Medicine in the Fourth Industrial Revolution: What Should We Prepare? / 임상당뇨병

The power of the Internet, mobile devices, and data science including artificial intelligence is making a big difference in our daily lives. The introduction and proliferation of electronic health records, personal health records, and artificial intelligence in the medical field raises expectations that the future of medical practice will change. Both individuals and medical institutions will receive or perform multiple medical services based on much larger and more complete health and medical datasets. Medicine is also expected to increasingly make use of real world evidence (RWE), based on data supplied in the form of real world data (RWD), that will be applied in the clinical setting in real time. Further, the learning healthcare system will complete the data-driven medicine that will be used to deliver future medical care. For these reasons, doctors need to be more data-friendly and respond to these changes.

Medicine in the Fourth Industrial Revolution: What Should We Prepare? / 임상당뇨병

The power of the Internet, mobile devices, and data science including artificial intelligence is making a big difference in our daily lives. The introduction and proliferation of electronic health records, personal health records, and artificial intelligence in the medical field raises expectations that the future of medical practice will change. Both individuals and medical institutions will receive or perform multiple medical services based on much larger and more complete health and medical datasets. Medicine is also expected to increasingly make use of real world evidence (RWE), based on data supplied in the form of real world data (RWD), that will be applied in the clinical setting in real time. Further, the learning healthcare system will complete the data-driven medicine that will be used to deliver future medical care. For these reasons, doctors need to be more data-friendly and respond to these changes.

Quantitative Assessment of Global and Regional Air Trappings Using Non-Rigid Registration and Regional Specific Volume Change of Inspiratory/Expiratory CT Scans: Studies on Healthy Volunteers and Asthmatics

OBJECTIVE: The purpose of this study was to compare air trapping in healthy volunteers with asthmatics using pulmonary function test and quantitative data, such as specific volume change from paired inspiratory CT and registered expiratory CT. MATERIALS AND METHODS: Sixteen healthy volunteers and 9 asthmatics underwent paired inspiratory/expiratory CT. DeltaSV, which represents the ratio of air fraction released after exhalation, was measured with paired inspiratory and anatomically registered expiratory CT scans. Air trapping indexes, DeltaSV0.4 and DeltaSV0.5, were defined as volume fraction of lung below 0.4 and 0.5 DeltaSV, respectively. To assess the gravity effect of air-trapping, DeltaSV values of anterior and posterior lung at three different levels were measured and DeltaSV ratio of anterior lung to posterior lung was calculated. Color-coded DeltaSV map of the whole lung was generated and visually assessed. Mean DeltaSV, DeltaSV0.4, and DeltaSV0.5 were compared between healthy volunteers and asthmatics. In asthmatics, correlation between air trapping indexes and clinical parameters were assessed. RESULTS: Mean DeltaSV, DeltaSV0.4, and DeltaSV0.5 in asthmatics were significantly higher than those in healthy volunteer group (all p < 0.05). DeltaSV values in posterior lung in asthmatics were significantly higher than those in healthy volunteer group (p = 0.049). In asthmatics, air trapping indexes, such as DeltaSV0.5 and DeltaSV0.4, showed negative strong correlation with FEF25-75, FEV1, and FEV1/FVC. DeltaSV map of asthmatics showed abnormal geographic pattern in 5 patients (55.6%) and disappearance of anterior-posterior gradient in 3 patients (33.3%). CONCLUSION: Quantitative assessment of DeltaSV (the ratio of air fraction released after exhalation) shows the difference in extent of air trapping between health volunteers and asthmatics.

Added Value of Magnetic Resonance Imaging in Staging of Malignant Pleural Mesothelioma

PURPOSE: We investigated the possible added value of magnetic resonance imaging (MR) in staging of malignant pleural mesothelioma (MPM) compared to computed tomography (CT). MATERIALS AND METHODS: We retrospectively enrolled 20 patients (M;F = 14:6; mean age, 53.5 yrs) who diagnosed as MPM by histology and underwent CT and MR at initial evaluation from Jan 1997 to Dec 2012. Two radiologists performed clinical staging by using CT alone or MR alone in consensus. In patients underwent surgery (n = 13), we evaluated the diagnostic accuracy of CT and MR in terms of staging compared to surgical staging. In all patients, we compared clinical staging of CT only and CT with MR. RESULTS: The diagnostic accuracy for T staging of CT only was 23.1% (3/13) and that of combined CT and MR was 38.5% (5/13), respectively. Among 13 patients underwent surgery, surgical stage was higher than combined CT and MR stage in 5 patients, but lower in 3 patients. CT only and combined CT and MR agreed in 85.0% (17/20). In cases of disagree (15.0%, 3/20), combined CT and MR showed higher stage than CT only. CONCLUSION: Combined CT and MR increases the diagnostic accuracy in staging of MPM compared to CT only and is important in determining the appropriate treatment in patients being considered for surgery.