Digital trials drive new technologies in health care

Just as the ECG sensor on your health app uses electrical sensors on the back of the wearable wristband to measure heart health, EEG sensors embedded in ear buds can measure brain health

Clinical advances and digital technologies are at an extraordinary crossroads that is pushing the frontiers of preventive, predictive and precision medicine, using artificial intelligence (AI), bioengineering, digitisation of clinical trials and improved understanding of human pathogen control. 

Just as the ECG sensor on your health app uses electrical sensors on the back of the wearable wristband to measure the health of your heart, EEG sensors embedded in earbuds can measure brain health and quantify brain activity, including cognitive decline over time. 

In the early days of the Covid-19 pandemic, bioengineering and AI were extensively utilised to understand the behaviour of the SARS-Cov2 virus to harness the advances in gene- and genome-editing at scale to accelerate the development of diagnostic tests, medicines, and vaccines. Genetic medicine is already being used to detect the risk of ALS with high predictivity. ALS, short for amyotrophic lateral sclerosis, is a progressive neurodegenerative disease in which nerve cells break down and reduce muscle function. However, when the disease will occur cannot be predicted.

Scientists in Italy have published studies on an AI-driven, non-invasive and cost-effective system based on machine meaning to support automated diagnosis of anaemia to a high degree of accuracy. Traditional methods used to detect anaemia consist of blood tests and physical examination of the pallor of the fingertips, palms, nail beds and eye conjunctiva. The new system has been trained on a dataset that derives from eye conjunctiva photos of Indian and Italian patients. 

“The proposed system uses a low-cost device, which makes it suitable for widespread use. The performance of the learning algorithms utilising two different areas of the mucous membrane of the eye is discussed. In particular, the RUSBoost algorithm, when appropriately trained on palpebral conjunctiva images, shows good performance in classifying anemic and nonanemic patients. The results are very robust, even when considering different ethnicities,” write researchers from Italy. 

 

 

Other than developing vaccines in record time, “the pandemic accelerated two big AI-related trends — how do we remotely deliver complex and acute care to treat patients at home, and virtualization of clinical trials,” said Kuldeep Singh Rajput, chief executive officer, Biofourmis, a US-based digital health company that delivers acute-level remote monitoring and management to improve outcomes and reduce hospitalisations. 

As always, data protection is vital, more so when it is to do with human biology, as the potential for misuse is exponential, said legal ethicist Nita A Farahany, Robinson O Everett Distinguished Professor of Law & Philosophy and founding director of the Initiative for Science & Society at Duke University.

As radical new tools expand the frontiers of care to enhance predictive and precision medicine to transform health care, inclusiveness must remain at the core to ensure equitable health care. Dr Megan J Palmer, executive director of bio policy and leadership initiatives and adjunct professor in the department of bioengineering at Stanford University, underscored the need for responsible development biotechnology to ensure advances in synthetic biology and to not widen the gap in access to quality health care. Dr Palmer, who co-chairs the WEF Global Future Council In Synthetic Biology, was at the WEF 2023 session on “Transforming Medicine, Redefining Life” in Davos, along with Rajput and Farahany. 

For societies to truly capitalise on advancements to harness the power of AI at the grassroots, strong regulation is needed for scale-up to ensure that technology is an enabler for not just patients but also those who are delivering care. “AI will never replace a physician or a nurse but will support them to become operationally efficient,” said Rajput.