Ten threats to global health in 2019

The world is facing multiple health challenges. These range from outbreaks of vaccine-preventable diseases like measles and diphtheria, increasing reports of drug-resistant pathogens, growing rates of obesity and physical inactivity to the  health impacts of environmental pollution and climate change and multiple humanitarian crises.   

To address these and other threats, 2019 sees the start of the World Health Organization’s new 5-year strategic plan – the 13th General Programme of Work. This plan focuses on a triple billion target:  ensuring 1 billion more people benefit from access to universal health coverage, 1 billion more people are protected from health emergencies and 1 billion more people enjoy better health and well-being. Reaching this goal will require addressing the threats to health from a variety of angles. 

Here are 10 of the many issues that will demand attention from WHO and health partners in 2019. 

• Air pollution and climate change
• Noncommunicable diseases
• Global influenza pandemic
• Fragile and vulnerable settings
• Antimicrobial resistance
• Ebola and other high-threat pathogens
• Weak primary health care
• Vaccine hesitancy
• Dengue 
• HIV

The full World Health Organization article can be viewed at this link.  

Physicians can reduce medical errors with the help of AI

A 2016 study conducted by Johns Hopkins found that medical errors are the third leading cause of death in the U.S. This is a concerning statistic that physicians work tirelessly to change and hospitals continue to adjust their processes and procedures to reduce medical errors. Some hospitals implement new software that provides early warnings for potential risks when prescribing medication and offers clinical decision support. Fortunately, AI addresses some of the challenges physicians and hospitals face as they work to reduce medical errors.

The full SearchHealthIT article can be viewed at this link.  

Doctor’s career path offers economic insight on patient choices

As a physician, a portion of your patients will smoke, avoid seatbelts or skip doses of medication. In those instances, patients are doing things that are not in their own best interest.

Rather than ask the obvious question—why do patients act against their own interests?—one physician is taking a different tack when it comes to such self-defeating behaviors.

“We will be much more effective at improving health behavior if we work with the irrational parts of our nature ... instead of ignoring them or fighting against them,” said David Asch, MD, MBA. “When it comes to health care, understanding our irrationality is just another tool in our tool box. And harnessing that irrationality, that maybe the most rational move of all.”

The full American Medical Association article can be viewed at this link.  

The Use Of Telemedicine By Physicians: Still The Exception Rather Than The Rule

Using data from the American Medical Association’s 2016 Physician Practice Benchmark Survey, we provide the first nationally representative estimates of physicians’ use of telemedicine. In 2016, 15.4 percent of physicians worked in practices that used telemedicine for a wide spectrum of patient interactions, including e-visits as well as diagnoses made by radiologists who used telemedicine to store and forward data. In the same year, 11.2 percent of physicians worked in practices that used telemedicine for interactions between physicians and health care professionals. We found that in addition to specialty, larger practice size was an important correlate of telemedicine use. This suggests that despite regulatory and legislative changes to encourage the use of telemedicine, the financial burden of implementing it may be a continuing barrier for small practices.

The full article can be downloaded below.

Low-calorie sweeteners and health outcomes: A demonstration of rapid evidence mapping (rEM)

“Evidence Mapping” is an emerging tool that is increasingly being used to systematically identify, review, organize, quantify, and summarize the literature. It can be used as an effective method for identifying well-studied topic areas relevant to a broad research question along with any important literature gaps. However, because the procedure can be significantly resource-intensive, approaches that can increase the speed and reproducibility of evidence mapping are in great demand.

We propose an alternative process called “rapid Evidence Mapping” (rEM) to map the scientific evidence in a time-efficient manner, while still utilizing rigorous, transparent and explicit methodological approaches. To illustrate its application, we have conducted a proof-of-concept case study on the topic of low-calorie sweeteners (LCS) with respect to human dietary exposures and health outcomes. During this process, we developed and made publicly available our study protocol, established a PECO (Participants, Exposure, Comparator, and Outcomes) statement, searched the literature, screened titles and abstracts to identify potentially relevant studies, and applied semi-automated machine learning approaches to tag and categorize the included articles. We created various visualizations including bubble plots and frequency tables to map the evidence and research gaps according to comparison type, population baseline health status, outcome group, and study sample size. We compared our results with a traditional evidence mapping of the same topic published in 2016 (Wang et al., 2016).

We conducted an rEM of LCS, for which we identified 8122 records from a PubMed search (January 1, 1946–May 1, 2014) and then utilized machine learning (SWIFT-Active Screener) to prioritize relevant records. After screening 2267 (28%) of the total set of titles and abstracts to achieve 95% estimated recall, we ultimately included 297 relevant studies. Overall, our findings corroborated those of Wang et al. (2016) and identified that most studies were acute or short-term in healthy individuals, and studied the outcomes of appetite, energy sensing and body weight. We also identified a lack of studies assessing appetite and dietary intake related outcomes in people with diabetes. The rEM approach required approximately 100 person-hours conducted over 7 calendar months.

Rapid Evidence Mapping is an expeditious approach based on rigorous methodology that can be used to quickly summarize the available body of evidence relevant to a research question, identify gaps in the literature to inform future research, and contextualize the design of a systematic review within the broader scientific literature, significantly reducing human effort while yielding results comparable to those from traditional methods. The potential time savings of this approach in comparison to the traditional evidence mapping process make it a potentially powerful tool for rapidly translating knowledge to inform science-based decision-making.

The full article can be downloaded below.  

BRCA Challenge: BRCA Exchange as a global resource for variants in BRCA1 and BRCA2

The BRCA Challenge is a long-term data-sharing project initiated within the Global Alliance for Genomics and Health (GA4GH) to aggregate BRCA1 and BRCA2 data to support highly collaborative research activities. Its goal is to generate an informed and current understanding of the impact of genetic variation on cancer risk across the iconic cancer predisposition genes, BRCA1 and BRCA2. Initially, reported variants in BRCA1 and BRCA2 available from public databases were integrated into a single, newly created site, www.brcaexchange.org. The purpose of the BRCA Exchange is to provide the community with a reliable and easily accessible record of variants interpreted for a high-penetrance phenotype. More than 20,000 variants have been aggregated, three times the number found in the next-largest public database at the project’s outset, of which approximately 7,250 have expert classifications. The data set is based on shared information from existing clinical databases—Breast Cancer Information Core (BIC), ClinVar, and the Leiden Open Variation Database (LOVD)—as well as population databases, all linked to a single point of access. The BRCA Challenge has brought together the existing international Evidence-based Network for the Interpretation of Germline Mutant Alleles (ENIGMA) consortium expert panel, along with expert clinicians, diagnosticians, researchers, and database providers, all with a common goal of advancing our understanding of BRCA1 and BRCA2 variation. Ongoing work includes direct contact with national centers with access to BRCA1 and BRCA2 diagnostic data to encourage data sharing, development of methods suitable for extraction of genetic variation at the level of individual laboratory reports, and engagement with participant communities to enable a more comprehensive understanding of the clinical significance of genetic variation in BRCA1 and BRCA2.

The full article can be downloaded below.  

Experian, Change Healthcare collaborating on new identity management platform

Change Healthcare and Experian Health have joined forces to develop new technology for the accurate identification of patients across care settings.

Officials from both companies said the platform will build on Experian Health identity management tools and work with Change Healthcare’s Intelligent Healthcare Network, helping match patient records across payers, providers and other healthcare organizations nationwide.

The full Healthcare IT News article can be viewed at this link.  

Wireless healthcare

The work of Professor Eisuke Hanada and Professor Takato Kudou has been a driving force of innovation in medical technology. Here, they discuss their focus on manipulating wireless communication systems to assist medical efforts

At Saga University, the Hanada Laboratory and its collaborators have plunged into the world of wireless communication in medical devices, developing novel systems for real-world application in hospital environments.

The full Impact article can be downloaded below.  

Remote Patient Monitoring and Telemedicine in Neonatal and Pediatric Settings: Scoping Literature Review

While the current telemedicine approaches show promise, limited studied conditions and small sample sizes affect generalizability, therefore, warranting further research. The information presented can inform health care providers of the most widely implemented, studied, and effective forms of telemedicine for patients and their families and the telemedicine initiatives that are most cost efficient for health systems. While the focus of this review is to summarize some telehealth applications in pediatrics, we have also presented research studies that can inform providers about the importance of data sharing of remote monitoring data between hospitals. Further reports will be developed to inform health systems as the systematic literature review continues.

The full article can be downloaded below.  

Digital Healthcare Growth Drivers In 2019

The digital transformation of healthcare will see significant growth in the next 12 months fueled by institutional interest in driving down costs and improving patient engagement. Expect increased pharma investment, improving regulatory status, payer engagement with digital tools and better telemedicine connectivity through consolidation.

Digital health will build on the major events of the past year. Amazon made headlines at the beginning of 2018 with its announcement of collaborating with Berkshire Hathaway and JP Morgan to create a new entity to improve care options for their employees. Towards the end of the year Amazon got attention again with its expansion into software to digitize and mine patient medical records to improve treatment and cut costs. It joins the ranks of IBM and UnitedHealthcare’s Optum, as well as Apple and Google’s efforts to mobilize, organize and analyze health records. The anticipated buyer for all these services are health systems that have historically lagged in fully embracing the potential of electronic record analytics.

The full Forbes article can be viewed at this link.