Recently, I published a Turkish article about my predictions on how emergency medicine will be in 2040 in the well-known Turkish FOAMed blog Acilci.net. In this article, we had the opportunity to brainstorm through a futuristic story about a typical Emergency Department in 2040. We have also conducted an online survey to collect the future projections of more than 40 scientists working on medicine, genetics and engineering fields; and included these predictions in the said article.
As this article was praised, I want to write about 5 ways technology will change Emergency Medicine in the coming years.
Virtual reality is an immersive, three-dimensional, computer-generated environment. While it may seem like technology for gaming and entertainment, it is exceptionally suitable to be used in medicine. One of the most prominent applications of it is in teaching Anatomy, allowing manipulations and dissections on the human body, more precisely than classical cadaveric dissections. Any medical student can access these materials from anywhere in the world. It is also cost-effective and requires less expertise, making it a dream come true for medical faculties(1). Surgical teams started to use 3D printing to build amazingly lifelike reproductions of real patients, and VR will only make it easier and better.
Sağlıkta Yapay Zeka Kongresi 2020'de "Sağlıkta Mobil AI ve AR Teknolojileri" sunumumu gerçekleştirdim. Geliştirdiğimiz AI destekli uygulamaları anlatarak, AR tabanlı uygulamalarımızdan birkaçını canlı olarak dinleyicilere sundum. pic.twitter.com/V1feFPZFTp— Dr.Yusuf Yeşil 🚀 (@dryusufyesil) 17 January 2020
Artificial Intelligence (AI) is a popular term these days. It means “a system’s ability to correctly interpret external data, to learn from such data, and to use those learnings to achieve specific goals and tasks through flexible adaptation.”(2) Scientists all over the world are working determinedly to gain maximum benefit from this technology. AI outperforms a conventional algorithm for emergency department electrocardiogram interpretation. Apparently, it can even diagnose heart arrhythmias with cardiologist-level accuracy. An AI-enabled ECG can detect if a patient has atrial fibrillation even if the patient has a normal sinus rhythm during the test(3). Can we determine the ejection fraction using ECG? For sure. Is it possible to determine age and gender? Of course. If you are tired about ECG, let’s try another one: Can atrial fibrillation be detected just by looking at a patient’s face? Well it turns out deep-learning and a smartphone camera are all you need to do so. AI is capable of surpassing human experts in breast cancer prediction, and it can read X-Rays better than humans. It can diagnose pneumonia better than radiologists. An Israeli company announced that its algorithms were successful in helping to detect the presence of coronary artery disease. Another initiative, Sonde Health Inc., develops a voice-based technology platform for monitoring and diagnosing mental and physical medical conditions. AI will also help to solve doctor shortages: According to MIT Technology Review, Chinese doctors and tech companies are developing tools to automate routine medical tasks and alleviate China’s doctor shortage.
And these are just the baby steps of AI!
When we say «Health wearables,» the first thing that comes into mind might be a smartwatch capable of health features, but it covers an area much broader than that (Can we count pocket-sized ultrasound devices as Health Wearables? Probably.) A tech company Kymira works on a heart monitoring t-shirt that uses a single-lead ECG and movement reducing hardware to offer an accurate reading of heart rate during exercise. Just like Apple Watch, AliveCor’s Kardia measures ECGs and can detect atrial fibrillation with high sensitivity. With the slogan of «Personal ECG for the whole family», Wiwe can detect arrhythmias, help making risk assessment for stroke and sudden cardiac arrest, and also determine blood oxygen levels. The Clinicloud, the EKO Core, the eKuore Pro measure heart and lung sounds as digital stethoscopes. Omron Blood Pressure Smartwatch and the MOCAcare pocket sensor, can monitor blood pressure.
Traditionally EEGs are tests that require hospital settings, but a new device lets you record EEGs in your home. With a noninvasive neural interface that sits on the back of the head, it is possible to control compatible software. Do you want to send a text message with a thought? Say no more!
Great new apps and devices let visually impaired people engage with their environments in ways that were a dream once.
The 3D printing process builds a three-dimensional object from a computer-aided design model. Due to the increasing technological developments, there have been significant improvements in the field of 3D printing in recent years. For example, US-based CELLINK develops bioprinters and bioprinting materials for providing models to enable 3D cell culture, personalized medicine, and enhanced therapeutics. United Therapeutics, managed to bioprint lung tissues. Scientists from Spain have presented a prototype for a 3D bioprinter that can make functional human skin. 3D printed orthopedic casts became an alternative to conventional casting to treating bone fractures.
CRISPR and genomics
CRISPR is the abbreviation of «clustered regularly interspaced short palindromic repeats,» and it is a family of DNA sequences found within the genomes of prokaryotic organisms. Since the description of it in 1987 by Yoshizumi Ishino and his colleagues’, CRISPR have attracted researchers’ attention due to its great potential. By the end of 2014 more than 1000 research papers had been published that mentioned CRISPR (4). CRISPR associated nucleases have shown to be useful as a tool for molecular testing. Scientists used CRISPR to successfully delete one of the defective genes responsible for hypertrophic cardiomyopathy in human embryos. In 2017, a team of Chinese researchers successfully increased resistance to HIV in mice by replicating a mutation. Researchers managed to treat mice infected with antibiotic-resistant infections using CRISPR-engineered bacteriophages. CRISPR may help grow new and healthier food. It also helps fighting with the disease in Ways we couldn’t even imagine in the past: By targeting female reproduction in the malaria mosquito vector Anopheles gambiae, scientists try to eradicate malaria.
We still have a long way to go. It is not difficult to predict that some of the «magnificent» innovations promoted today will turn up to be phony. Although technology advances; problems such as anti-vaccination, global warming, poverty will open up new fronts. Still, the future will absolutely bring great potentials. We are eagerly looking forward to see.
References and Further Reading
- Al-Jibury O. Use of Virtual Reality in Medical Education – Reality or Deception? Med Case Rep. 2017, 3:1. doi: 10.21767/2471-8041.1000039
- Kaplan, Andreas; Haenlein, Michael (1 January 2019). “Siri, Siri, in my hand: Who’s the fairest in the land? On the interpretations, illustrations, and implications of artificial intelligence”. Business Horizons. 62 (1): 15–25. doi:10.1016/j.bushor.2018.08.004
- Attia ZI, Noseworthy PA, Lopez-Jiminez F, et al. An Artificial Intelligence-Enabled ECG Algorithm for the Identification of Patients With Atrial Fibrillation During Sinus Rhythm: A Retrospective Analysis of Outcome Prediction. Lancet 2019;394:861-867.
- Doudna JA, Charpentier E. Genome editing. The new frontier of genome engineering with CRISPR-Cas9. Science 2014. 346 (6213): 1258096. doi:10.1126/science.1258096