A.I. VERSUS M.D. – What happens when diagnosis is automated?

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170403_r29646-1200x630-1490293692One evening last November, a fifty-four-year-old woman from the Bronx arrived at the emergency room at Columbia University’s medical center with a grinding headache. Her vision had become blurry, she told the E.R. doctors, and her left hand felt numb and weak. The doctors examined her and ordered a CT scan of her head.

A few months later, on a morning this January, a team of four radiologists-in-training huddled in front of a computer in a third-floor room of the hospital. The room was windowless and dark, aside from the light from the screen, which looked as if it had been filtered through seawater. The residents filled a cubicle, and Angela Lignelli-Dipple, the chief of neuroradiology at Columbia, stood behind them with a pencil and pad. She was training them to read CT scans.

“It’s easy to diagnose a stroke once the brain is dead and gray,” she said. “The trick is to diagnose the stroke before too many nerve cells begin to die.” Strokes are usually caused by blockages or bleeds, and a neuroradiologist has about a forty-five-minute window to make a diagnosis, so that doctors might be able to intervene—to dissolve a growing clot, say. “Imagine you are in the E.R.,” Lignelli-Dipple continued, raising the ante. “Every minute that passes, some part of the brain is dying. Time lost is brain lost.”

By  | The New Yorker

Illustration Credit: Daniel Savage


Inpatient Rehab Offers No Benefit Over Home Exercise Program After Knee Replacement Surgery

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shutterstock_427586080A new study finds that inpatient rehabilitation seems to offer no overall benefit when compared with a monitored home-based regimen for patients recovering from standard knee replacement surgery, more formally known as “total knee arthroplasty.”

The results of the study were published online earlier this week in JAMA.

The researchers studied 165 adults (older than 40) undergoing single-knee total knee replacement for osteoarthritis. They divided the two groups: one that received 10 days of inpatient rehabilitation followed by an eight-week monitored home program, and the second group that underwent only the home program.

Both approaches for rehabilitation centered upon exercises that incorporated aerobic, muscle-specific and range-of-motion exercises. The researchers also enrolled an additional 87 patients who declined randomization in the home program as an observation group.

The researchers evaluated the two programs by measuring the distance participants could walk on a six-minute test, 26 weeks after surgery. They ultimately found that there was no significant difference in the distance walked between the 2 groups.   Postoperative pain and “quality of life” were not significantly different between the groups studied.  In addition, the number of complications was greater in the inpatient vs the home group (12 vs. 9).

By Robert Glatter, MD | Forbes

Image Credit: Shutterstock


Arthritis afflicts about 1 in 4 adults in the U.S., CDC report finds

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abhar-iran-hands-elder-old-man-canon-eos-500d-ef50mm-hadi-asgariAbout one in four adults in the United States suffers from arthritis, according to a new Centers for Disease Control and Prevention Vital Signs report published Tuesday.

Of the 54 million adults in the United States who have this debilitating condition, not all are elderly. About 60 percent of those with arthritis were between the ages of 18 and 64, that is, working age. Activity limitations from arthritis increased by 20 percent since 2002, the report found. Simple, everyday tasks, such as walking or lifting bags, are challenging for 24 million people affected by the condition in the United States.

Even though movement is painful and difficult for people with arthritis, the report suggests that increased physical activity can mitigate arthritis symptoms by 40 percent. Despite the proven health benefits of physical activity for arthritis symptoms, about 1 in 3 adults with arthritis in the United States self-reports being physically inactive.


Here’s What Convinced a Heart Surgeon to Use 3D Printing

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C6a-4YPWQAAYg6KDr. Sloane Guy thought 3D printing models was just a gimmick, until he held one in his hands.

When I walked into Dr. Sloane Guy’s office Tuesday morning, he and a cardiac surgery nurse practitioner were surveying a detailed 3D image on his computer screen. It was a CT scan of a patient’s heart. As Guy, an open heart surgeon, manipulated the image on the screen he and Amber Lennon, the nurse practitioner, discussed whether the patient would be a good candidate for robotic surgery, Guy’s specialty. The other option would be the old-fashioned way, which would require a sternotomy, colloquially known as “cracking open the ribcage.” They opted for the latter.

“We’ll just have to let him know that this is the reason we do these studies, to look for things that may make him non ideal [for robotic surgery],” said Guy, who’s also an associate professor at Weill Cornell Medicine in New York. “There’s nothing wrong with a sternotomy. What’s important is that we get him through surgery safely.”

By Kaleigh Rogers | MOTHERBOARD

 Image Credit: Kaleigh Rogers/Motherboard


Doctors turn to 3D printing to source medical supplies in earthquake-recovering Nepal

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8317820-3x2-700x467Until recently, staff at the health clinic in Bhotechaur village, in Nepal’s Sindhupalchowk region, had no way to examine their patients’ ears for signs of infection.

While otoscopes might be a common medical item in the West, for remote mountain hospitals in Nepal, sourcing such equipment can be next to impossible.

But when Nepalese engineer Ram Chandra Thapa heard about the problems facing the Bhotechaur clinic, he realised he could offer a simple solution.

He specialises in 3D printing, so he designed and printed a plastic otoscope.

“All the doctors and medical practitioners … they are happy with our [3D-printed] equipment,” Mr Thapa said.

“The items that we develop using 3D printers are cheaper, and they can be made in the field.”

Mr Thapa works for Field Ready, a US-based non-profit organisation that specialises in 3D printing plastic equipment for humanitarian and emergency situations.

By Nick Parkin | ABC (AU)

Image Credit: Nick Parkin


A digital revolution in health care is speeding up

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20170304_wbd001_0When someone goes into cardiac arrest, survival depends on how quickly the heart can be restarted. Enter Amazon’s Echo, a voice-driven computer that answers to the name of Alexa, which can recite life-saving instructions about cardiopulmonary resuscitation, a skill taught to it by the American Heart Association. Alexa is accumulating other health-care skills, too, including acting as a companion for the elderly and answering questions about children’s illnesses. In the near future she will probably help doctors with grubby hands to take notes and to request scans, as well as remind patients to take their pills.

Alexa is one manifestation of a drive to disrupt an industry that has so far largely failed to deliver on the potential of digital information. Health care is over-regulated and expensive to innovate in, and has a history of failing to implement ambitious IT projects. But the momentum towards a digital future is gathering pace. Investment into digital health care has soared.

By The Economist

Image Credit: Dave Simonds


Doctors Gave This Man a New Face

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transplant1In 2006, a 21-year old Andy Sandness unsuccessfully attempted suicide. He had aimed a bullet at his chin, which ended up destroying the lower half of his face. He was rushed to Mayo Clinic in Rochester, Minnesota where doctors finally stabilized him, but nothing could be done about his missing jaw, teeth, and nose.

Sandness went back to his home and job in Wyoming, but six years later, the Mayo Clinic delivered some hopeful news. In 2012, the hospital proposed the idea of a face transplant, a procedure with many risks and possible complications following the final surgery. But, Sandness accepted the dangers, staying hopeful, and agreed to the operation.

By Kathleen Riley | Futurism

Image Credit: Mayo Clinic & 3D Systems