Artificial Intelligence Role in Population Health

Artificial intelligence to play key role in population health

The increasing use of artificial intelligence (AI) to analyze large patient data sets promises to change the face of population health management in a way that will be far reaching across the industry and a game changer to the way physicians monitor and care for their patients.

Making Better Decisions

AI’s ability to raise the level of evidence-based medicine can help primary care physicians make better decisions in several areas.

These include:

  • The ability to determine appropriate treatments for their patients and how best to monitor their care during and after hospitalization
  • Improving efficiency and productivity in care team workflows
  • Finding better ways to reduce overall costs associated with patient care.

Analyzing Big Data To Foreshadow Illness

Supercomputers that compare and analyze large groups of patients’ clinical data, diagnostic images and claims data, are capable of identifying subtle patterns and changes in health and wellness that can foreshadow the start of an illness, monitor the effectiveness of drug treatments and identify patients’ health risks.

For example, when researchers at the MRC London Institute of Medical Sciences, wanted to find out which patients with pulmonary hypertension had the greatest risk of heart failure, they used AI software to analyze images of patients’ hearts and constructed a smart 3D heart that predicts patient survival rates.

The study, published in the journal Radiology, noted that researchers used the software to analyze MRI scans of 256 patients’ hearts along with blood tests to identify when the heart was about to fail.

With each heartbeat, the software examined the movement of 30,000 different points in the heart’s structure, and combined this information with historic patient health records to learn which abnormalities would predict when patients would die.

Seeing Into the Future – Artificial Intelligence Role in Population Health

The study found that the software could see around five years into the future and correctly predict which patients would still be alive after one year about 80% of the time. This information is critical for physicians to determine when to intervene to save a patient’s life and what course of treatment should be taken, including drugs, injections straight to the blood vessel or a lung transplant.

On the cancer front, data presented at last year’s American Society of Clinical Oncology conference showed that a drug developed by biotechnology company Berg LLC using AI can slow the growth of cancer in clinical trials.

Cosmetic Foot Surgery

Cosmetic Foot Surgery

Cosmetic Foot Surgery: Fashion’s Pandora’s Box?

Foot and ankle surgeons warn against taking part in growing surgery trend.  

Getting excited over a snazzy pair of Jimmy Choo stilettos is one thing—having your feet surgically altered to wear them is another. As extreme and imprudent as it may sound, the cosmetic surgery craze is not just for faces anymore—it has now moved to the feet, and it is kicking up a storm.

Today, a host of women are turning to cosmetic surgery to give their feet a “face lift” and fit them into high-fashion shoes. But physician members of the American College of Foot and Ankle Surgeons, who specialize in foot surgery, are taking a stand and calling this an ill-advised trend.

Fillers to Alteration Surgery

Cosmetic foot surgery runs the gamut, from injectable fillers to toe shortening or lengthening and bunion and hammertoe surgery when there is no pain or dysfunction. Many of these foot-perfecting techniques are borrowed from medical procedures established years ago to relieve pain and restore function, not to alter the size or look of the foot.

“Undergoing foot surgery solely for cosmetic reasons raises serious concerns,” says Michael Cornelison, DPM, FACFAS, a Cupertino, California foot and ankle surgeon and Fellow member of the American College of Foot and Ankle Surgeons. “We need our feet for walking and getting around, so breaking these bones to reconstruct them for appearance’s sake is a troubling matter. It often affects function and can bring risks and complications.”

In fact, the American College of Foot and Ankle Surgeons considers this fad so disturbing that it has taken an official position, asserting that cosmetic foot surgery should not be undertaken because it carries risks without medical benefit.

“I tell my patients that one of the biggest potential risks is taking a foot that doesn’t hurt and in the attempt to make it look better, turning it into a foot that gives you chronic pain,” says Dr. Cornelison.

Unmet Expectations and Scars

Another big drawback is the likely possibility that the patient’s expectations will not be entirely met because surgery cannot make an “abnormal” foot look completely normal. What is more, the incision can leave an unsightly scar.

Along with chronic pain and scarring, other potential risks of cosmetic foot surgery include infection, worsened deformity, bleeding, nerve damage and a serious reaction to the anesthesia.

Despite these caveats, it is easy to see why many are lured into surgically changing the appearance of their feet. Marketing tactics give these procedures spa-like names that trivialize the seriousness of surgery and make each “service” seem like a rejuvenating, risk-free beauty treatment.

“Those who are compelled by these terms to pursue cosmetic surgery for their feet should be sure to ask for a description of all the possible risks and negative consequences, along with what the procedure is expected to do,” urges Thomas S. Roukis, DPM, PhD, FACFAS, president of the American College of Foot and Ankle Surgeons and a foot and ankle surgeon from La Crosse, Wisconsin. “To get a full understanding of the surgery, it’s important to seek the opinion of an experienced foot and ankle surgeon who has done these procedures for medical rather than cosmetic reasons.”

Down Time and Complication Risks

Furthermore, as cosmetic surgery moves south on the body—from the face to the chest to the tummy to the feet—it is crucial to consider the need to function well. “We typically take our feet for granted and don’t realize how much we depend on them to walk, drive, shop and take care of family members, for example,” says Dr. Roukis. “The last thing you want is to undergo all the post-op downtime and possible risks and complications for a questionable benefit.”

Benefits of Surgery for Pain and Dysfunction

It is important to realize, however, that foot and ankle surgery is frequently a positive life-changing event for people who have suffered from pain and/or dysfunction not adequately relieved by nonsurgical treatments and where the risks of surgery are far outweighed by the potential benefits.

Playing With Pain Can Ruin Tennis Game


Playing with Pain Can Ruin Your Tennis Game

Quick, repetitive footwork ID’d as culprit.

Playing with pain can ruin tennis game – Foot pain began affecting Donna’s tennis game, and she was determined not to let it keep her from the sport she loved.

The 47-year-old avid tennis player from Arizona tried to play through the pain and rest her feet between matches. But when the pain became too much, and even started affecting her everyday activities, she made an appointment with a foot and ankle surgeon. His diagnosis: Donna was suffering from plantar fasciitis and a neuroma.

According to Donna’s doctor, Kris DiNucci, DPM, FACFAS, a Fellow of the American College of Foot and Ankle Surgeons, the conditions plaguing her are common among court-playing athletes.

Repetitive Foot Movements and Forefoot Pressure

“Because playing tennis requires quick, repetitive foot movements and continuous forefoot pressure, neuromas, (a thickening of the nerve tissue in the foot from compression) are common,” DiNucci says. “In addition, those same movements can cause athletes to develop plantar fasciitis, an inflammation of the strong ligament that extends from the heel to the toes,” he added.

Starting With Non-surgical Treatment

“If treated early, both conditions can be resolved nonoperatively. But as the condition progresses, surgical methods may be required to help patients get back to their sport and their everyday activities.”

Donna’s treatment regimen included stretching exercises, icing, a cortisone injection, an adjustment to her shoes and custom orthotics. “Within four months, the heel pain from the plantar fasciitis had improved tremendously. But the pain in the ball of my foot from the neuroma was still bad, and Dr. DiNucci recommended surgery,” Donna said.

“While surgery is not always needed to treat neuromas, in Donna’s case, it was necessary because she wasn’t responding to nonsurgical treatments,” DiNucci said.

Four weeks after surgery, Donna was back on the tennis courts and eight weeks post-op, she was back to her normal three-to-four-days-a-week tennis game.

All Court-playing Athletes are Susceptible to Injury

Court-playing athletes, such as tennis and basketball players, are also susceptible to Achilles tendonitis, sesamoiditis, stress fractures, ankle sprains and posterior tibial tendonitis, which all can be brought on from the high-impact movements of playing on hard surfaces. “Players with existing foot maladies or structural abnormalities of the lower extremity also need to be extra cautious while playing since their conditions can put them at a higher risk for overuse injury,” says Dr. DiNucci.

No matter the sport, athletes must take preventive methods to protect their feet to keep themselves in the game. Supportive shoes tailored to the sport are vital, along with proper training and stretching before and after play. If athletes are injured or experience pain or discomfort in their feet or ankles, it’s best to be examined by a foot and ankle surgeon. Early intervention is the key to proper healing.

As for Donna, she’s back on her feet and has made modifications to her game, such as stretching before and after a match and wearing more supportive shoes with her orthotics.

Tennis Injuries to the Foot and Ankle

Tennis involves much foot work. Foot and ankle injuries can occur from the continuous side-to-side and quick stopping and starting motions required in this sport. The playing surface also plays a role, as hard courts are less forgiving compared to clay courts. Tennis players should be aware of the following risks:

Prevent Spring Sports Injuries – Kids

Six Tips to Prevent Kids’ Spring Sports Injuries


Prevent Spring Sports Injuries – Kids  Foot & ankle surgeons stress importance of safe transition from winter to spring sports.

In today’s competitive youth sports landscape, many young athletes transition from playing winter to spring activities without considering the increased risk of incurring a sports-related injury. The American College of Foot and Ankle Surgeons (ACFAS) encourages parents to help their athletes play it safe and take the necessary precautions to prevent foot and ankle injuries that can occur when going from indoor to outdoor sports.

Different Set of Concerns When Transitioning Between Seasons


New Surgical Mask

The surgical masks people wear to stop the spread of diseases don’t work well — that isn’t what they’re designed for. Pathogens like influenza are transmitted in aerosol droplets when we cough or sneeze. Masks trap the droplets but the virus remains infectious. New Surgical Mask – Scientists took on the challenge of improving the masks, using salt to turn them into virus killers.

A University of Alberta engineering researcher has developed a new way to treat common surgical masks so they are capable of trapping and killing airborne viruses. His research findings appear in the journal Scientific Reports, published by Nature Publishing Group.

Hyo-Jick Choi, a professor in the University of Alberta Department of Chemical and Materials Engineering, noticed that many people wear a simple surgical-style mask for protection during outbreaks of influenza or other potentially deadly viruses such as severe acute respiratory syndrome (SARS) or Middle East respiratory syndrome (MERS).

Masks weren’t designed to prevent the spread of viruses

Trouble is, the masks weren’t designed to prevent the spread of viruses.

“Surgical masks were originally designed to protect the wearer from infectious droplets in clinical settings, but it doesn’t help much to prevent the spread of respiratory diseases such as SARS or MERS or influenza,” says Choi.

Airborne pathogens like influenza are transmitted in aerosol droplets when we cough or sneeze. The masks may well trap the virus-laden droplets but the virus is still infectious on the mask. Merely handling the mask opens up new avenues for infection. Even respirators designed to protect individuals from viral aerosols have the same shortcoming viruses trapped in respirators still pose risks for infection and transmission.

Masks’ Potential to Saves Lives

Masks capable of killing viruses would save lives, especially in an epidemic or pandemic situation. During the 2014-2015 season nearly 8,000 Canadians were hospitalized with the flu. That same year, deaths related to influenza in Canada reached an all-time high of nearly 600.

Knowing that the masks are inexpensive and commonly used, Choi and his research team went about exploring ways to improve the mask’s filter. And this is where a problem he is struggling with in one field of research — the development of oral vaccines like a pill or a lozenge — became a solution in another area.

A major hurdle in the development of oral vaccines is that when liquid solutions dry, crystals form and destroy the virus used in vaccines, rendering the treatment useless. In a nifty bit of engineering judo, Choi flipped the problem on its head and turned crystallization into a bug buster, using it as a tool to kill active viruses.

Salt Crystals as Bug Busters

Choi and his team developed a salt formulation and applied it to the filters, in the hope that salt crystals would “deactivate” the influenza virus.

The mechanics of simple chemistry make the treatment work. When an aerosol droplet carrying the influenza virus contacts the treated filter, the droplet absorbs salt on the filter. The virus is exposed to continually increasing concentrations of salt. As the droplet evaporates, the virus suffers fatal physical damage when the salt returns to its crystalized state.

While developing solid vaccines, Choi observed that sugar used for stabilizing the vaccine during the drying process crystalizes as it dries out. When crystals form, sharp edges and spikes take shape and they physically destroy the virus vaccine.

“We realized that we could use that to our advantage to improve surgical masks,” said Choi.

Treatment to Improve Filter inside Masks

In a series of experiments and tests at the University of Alberta and in the Department of Medical Zoology at the Kyung Hee University School of Medicine in Seoul, South Korea, the team arrived at a perfect treatment that improves the efficacy of the fibre filter inside the masks.

By using a safe substance (table salt) to improve an existing, approved product, Choi sees very few roadblocks to implementing the innovation.

The research was funded by the University of Alberta. Choi has been awarded a provisional patent for the development of virus deactivation systems based on the salt-crystallization mechanism.