyses were performed using the spss software package (version 22.00).

RESULTS

Antipyretics (59%) and antibiotics (25%) were the most commonly used medicines by parents without prescription. Nearly half of the parents stated that they gave liquid medicine with a household spoon. It was found that 54% of the parents whose children refused to take tablets or liquid medicine mixed these medications into foods. Treatment was delayed in 20·7% of the children who refused to take tablets and in 29·1% of the children who refused to take liquid medicine. As a result of the project, a form and device were developed as a solution to the problems experienced by parents while administering oral medication in the home environment.

CONCLUSION

The results of the study showed that a significant percentage of the parents did not use the correct equipment to administer medications, used non-prescription medicines, did not administer medications at correct intervals and mixed medication into foods.

RELEVANCE TO CLINICAL PRACTICE

Healthcare professionals, especially nurses, should continually evaluate medication administration by parents at home and the readmission rate in the emergency department to further improve children's health.

Do new drugs increase life expectancy? A critique of a Manhattan Institute paper

A recent study published by the Manhattan Institute, "Why Has Longevity Increased More in Some States than in Others? The Role of Medical Innovation and Other Factors," purported to show that the more rapid adoption of new drugs has substantial benefits in the form of increased life expectancy, higher productivity and lower non-drug health care expenditures. This study has been cited as evidence supporting the more rapid acceptance of new drugs in Medicaid, Medicare, and other public programs and has helped to shape public debate on the value of new drugs. This analysis questions the key conclusions of the study. It points out that the key statistical regressions appear to be misspecified, since they show anomalies such as a negative correlation between income growth and life expectancy and find no relationship between education and productivity growth. Methodological flaws addressed include lack of adjustment for infant mortality rates; inadequate proxy measures of health status; lack of adjustment for ages of individuals and other sociodemographic factors; inherent problems with the definition of drug age, or 'vintage;' and the failure to consider reverse causation as an obvious explanation for several findings. The Manhattan Institute study does not provide reliable evidence for favoring adoption of newer drugs in either public or private health care programs.

Critical analysis of valuation and strategical orientation of merger and acquisition deals in the pharmaceutical industry

INTRODUCTION

The pharmaceutical industry is undergoing major shifts due to changing macro and micro factors. As the industry is highly capital intensive and patents are expiring, the outlook is on generating inorganic growth, mainly through M&A. Using the income valuation approach, one analyses two completed deals in 2016 above 1bn USD. Thereafter one outlines the main motives behind M&A deals and concluded by discussing whether M&A harms medical innovations.

AREAS COVERED

The paper is based on empirical study questioning existing literature in order to critically analyse valuation and the strategical orientation of pharmaceutical companies.

EXPERT COMMENTARY

Pharmaceutical companies understand the changing market conditions and favour their expertise. The restructuring of the industry moves to small niche companies (I.e. Biopharma or biotech companies) researching key innovations and big companies purchasing them to develop them, create clinical trials and distribute them as this is a costly manner Conclusion: One can expect more M&A deals during the next years focusing on value rather than volume. Pharmaceutical players resilient to the market changes may survive if they change their business model from a traditional vertical one to outsourcing and diversification including external players.

Technology Literacy in Undergraduate Medical Education: Review and Survey of the US Medical School Innovation and Technology Programs

BACKGROUND

Modern innovations, like machine learning, genomics, and digital health, are being integrated into medical practice at a rapid pace. Physicians in training receive little exposure to the implications, drawbacks, and methodologies of upcoming technologies prior to their deployment. As a result, there is an increasing need for the incorporation of innovation and technology (I&T) training, starting in medical school.

OBJECTIVE

We aimed to identify and describe curricular and extracurricular opportunities for innovation in medical technology in US undergraduate medical education to highlight challenges and develop insights for future directions of program development.

METHODS

A review of publicly available I&T program information on the official websites of US allopathic medical schools was conducted in June 2020. Programs were categorized by structure and implementation. The geographic distribution of these categories across US regions was analyzed. A survey was administered to school-affiliated student organizations with a focus on I&T and publicly available contact information. The data collected included the founding year, thematic focus, target audience, activities offered, and participant turnout rate.

RESULTS

A total of 103 I&T opportunities at 69 distinct Liaison Committee on Medical Education-accredited medical schools were identified and characterized into the following six categories: (1) integrative 4-year curricula, (2) facilitated doctor of medicine/master of science dual degree programs in a related field, (3) interdisciplinary collaborations, (4) areas of concentration, (5) preclinical electives, and (6) student-run clubs. The presence of interdisciplinary collaboration is significantly associated with the presence of student-led initiatives (P=.001). "Starting and running a business in healthcare" and "medical devices" were the most popular thematic focuses of student-led I&T groups, representing 87% (13/15) and 80% (12/15) of respondents, respectively. "Career pathways exploration for students" was the only type of activity that was significantly associated with a high event turnout rate of >26 students per event (P=.03).

CONCLUSIONS

Existing school-led and student-driven opportunities in medical I&T indicate growing national interest and reflect challenges in implementation. The greater visibility of opportunities, collaboration among schools, and development of a centralized network can be considered to better prepare students for the changing landscape of medical practice.

Technical Blossom in Medical Care: The Influence of Big Data Platform on Medical Innovation

Medical innovation has consistently been an essential subject and a source of support for public health research. Furthermore, improving the level of medical research and development is of great concern in this field. This paper highlights the role of big data in public medical innovation. Based on a sample of China’s listed firms in the medical industry from 2013 to 2018, this paper explores the exogenous shock effect of China’s big data medical policy. Results show that the construction of the medical big data platform effectively promotes innovation investment and the innovation patent of medical firms. In addition, the heterogeneity of this promoting effect is reflected in firm size through the overcoming of different innovation bottlenecks. The research conclusions support the positive significance of the macro-led implementation of the medical big data platform, and suggest that the positive economic externalities generated by this policy are critical to public health.

Personalised Medicine and the Economy of Biotechnological Promise

Rather than seek to distinguish hype from legitimate promise, it may be more helpful to think about personalised medicine as embodying a promissory economy which serves both to mobilize resources for research and — partly at least — to determine the ends to which that research is directed. Personalised medicine is a development of the larger promissory economy of medical biotechnology. As such, it systematically conflates public benefit with the pursuit of commercial and especially pharmaceutical interests. Consequently, research and development in personalised medicine tends to favour the production of expensive new treatments over unprofitable forms of prevention or more effective use of older therapies. A rebalancing of research priorities is needed to favour the pursuit of public benefit, even when it does not deliver private profits. This will in turn require sustained reflection, self-criticism and often self-denial on the part of public research funders and the scientists they support.

Teaching Principles of Medical Innovation and Entrepreneurship Through Hackathons: Case Study and Qualitative Analysis

BACKGROUND

Innovation and entrepreneurship training are increasingly recognized as being important in medical education. However, the lack of faculty comfort with the instruction of these concepts as well as limited scholarly recognition for this work has limited the implementation of curricula focused on these skills. Furthermore, this lack of familiarity limits the inclusion of practicing physicians in health care innovation, where their experience is valuable. Hackathons are intense innovation competitions that use gamification principles to increase comfort with creative thinking, problem-solving, and interpersonal collaboration, but they require further exploration in medical innovation.

OBJECTIVE

To address this, we aimed to design, implement, and evaluate a health care hackathon with 2 main goals: to improve emergency physician familiarity with the principles of health care innovation and entrepreneurship and to develop innovative solutions to 3 discrete problems facing emergency medicine physicians and patients.

METHODS

We used previously described practices for conducting hackathons to develop and implement our hackathon (HackED!). We partnered with the American College of Emergency Physicians, the Stanford School of Biodesign, and the Institute of Design at Stanford (d.school) to lend institutional support and expertise in health care innovation to our event. We determined a location, time frame, and logistics for the competition and settled on 3 use cases for teams to work on. We planned to explore the learning experience of participants within a pragmatic paradigm and complete an abductive thematic analysis using data from a variety of sources.

RESULTS

HackED! took place from October 1-3, 2022. In all, 3 teams developed novel solutions to each of the use cases. Our investigation into the educational experience of participants suggested that the event was valuable and uncovered themes suggesting that the learning experience could be understood within a framework from entrepreneurship education not previously described in relation to hackathons.

CONCLUSIONS

Health care hackathons appear to be a viable method of increasing physician experience with innovation and entrepreneurship principles and addressing complex problems in health care. Hackathons should be considered as part of educational programs that focus on these concepts.

Quantifying Gains in the War on Cancer Due to Improved Treatment and Earlier Detection

INTRODUCTION

There have been significant improvements in both treatment and screening efforts for many types of cancer over the past decade. However, the effect of these advancements on the survival of cancer patients is unknown, and many question the value of both new treatments and screening efforts.

METHODS

This study uses a retrospective analysis of SEER Registry data to quantify reductions in mortality rates for cancer patients diagnosed between 1997 and 2007. Using variation in trends in mortality rates by stage of diagnosis across cancer types, we use logistic regression to decompose separate survival gains into those attributable to advances in treatment versus advances in detection. We estimate the gains in survival due to gains in both treatment and detection overall and separately for 15 of the most common cancer types.

RESULTS

We estimate that 3-year cancer-related mortality of cancer patients fell 16.7% from 1997 to 2007. Overall, advances in treatment reduced mortality rates by approximately 12.2% while advances in early detection reduced mortality rates by 4.5%. The relative importance of treatment and detection varied across cancer types. Improvements in detection were most important for thyroid, prostate and kidney cancer. Improvements in treatment were most important for non-Hodgkins lymphoma, lung cancer and myeloma.

CONCLUSION

Both improved treatment options and better early detection have led to significant survival gains for cancer patients diagnosed from 1997 to 2007, generating considerable social value over this time period.

Improving Patient Involvement in the Lifecycle of Medicines: Insights From the EUPATI BE Survey

EUPATI Belgium (EUPATI.be) is an informal gathering of local partners who are interested in improving patient involvement in healthcare innovation and medicines research and development. EUPATI.be brings together various stakeholders from different areas related to healthcare including patients, academia and industry. In doing so, we create an innovative collaborative approach where actors from different backgrounds work toward improving patient involvement in medical research, and putting the patient at the center of the Belgian healthcare system. Previously, we performed in-depth interviews with a small group of stakeholders on patient involvement. Here, we elaborate on our previous findings by using a nation-wide survey to inquire into Belgian stakeholders' perception on patient involvement. To this end, an electronic survey was available in French, Dutch and English, and accessible for 11 months. Twelve questions were asked, including 11 multiple choice questions and 1 open question. The latter was thematically analyzed according to the framework method. A total of 117 responses were registered and descriptive statistics were performed. The majority of respondents could be categorized into patient, academia and industry, whereas policy makers, payers, and healthcare professionals were underrepresented. We identified several barriers that hamper patient involvement, which were sometimes more reported by specific stakeholder groups. Next, we found that various stakeholders still consider patient involvement as a passive role, i.e., medical subject in a clinical trial. Respondents also reported that the role of the various stakeholders needed more clarification; this was also confirmed by the level of trust amongst the various stakeholders. Existing and the wish for more collaboration with the various stakeholders was reported by almost all respondents. Based on this survey, we can define the potential of involving patients in the medical research and development in the Belgian landscape. Our results will help to understand and tackle the various barriers that currently hamper patient involvement, whilst highlighting the need for a collaborative landscape from the multi-stakeholder perspective.

A Reexamination of the Costs of Medical R&D Regulation

Recent evidence suggests that the economic value of increased health has been enormous, with most of these gains being driven by medical R&D. The R&D process for pharmaceuticals is particularly expensive and time consuming, with well-known studies from the Tufts Center for the Study of Drug Development suggesting that developing a single successful drug costs around $1 billion and takes roughly 12 years. We argue that these estimates are incomplete because they do not incorporate the social costs imposed by the regulatory process, namely the costs to producers in terms of forgone profits and the costs to consumers in terms of delayed access to drugs. In this article, we develop a framework to estimate the social costs imposed by the regulatory process. Under this framework, delays in drug development are socially costly because of reduced consumer surplus (due to delayed access to beneficial therapies), reduced producer variable profits, and increased R&D expenditures. We apply this framework to the case of therapies aimed at treating AIDS, non-Hodgkin's lymphoma, and breast cancer. In each case, we find that the effects of drug delays on consumer surplus and variable producer profits are far larger than the effects on R&D costs. These findings suggest that patients, not firms, would be the primary beneficiaries from any improvements in streamlining the drug development process.

Product Development Partnerships: Delivering Innovation for the Elimination of African Trypanosomiasis?

African trypanosomiasis has been labelled as a 'tool-deficient' disease. This article reflects on the role that Product Development Partnerships (PDPs) have played in delivering new tools and innovations for the control and elimination of the African trypanosomiases. We analysed three product development partnerships-DNDi, FIND and GALVmed-that focus on delivering new drugs, diagnostic tests, and animal health innovations, respectively. We interviewed key informants within each of the organisations to understand how they delivered new innovations. While it is too early (and beyond the scope of this article) to assess the role of these three organisations in accelerating the elimination of the African trypanosomiases, all three organisations have been responsible for delivering new innovations for diagnosis and treatment through brokering and incentivising innovation and private sector involvement. It is doubtful that these innovations would have been delivered without them. To varying degrees, all three organisations are evolving towards a greater brokering role, away from only product development, prompted by donors. On balance, PDPs have an important role to play in delivering health innovations, and donors need to reflect on how best to incentivise them to focus and continue to deliver new products.

"Smart Process" of Medical Innovation: The Synergism Based on Network and Physical Space

Medical innovation has a profound impact on public health, and it is always of social concern to encourage innovation and enhance the value in health care delivery. Based on a sample of China’s listed firms in the medical industry from 2007 to 2018, this paper highlights the independent and mixed roles of informatization and high-speed rail in public medical innovation. The results show that informatization at network space and high-speed rail at physical space effectively promote the innovation of medical enterprises. In addition, “online” information technology and “offline” high-speed rail technology have a synergistic effect on medical innovation, especially in areas with a low level of innovation. The conclusion supports the positive significance of technology in the application of public health and proposes that the construction of smart society is very important to public health.

Revolutionizing Orthopedic Healthcare: The Role of Robotics

Integrating robotics into orthopedic healthcare represents a transformative paradigm shift driven by technological advancements. This editorial explores the profound impact of robotics on the diagnosis, treatment, and rehabilitation of musculoskeletal conditions. Robotics redefines precision in orthopedic surgery through advanced imaging and real-time feedback, resulting in minimized disruption to tissues and faster recovery. Personalized treatment plans leverage robotics' capabilities to tailor procedures to individual anatomical characteristics, enhancing outcomes and reducing complications. Minimally invasive procedures, facilitated by robotics, mitigate trauma and expedite patient recovery. This collaboration between surgeons and robotic systems enhances precision without supplanting human expertise. Moreover, robotics extends to postoperative rehabilitation, utilizing exoskeletons and motion-capture systems to optimize mobility and strength recovery. While challenges of cost and training exist, proactive collaborations are shaping the future of robotics in orthopedic care. Ethical considerations underline the importance of balancing human intervention with robotic assistance. As robotics evolves, orthopedic healthcare embraces a future where technology and human expertise synergize, ultimately conquering musculoskeletal conditions.

Balancing medical innovation and affordability in the new healthcare ecosystem in China: Review of pharmaceutical pricing and reimbursement policies

The China Basic Medical Insurance Program was created in 1999 with three objectives: equal accessibility, affordability, and quality. Today, it has become the biggest medical insurance program in the world, covering 95% of China's population. Since 2015, China's healthcare ecosystem has been reshaped by increasing innovation, which has in turn been driven by regulatory reform, enhancement of research and development capability, and capital market development. There has also been improved regulatory efficiency to reduce lags in launching drugs. In 2022, nearly 20% of novel active substances launched globally were from China. China has also risen to become the second biggest contributor to innovation in terms of pipelines. Using a "fast-follow" strategy, many locally developed innovative drugs can compete with products from multinational companies in their quality and pricing. However, China's pharmaceutical and biotechnology industry will continue to face challenges in pricing and reimbursement, as well as a shortened product lifecycle with rapid price erosion. The government has already accelerated the timeline for updating the drug reimbursement list and is willing to create a high-quality medical insurance program. However, some obstacles are hard to overcome, including reimbursement for advanced therapies, limited funding and an increasing burden of disease due to an aging population. This article reviews the trajectory of medical innovation in China, including the challenges. Looking forward, balancing affordability and innovation will be critical for China to continue the trajectory of growth. The article also offers some suggestions for future policy reform, including optimizing reimbursement efficiency with a focus on high-quality solutions, enhancing the value assessment framework, payer repositioning from "value buyer" to "strategic buyer", and developing alternative market access pathways for innovative drugs.

Jonas Salk (1914-1995): Pioneering the Fight Against Polio and Beyond

Jonas Salk (October 28, 1914 - June 23, 1995) was an American medical researcher celebrated for his pioneering work in virology, particularly the development of the first successful polio vaccine. This review highlights Salk's multifaceted talent and contributions. His research on the poliovirus led to the creation of the inactivated polio vaccine, proving that it could prevent the disease. In 1955, the discovery of the polio vaccine was a pivotal moment in the fight against poliomyelitis. Salk's contributions are celebrated in the record of medical history, highlighting his impact on modern medicine and public health. As a professor of bacteriology, preventive medicine, and experimental medicine, Salk's scientific journey, from his innovative methods to the creation and widespread use of the inactivated polio vaccine, helped eradicate polio from various parts of the world. His contributions beyond polio, such as his work on the influenza vaccine and the founding of the Salk Institute for Biological Studies, are also well known. By exploring Salk's legacy, this review examines how his work and dedication continue to influence modern medicine, public health, and science, impacting humanity.

Redefining informed consent form in cell and gene therapy trials

Informed consent is a foundation of the ethical conduct of research involving human participants. Based on the ethical principle of respect for persons, the goal of informed consent is to ensure that participants are aware of the risks and potential benefits and make a voluntary decision about participating in clinical trial research. The extraordinary scientific advances happening globally, have demonstrated the potential of regenerative therapies in transforming the health of the nation by providing a therapeutic option for diseases that were previously considered incurable. These therapies, which include cells and gene therapy (GT) labeled as Advanced Therapeutic Medicinal Products globally, have complex mechanisms of action. Owing to their highly personalized and intricate nature of these therapies, developing the latter often presents unique challenges above and beyond those encountered for small molecule drugs. We recently looked through some cell and GT clinical trials and realized the lacunae in the informed consent form (ICF) provided by the investigators. Especially in a country like India, where the general understanding and perception of patients is limited regarding clinical trials, it is felt that any lapses in the consent process may jeopardize the informed decision-making and safety of the participants and tarnish the reputation of India globally. The present article highlights the need for appropriate patient and public education on the various aspects of cell and gene therapies and aims to address all the elements of ICF in light of the challenges associated with these innovative therapies.

From Platelets to Preschoolers: The Pioneering Journey of Dr. Valentin Fuster in Cardiology and Global Health Education

Dr. Valentin Fuster's career, blending pioneering research with global health education, has profoundly influenced cardiology and public health. From his early life in Barcelona's medical community to groundbreaking contributions at major institutions like Mount Sinai and Harvard, Dr. Fuster has led transformative research on cardiovascular diseases and their prevention. His work spans from detailed studies on platelets and aspirin's preventative roles to innovative uses of MRI for understanding atherosclerosis. Beyond academia, he has significantly impacted public health through educational programs like the character "Dr. Ruster" on Sesame Street, advocating heart-healthy lifestyles to preschoolers worldwide. Dr. Fuster's dual focus on advanced medical research and community health initiatives exemplifies an integrated approach to tackling heart disease on multiple fronts.

Haptic Technology: Exploring Its Underexplored Clinical Applications-A Systematic Review

BACKGROUND/OBJECTIVES

Haptic technology has transformed interactions between humans and both tangible and virtual environments. Despite its widespread adoption across various industries, the potential therapeutic applications of this technology have yet to be fully explored.

METHODS

A systematic review of randomized controlled trials (RCTs) and randomized crossover trials was conducted, utilizing databases such as PubMed, Embase, Cochrane Library, and Web of Science. This review included studies reporting clinical applications of haptic technology in rehabilitation, cognition, wellness, and mental health among adult subjects.

RESULTS

This systematic review included 34 studies, of which 20 focused on clinical outcomes and 14 on learning clinical skills. The results showed that haptic devices, both robotic and non-robotic, enhance sensorimotor performance and motor function in rehabilitation settings, especially in post-stroke recovery, with reported effect sizes ranging from 0.2 to 0.7. The majority of the haptic technologies reported were integrated into robotic systems (40%). Haptic devices were also reported to improve clinical skills training by providing tactile feedback that enhances procedural performance and trainee self-efficacy. In fact, surgical simulations accounted for 79% of all the modalities used for medical training.

CONCLUSIONS

This review underscores the potential yet underexplored applications of haptic technology in healthcare, including medical education, rehabilitation, cognition, and mental health. The key limitations of this review include heterogeneity across studies, small sample sizes, and a scarcity of comprehensive, long-term investigations. Therefore, future research should aim to validate these findings further and expand the applications of haptic technology to maximize its utility in the healthcare industry and clinical practice.

From Injury to Innovation: Margaret Dix's Pioneering Work in Neuro-Otology

Margaret Ruth Dix made groundbreaking contributions to neuro-otology, particularly in the study of vestibular disorders. Together with Charles Hallpike, Dix developed the Dix-Hallpike maneuver, a diagnostic technique that is still widely used today for benign paroxysmal positional vertigo (BPPV). Their research provided critical insights into BPPV, although they initially misidentified its cause, attributing it to otolithic disturbances instead of semicircular canal dysfunction. In addition to her work on BPPV, Dix made important contributions to caloric testing, Meniere's disease, and pure tone audiometry for young children, among other areas. Her efforts led to more effective diagnostic and educational methods. Despite some early misconceptions, the work of Dix and Hallpike remains a cornerstone of neuro-otology. The Dix-Hallpike maneuver continues to be essential for diagnosing BPPV, and their research has had a lasting impact on clinical practice and scientific knowledge in the field.