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1.
Eur Heart J ; 45(35): 3204-3218, 2024 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-38976371

RESUMO

The advent of digital health and artificial intelligence (AI) has promised to revolutionize clinical care, but real-world patient evaluation has yet to witness transformative changes. As history taking and physical examination continue to rely on long-established practices, a growing pipeline of AI-enhanced digital tools may soon augment the traditional clinical encounter into a data-driven process. This article presents an evidence-backed vision of how promising AI applications may enhance traditional practices, streamlining tedious tasks while elevating diverse data sources, including AI-enabled stethoscopes, cameras, and wearable sensors, to platforms for personalized medicine and efficient care delivery. Through the lens of traditional patient evaluation, we illustrate how digital technologies may soon be interwoven into routine clinical workflows, introducing a novel paradigm of longitudinal monitoring. Finally, we provide a skeptic's view on the practical, ethical, and regulatory challenges that limit the uptake of such technologies.


Assuntos
Inteligência Artificial , Saúde Digital , Humanos , Inteligência Artificial/tendências , Saúde Digital/tendências , Exame Físico/instrumentação , Exame Físico/métodos , Exame Físico/tendências , Medicina de Precisão/instrumentação , Medicina de Precisão/métodos , Medicina de Precisão/tendências
2.
Georgian Med News ; (351): 23-32, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-39230216

RESUMO

BACKGROUND: Digital technologies have expanded in the field of dentistry, especially in the clinical and diagnostic aspects of occlusal abnormalities. Consequently, the purpose of this narrative review is to identify and synthesize data concerning the effects of these sophisticated digital technologies on improved diagnostic performance, treatment interventions, and patient outcomes. METHODS: Cochrane, Scopus, Web of Science, and PubMed were searched and, therefore, performed to find the pertinent digital technologies in dentistry from the published literature. The search was conducted in the period between 2000 and 2024. The criteria for inclusion of the studies targeted technologies that were Cone-Beam Computed Tomography (CBCT), intraoral scanners, 3D imaging, and Computer-Aided Design and Manufacturing (CAD/CAM). Some of the comparing between conventional and modern approaches were raised. RESULTS: Digital technologies have enhanced the diagnostic process due to extended visualization and precise evaluation of occlusal disturbances Conclusion: It has been seen that the application of information technologies in dentistry significantly improved the diagnostics and therapy of occlusion disturbances. While there are some invincible challenges posed by these advancements, the prospects are noteworthy when it comes to accuracy, efficiency, and patient benefits.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Humanos , Desenho Assistido por Computador , Tomografia Computadorizada de Feixe Cônico/métodos , Imageamento Tridimensional/métodos , Má Oclusão/diagnóstico por imagem , Má Oclusão/terapia , Saúde Digital/tendências
4.
Artigo em Inglês | MEDLINE | ID: mdl-39200576

RESUMO

Amid global health challenges, resilient health systems require continuous innovation and progress. Stakeholders highlight the critical role of digital technologies in accelerating this progress. However, the digital health field faces significant challenges, including the sensitivity of health data, the absence of evidence-based standards, data governance issues, and a lack of evidence on the impact of digital health strategies. Overcoming these challenges is crucial to unlocking the full potential of digital health innovations in enhancing healthcare delivery and outcomes. Prioritizing security and privacy is essential in developing digital health solutions that are transparent, accessible, and effective. Non-fungible tokens (NFTs) have gained widespread attention, including in healthcare, offering innovative solutions and addressing challenges through blockchain technology. This paper addresses the gap in systematic-level studies on NFT applications in healthcare, aiming to comprehensively analyze use cases and associated research challenges. The search included primary studies published between 2014 and November 2023, searching in a balanced set of databases compiling articles from different fields. A review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework and strictly focusing on research articles related to NFT applications in the healthcare sector. The electronic search retrieved 1902 articles, ultimately resulting in 15 articles for data extraction. These articles span applications of NFTs in medical devices, pathology exams, diagnosis, pharmaceuticals, and other healthcare domains, highlighting their potential to eliminate centralized trust sources in health informatics. The review emphasizes the adaptability and versatility of NFT-based solutions, indicating their broader applicability across various healthcare stages and expansion into diverse industries. Given their role in addressing challenges associated with enhancing data integrity, availability, non-repudiation, and authentication, NFTs remain a promising avenue for future research within digital health solutions.


Assuntos
Saúde Digital , Humanos , Blockchain , Tecnologia Digital/organização & administração , Tecnologia Digital/tendências , Saúde Digital/organização & administração , Saúde Digital/tendências
5.
Stud Health Technol Inform ; 316: 185-189, 2024 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-39176704

RESUMO

The paper provides a brief overview of developments in the area of digitalisation of medical services. Key factors for telemedicine goals are identified and a new trend in medical technology development using artificial intelligence is presented. The final part of the article presents an analysis of data from a study on the implementation of telemedicine solutions in cardiology in one of the largest Polish research institutes with two hospitals. Risks and drivers for the development of telemedicine in the assessment of patients in cardiology are identified. E-health solutions connect the needs of patients and technological advances, crossing the barriers of traditional healthcare systems. Telemedicine requires more involvement of the patient in diagnosis, and the ability to recognise worrying symptoms is important for further treatment.


Assuntos
Saúde Digital , Telemedicina , Humanos , Inteligência Artificial , Cardiologia , Polônia , Telemedicina/tendências , Saúde Digital/tendências
6.
Health Soc Care Deliv Res ; 12(21): 1-68, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-39056123

RESUMO

Background: General practices are facing challenges such as rising patient demand and difficulties recruiting and retaining general practitioners. Greater use of digital technology has been advocated as a way of mitigating some of these challenges and improving patient access. This includes Digital First Primary Care, when a patient's first contact with primary care is through a digital route, either through a laptop or smartphone. The use of Digital First Primary Care has been expedited since COVID-19. There is little evidence of staff experiences of using Digital First Primary Care with more complex patients, such as those with multiple long-term conditions. Objective: To understand the experiences of those with multiple long-term conditions of Digital First Primary Care from the perspectives of healthcare professionals and stakeholders. Design: This was a qualitative evaluation, comprised of four distinct work packages: Work package 1: Locating the study within the wider context, engaging with literature, and co-designing the study approach and research questions with patients. Work package 2: Interviews with health professionals working across general practice and key expert topic stakeholders, including academics and policy-makers. Work package 3: Analysis of data and generation of themes, and testing findings with patients. Work package 4: Synthesis, reporting and dissemination. Results: The study commenced in January 2021 and in total 28 interviews were conducted with 14 health professionals and 15 stakeholders between January and August 2022. From the perspective of health professionals, Digital First Primary Care approaches could enable patients to speak with a clinician more quickly than traditional approaches. Those with multiple long-term conditions could submit healthcare readings from home, though health professionals felt patients may struggle navigating digital systems not designed to capture the nuances associated with living with multiple conditions. Clinicians expressed preferences for seeing patients face-to-face, particularly those with multiple long-term conditions, to identify non-verbal cues about a patient's health. Digital First Primary Care approaches provided an opportunity for clinicians to engage with the carers of patients living with multiple long-term conditions, yet there were concerns around obtaining consent and confidentiality. There remain debates among stakeholders about the nature and extent to which Digital First Primary Care impacts on staff workload. Limitations: At the time of data collection, general practices were facing considerable pressure to deliver care and respond to the COVID-19 pandemic. While it was originally intended that the study would include interviews with patients with multiple long-term conditions and their carers, none of the general practices that took part in the study were willing and/or able to recruit patients and carers in the time available. Conclusions: The rapid implementation of Digital First Primary Care, at a time of immense pressures, meant there has been little time for considering the impact on patients, including those with multiple long-term conditions. The impacts on care continuity depended largely on how surgeries implemented their approaches. Staff and stakeholders felt that Digital First Primary Care, as an additional route for accessing primary care, could be useful for patients with multiple long-term conditions but not at the expense of face-to-face consultations. Future work: Future research obtaining patient and carer views of digital-first approaches, understanding the impacts on carers and how approaches are designed with patients with more complex conditions in mind, is essential. Funding: This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: 16/138/31) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 21. See the NIHR Funding and Awards website for further award information.


Healthcare professionals want to provide the best primary care in the face of increasing pressures, as well as improve access to care for patients. Digital First Primary Care is one response to this situation, when a patients' first contact with primary care is through a digital route, either through a laptop or smartphone. Online systems allow the patient to provide information to their practice about their symptoms or needs and request a response from a health professional. Our study aimed to understand how Digital First Primary Care works for healthcare professionals providing care to increasing numbers of patients with multiple long-term conditions and their carers. Firstly, we examined the relatively limited existing findings and then interviewed healthcare professionals and key stakeholders experienced in digital approaches within primary care (e.g. from policy organisations, universities and the National Health Service). While we attempted to speak to patients and carers directly, unfortunately the pressures in general practice meant we were unable to do so. However, the study was co-designed with patients. Healthcare professionals and stakeholders felt that patients with multiple long-term conditions faced additional challenges with the use of Digital First Primary Care compared to other patients. For example, they reported difficulties navigating online forms and not being able to speak with a general practitioner who knew them well. There were differing views from healthcare professionals and stakeholders about how far Digital First Primary Care could help staff in general practice and enhance care. For some clinicians, the workload was easier to manage and some simple tasks (e.g. sick notes) could be completed quickly. This could reduce stress for staff and mean more patients could be seen per day. Others felt that the digital system had shortcomings. This could be important for patients with multiple long-term conditions; for example, when a digital form may not fully inform the general practitioner as to the exact nature of the problem, potentially requiring a further follow-up appointment. Health professionals reported that carers of patients with multiple long-term conditions generally liked the new systems as they helped to improve contact with general practice staff. The summary was co-authored by members of the BRACE Patient and Public Involvement group.


Assuntos
Saúde Digital , Múltiplas Afecções Crônicas , Relações Médico-Paciente , Inglaterra , Múltiplas Afecções Crônicas/terapia , Saúde Digital/normas , Saúde Digital/tendências , Humanos , Medicina Estatal/organização & administração , Medicina Estatal/normas , Medicina Estatal/tendências , Satisfação do Paciente/estatística & dados numéricos , Engajamento do Médico/estatística & dados numéricos , Entrevistas como Assunto
7.
JMIR Public Health Surveill ; 10: e49719, 2024 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-39265164

RESUMO

Traditional public health surveillance efforts are generally based on self-reported data. Although well validated, these methods may nevertheless be subjected to limitations such as biases, delays, and costs or logistical challenges. An alternative is the use of smart technologies (eg, smartphones and smartwatches) to complement self-report indicators. Having embedded sensors that provide zero-effort, passive, and continuous monitoring of health variables, these devices generate data that could be leveraged for cases in which the data are related to the same self-report metric of interest. However, some challenges must be considered when discussing the use of mobile health technologies for public health to ensure digital health equity, privacy, and best practices. This paper provides, through a review of major Canadian surveys and mobile health studies, an overview of research involving mobile data for public health, including a mapping of variables currently collected by public health surveys that could be complemented with self-report, challenges to technology adoption, and considerations on digital health equity, with a specific focus on the Canadian context. Population characteristics from major smart technology brands-Apple, Fitbit, and Samsung-and demographic barriers to the use of technology are provided. We conclude with public health implications and present our view that public health agencies and researchers should leverage mobile health data while being mindful of the current barriers and limitations to device use and access. In this manner, data ecosystems that leverage personal smart devices for public health can be put in place as appropriate, as we move toward a future in which barriers to technology adoption are decreasing.


Assuntos
Saúde Pública , Telemedicina , Humanos , Canadá , Saúde Pública/métodos , Saúde Pública/estatística & dados numéricos , Saúde Pública/tendências , Telemedicina/estatística & dados numéricos , Telemedicina/tendências , Saúde Digital/estatística & dados numéricos , Saúde Digital/tendências
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