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Algorithms, Closer Connection With Doctors Define Patient Care in 2023

Science

From systems able to predict sports performance at the Olympics to “fixes” for pacemaker issues to rapid diagnostics, medicine is taking more advantage of technology in 2023 than ever before. This allows doctors to return to classic medicine and spend more time with their patients while also paying attention to climate considerations and carbon footprint, Semmelweis University says.

Assessing and predicting athletic performance and optimizing training are questions even the most experienced coaches have a hard time answering. Artificial intelligence, however, can bring them closer to solving such problems. With the help of a brand new system developed by Semmelweis University in Budapest, which compares more than 100 parameters of sports cardiology and other tests (e.g. blood samples), athletes’ performance will become much more predictable.

"The method and the related study are planned to be published this year by Semmelweis University," says Béla Merkely, head of the university’s Heart and Vascular Center.

Breakthrough in Fixing Pacemaker Malfunction

In 2023, those with pacemakers who experience heart failure due to altered heart function may finally receive treatment based on evidence, not individual decisions. A new trial by Semmelweis University, which included and followed up a large cohort of patients with reduced ejection fraction due to pacing, may serve as essential guidelines for cardiologists worldwide.

“Due to pacing, after a period of time, 20% of pacemaker-implanted patients may develop heart failure and become candidates for cardiac resynchronization therapy. This involves implanting another electrode along the left ventricle lateral wall," notes Merkely.

Since 5% of the population suffers from heart failure and a fifth of those with a pacemaker will experience heart failure as a result of the above-mentioned reasons, the evidence provided by the trial may be a milestone in cardiology.

Artificial intelligence (AI) will help radiologists turn to deep medicine, with deeper connections and more time with patients – the very aspect this field has lost during the past decades 

From introducing AI-based triage software to installing CT scanners that can provide far more precise assessment of diseases while emitting a fraction of the radiation, the COVID pandemic has accelerated digitalization in the field of radiology as well. All this helps radiologists to gradually return to the roots of medicine and participate in multidisciplinary teams or interact more with their patients.

"In 5-10 years, AI will handle most of the repetitive tasks and evaluation, which will allow radiologists to take on a more consultative role and actually spend more time with patients – the very aspect of patient care technology will never be able to replace," says Pál Maurovich Horvat, head of Medical Imaging Center of Semmelweis University.

The expansion of AI won’t stop at evaluation though, the expert notes. The entire diagnostics chain will see make good use of it.

“It will set appointments, assist image reconstruction (which is key to reducing dose), support professionals in post-processing to cut time, and will also help reports make more sense for patients,” he adds.

A Less Invasive and More Effective Approach to Treat Diabetes

While the number of patients with diabetes in developing countries will continue to rise, in developed countries it is going to stall in part as a result of better diagnostics and the gradual implementation of prevention strategies. Since roughly 90% of people with type 2 diabetes– who make up 90% of people with diabetes – are overweight, dealing with obesity is going to be given a greater role.

From prescribing insulin, treatment is shifting towards new, innovative drugs that can be used to delay or replace insulin administration. 

These include glucagon-like peptide 1 (GLP-1), receptor agonists and sodium glucose cotransporter 2 (SGLT-2) inhibitors.

“GLP-1 receptor agonists can be given to many patients who previously were treated with insulin,” says professor Peter Kempler of Semmelweis University’s Department of Oncology.

In addition to stimulating insulin secretion, the latest drugs also reduce body weight as they curb the appetite, which is particularly beneficial for patients with type 2 diabetes. Certain molecules even have kidney- and heart-protective properties. Though the market has experienced a shortage of these drugs lately, these treatments are expected to gain more ground in 2023.

Reducing Carbon footprint in ERs by Rationalizing Care 

"Dampening the effects of climate change is given a greater focus in 2023 in emergency care as well. “We expect that the number of climate change-related incidents will continue to rise and we are preparing accordingly,” says Péter Krivácsy, head of ER at Semmelweis University’s Department of Pediatrics.

In line with that, efforts to reduce the environmental impact of care are also becoming more enhanced.

“Many children come to the ER with symptoms such as vomiting and diarrhea. “For years, we have been using a protocol that consists of a single treatment and the oral administration of the related electrolyte drink,” adds Krivácsy.

This way they were able to reduce not only the number of children admitted to the hospital and needing infusions but also their ecological footprint, as they don’t use cannulas, infusions, and infusion equipment.

In addition to the positive environmental impact, this also means that children do not have to experience pain and physicians can direct their care capacities to other patients.

“Progress does not always equal the introduction of technology or new drugs. It can also make a difference if we organize patient care more efficiently," explains the expert.

Mindfulness and Self-regulation

Resilience – flexible coping – is key to being able to prepare for the future and thrive, according to the university. This ability is largely dependent on people’s awareness of what impacts them.

“We know that we are influenced by the media but we are less aware of the extent to which it affects our well-being, our relationships, and our decisions," says Dóra Perczel-Forintos, head of the Department of Clinical Psychology at Semmelweis University. Mindfulness, a practice that is continuing to expand, can help us be more realistic and positive about reality.

Self-regulation is another key theme that is bound to gain more ground this year. Parenting is a good example of this which, after the strictness of the first half of the 20th century is now characterized by an almost complete abandonment of rules.

"This, however, prevents most young parents from enjoying parenthood in the early ages because they go to great lengths to keep their children happy often at their own expense," she notes.

As a large proportion of the adult population struggles with sleep problems following the coronavirus pandemic, sleep disorders are becoming ever more important.

"It helps to preserve and restore full working capacity if polysomnography tests performed in sleep laboratories are widely available and sleep disorders are treated," says Veronika Müller, director of the Department of Pulmonology at Semmelweis University.

“While we continue to pay special attention to the treatment of pneumonia, with regard to SARS-CoV2, it is necessary to introduce new, effective, and oral therapies (e.g. for patients at home) as we must prepare for the spread of influenza and other respiratory viral infections.”

In the early detection of interstitial lung diseases, the role of higher precision diagnostics –  such as high-resolution photon-counting CTs or low-dose CTs – will grow as these provide a more detailed image of the lungs than traditional X-rays. Significant progress is expected with the inhalation treatment of pulmonary hypertension (high blood pressure in the lungs resulting in severe shortness of breath or heart failure), which can be detected in addition to pulmonary fibrosis, the university adds.

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