scholarly journals From personalised nutrition to precision medicine: the rise of consumer genomics and digital health

2020 ◽  
Vol 79 (3) ◽  
pp. 300-310 ◽  
Author(s):  
J. Bernadette Moore
Keyword(s):  
Precision Medicine ◽  
New Technologies ◽  
Ethical Issues ◽  
Digital Health ◽  
Behavioural Change ◽  
Cost Benefit ◽  
Individual Characteristics ◽  
Dietary Intakes ◽  
Personalised Nutrition ◽  
Nutrition Services

Advances in genomics generated the concept that a better understanding of individual characteristics, e.g. genotype, will lead to improved tailoring of pharmaceutical and nutritional therapies. Subsequent developments in proteomics and metabolomics, in addition to wearable technologies for tracking parameters, such as dietary intakes, physical activity, heart rate and blood glucose, have further driven this idea. Alongside these innovations, there has been a rapid rise in companies offering direct-to-consumer genetic and/or microbiome testing, in combination with the marketing of personalised nutrition services. Key scientific questions include how disparate datasets are integrated, how accurate are current predictions and how these may be developed in the future. In this regard, lessons can be learned from systems biology, which aims both to integrate data from different levels of organisation (e.g. genomic, proteomic and metabolomic) and predict the emergent behaviours of biological systems or organisms as a whole. The present paper reviews the origins and recent advancement of ‘big data’ and systems approaches in medicine and nutrition. Conclusions are that systems integration of multiple technologies has generated mechanistic insights and informed the evolution of precision medicine and personalised nutrition. Pertinent ethical issues include who is entitled to access new technologies and how commercial companies are storing, using and/or re-mining consumer data. Questions about efficacy (both long-term behavioural change and health outcomes), cost-benefit and impacts on health inequalities remain to be fully addressed.

How to improve adherence to medication and lifestyle measures

2020 ◽  
pp. 117-126
Author(s):  
Ana Abreu ◽  
Miguel Mendes
Keyword(s):  
Health Professionals ◽  
New Technologies ◽  
Digital Health ◽  
Behavioural Change ◽  
Mortality And Morbidity ◽  
Therapeutic Goals ◽  
Adherence To Medication ◽  
Prevention Programmes ◽  
Lifestyle Measures ◽  
Theories Of Change

Pharmacological and non-pharmacological adherence are essential for reducing cardiovascular (CV) mortality and morbidity; however, non-adherence is a major issue. Correct medication intake is complex, in particular for certain groups of patients. Modification of habits and changing to a healthier lifestyle may be even more difficult. Nevertheless, factors influencing non-adherence and adherence facilitators have been identified, and specific strategies to overcome multiple barriers to both types of adherence are available. In this context, adequate health education and communication are fundamental. Models and theories of change and adherence and theories of behavioural change are presented in this chapter. New technologies, such as digital health tools, which assist patients and health professionals to maintain therapeutic goals, may be helpful. Participation in cardiac rehabilitation (CR) and secondary prevention programmes with a multifaceted approach can also improve adherence.

scholarly journals Personalised nutrition: the role of new dietary assessment methods

2015 ◽  
Vol 75 (1) ◽  
pp. 96-105 ◽  
Author(s):  
Hannah Forster ◽  
Marianne C. Walsh ◽  
Michael J. Gibney ◽  
Lorraine Brennan ◽  
Eileen R. Gibney
Keyword(s):  
Dietary Intake ◽  
New Technologies ◽  
Dietary Assessment ◽  
Assessment Methods ◽  
Dietary Advice ◽  
Dietary Intakes ◽  
Process Data ◽  
Dietary Changes ◽  
Personalised Nutrition ◽  
Dietary Assessment Methods

Food records or diaries, dietary recalls and FFQ are methods traditionally used to measure dietary intake; however, advancing technologies and growing awareness in personalised health have heightened interest in the application of new technologies to assess dietary intake. Dietary intake data can be used in epidemiology, dietary interventions and in the delivery of personalised nutrition advice. Compared with traditional dietary assessment methods, new technologies have many advantages, including their ability to automatically process data and provide personalised dietary feedback advice. This review examines the new technologies presently under development for the assessment of dietary intakes, and their utilisation and efficacy for personalising dietary advice. New technology-based methods of dietary assessment can broadly be categorised into three key areas: online (web-based) methods, mobile methods and sensor technologies. Several studies have demonstrated that utilising new technologies to provide tailored advice can result in positive dietary changes and have a significant impact on selected nutrient and food group intakes. However, comparison across studies indicates that the magnitude of change is variable and may be influenced by several factors, including the frequency and type of feedback provided. Future work should establish the most effective combinations of these factors in facilitating dietary changes across different population groups.

scholarly journals Digital Health for Supporting Precision Medicine in Pediatric Endocrine Disorders: Opportunities for Improved Patient Care

2021 ◽  
Vol 9 ◽  
Author(s):  
Luis Fernandez-Luque ◽  
Abdullah Al Herbish ◽  
Riyad Al Shammari ◽  
Jesús Argente ◽  
Bassam Bin-Abbas ◽  
...  
Keyword(s):  
Precision Medicine ◽  
New Technologies ◽  
Digital Health ◽  
Genomic Medicine ◽  
Healthcare Delivery ◽  
Digital Technologies ◽  
Endocrine Disorders ◽  
Growth Disorders ◽  
Pediatric Endocrinology ◽  
Obesity And Diabetes

Digitalization of healthcare delivery is rapidly fostering development of precision medicine. Multiple digital technologies, known as telehealth or eHealth tools, are guiding individualized diagnosis and treatment for patients, and can contribute significantly to the objectives of precision medicine. From a basis of “one-size-fits-all” healthcare, precision medicine provides a paradigm shift to deliver a more nuanced and personalized approach. Genomic medicine utilizing new technologies can provide precision analysis of causative mutations, with personalized understanding of mechanisms and effective therapy. Education is fundamental to the telehealth process, with artificial intelligence (AI) enhancing learning for healthcare professionals and empowering patients to contribute to their care. The Gulf Cooperation Council (GCC) region is rapidly implementing telehealth strategies at all levels and a workshop was convened to discuss aspirations of precision medicine in the context of pediatric endocrinology, including diabetes and growth disorders, with this paper based on those discussions. GCC regional investment in AI, bioinformatics and genomic medicine, is rapidly providing healthcare benefits. However, embracing precision medicine is presenting some major new design, installation and skills challenges. Genomic medicine is enabling precision and personalization of diagnosis and therapy of endocrine conditions. Digital education and communication tools in the field of endocrinology include chatbots, interactive robots and augmented reality. Obesity and diabetes are a major challenge in the GCC region and eHealth tools are increasingly being used for management of care. With regard to growth failure, digital technologies for growth hormone (GH) administration are being shown to enhance adherence and response outcomes. While technical innovations become more affordable with increasing adoption, we should be aware of sustainability, design and implementation costs, training of HCPs and prediction of overall healthcare benefits, which are essential for precision medicine to develop and for its objectives to be achieved.

P2Y12 inhibitors in neuroendovascular surgery: An opportunity for precision medicine

2021 ◽  
pp. 159101992199139
Author(s):  
Axel Rosengart ◽  
Malie K Collins ◽  
Philipp Hendrix ◽  
Ryley Uber ◽  
Melissa Sartori ◽  
...  
Keyword(s):  
Adverse Events ◽  
Precision Medicine ◽  
Point Of Care ◽  
Indirect Evidence ◽  
Cost Benefit ◽  
Interventional Cardiology ◽  
Platelet Inhibition ◽  
Response Monitoring ◽  
P2y12 Inhibitor ◽  
P2y12 Inhibitors

Introduction Dual antiplatelet therapy (DAPT), primarily the combination of aspirin with a P2Y12 inhibitor, in patients undergoing intravascular stent or flow diverter placement remains the primary strategy to reduce device-related thromboembolic complications. However, selection, timing, and dosing of DAPT is critical and can be challenging given the existing significant inter- and intraindividual response variations to P2Y12 inhibitors. Methods Assessment of indexed, peer-reviewed literature from 2000 to 2020 in interventional cardiology and neuroendovascular therapeutics with critical, peer-reviewed appraisal and extraction of evidence and strategies to utilize DAPT in cardio- and neurovascular patients with endoluminal devices. Results Both geno- and phenotyping for DAPT are rapidly and conveniently available as point-of-care testing at a favorable cost-benefit ratio. Furthermore, systematic inclusion of a quantifying clinical risk score combined with an operator-linked, technical risk assessment for potential adverse events allows a more precise and individualized approach to new P2Y12 inhibitor therapy. Conclusions The latest evidence, primarily obtained from cardiovascular intervention trials, supports that combining patient pharmacogenetics with drug response monitoring, as part of an individually tailored, precision medicine approach, is both predictive and cost-effective in achieving and maintaining individual target platelet inhibition levels. Indirect evidence supports that this gain in optimizing drug responses translates to reducing main adverse events and overall treatment costs in patients undergoing DAPT after intracranial stent or flow diverting treatment.

scholarly journals Perceptions of ‘Precision’ and ‘Personalised’ Medicine in Singapore and Associated Ethical Issues

2021 ◽  
Vol 13 (2) ◽  
pp. 179-194
Author(s):  
Serene Ong ◽  
Jeffrey Ling ◽  
Angela Ballantyne ◽  
Tamra Lysaght ◽  
Vicki Xafis
Keyword(s):  
Precision Medicine ◽  
Ethical Issues ◽  
Personalised Medicine ◽  
Large Population ◽  
Data Sets ◽  
Visual Aids ◽  
Policy Makers ◽  
The Social ◽  
Genomic Analyses ◽  
Common Understanding

AbstractGovernments are investing in precision medicine (PM) with the aim of improving healthcare through the use of genomic analyses and data analytics to develop tailored treatment approaches for individual patients. The success of PM is contingent upon clear public communications that engender trust and secure the social licence to collect and share large population-wide data sets because specific consent for each data re-use is impractical. Variation in the terminology used by different programmes used to describe PM may hinder clear communication and threaten trust. Language is used to create common understanding and expectations regarding precision medicine between researchers, clinicians and the volunteers. There is a need to better understand public interpretations of PM-related terminology. This paper reports on a qualitative study involving 24 focus group participants in the multi-lingual context of Singapore. The study explored how Singaporeans interpret and understand the terms ‘precision medicine’ and ‘personalised medicine’, and which term they felt more aptly communicates the concept and goals of PM. Results suggest that participants were unable to readily link the terms with this area of medicine and initially displayed preferences for the more familiar term of ‘personalised’. The use of visual aids to convey key concepts resonated with participants, some of whom then indicated preferences for the term ‘precision’ as being a more accurate description of PM research. These aids helped to facilitate dialogue around the ethical and social value, as well as the risks, of PM. Implications for programme developers and policy makers are discussed.

The Ethics of Mobile Health Technology

2017 ◽  
Vol 41 (S1) ◽  
pp. S39-S39
Author(s):  
S. Galderisi ◽  
F. Caputo
Keyword(s):  
Health Equity ◽  
Mobile Health ◽  
New Technologies ◽  
Ethical Issues ◽  
Professional Associations ◽  
Health Technology ◽  
Ethical Guidelines ◽  
High Quality ◽  
Quality Healthcare ◽  
Health Technologies

IntroductionMobile health (m-health) technology has been growing rapidly in the last decades. The use of this technology represents an advantage, especially for reaching patients who otherwise would have no access to healthcare. However, many ethical issues arise from the use of m-health. Health equity, privacy policies, adequate informed consent and a competent, safe and high quality healthcare need to be guaranteed; professional standards and quality of doctor-patient relationship in the digital setting should not be lower than those set for in-person practice.AimsTo assess advantages and threats that may arise from the wide use of m-health technologies, in order to guarantee the application of the best medical practices, resulting in the highest quality healthcare.MethodsA literature search has been conducted to highlight the most pressing ethical issues emerging from the spreading of m-health technologies.ResultsFew ethical guidelines on the appropriate use of m-health have been developed to help clinicians adopt a professional conduct within digital settings. They focus on the need for professional associations to define ethical guidelines and for physicians to take care of their education and online behavior when using m-health technologies.ConclusionsThe rapid spreading of m-health technologies urges us to evaluate all ethical issues related to its use. It would be advisable to produce an ethical code for the use of these new technologies, to guarantee health equity, privacy protection, high quality doctor-patient relationships and to ensure that m-health is not chosen over traditional care for merely economic purposes.Disclosure of interestSG received honoraria or Advisory board/consulting fees from the following companies: Lundbeck, Janssen Pharmaceuticals, Hoffman-La Roche, Angelini-Acraf, Otsuka, Pierre Fabre and Gedeon-Richter. All other authors have declared.

The Industrial Safety Professionals: A Comparative Analysis from World War I until the 1980S

1992 ◽  
Vol 22 (4) ◽  
pp. 705-727 ◽  
Author(s):  
Tom Dwyer
Keyword(s):  
World War I ◽  
Social Relations ◽  
New Technologies ◽  
Cost Benefit Analysis ◽  
Traditional Approach ◽  
Cost Benefit ◽  
The United States ◽  
Industrial Safety ◽  
Industrial Society ◽  
Industrial Medicine

The birth of industrial society produced demand for the services of professionals specialized in matters related to industrial safety. Three professions—safety engineering, industrial medicine, and ergonomics—are examined. These professions are observed to either submit to single sets of demands, to integrate contradictory demands, or to experience scission. Until the late 1960s their growth appears to have been relatively peaceful and uncontroversial. From this period onward, controversy breaks out over questions related to industrial safety, and professions and government administrations grow. Increasingly, the traditional approach of safety professionals is called into question, and they adopt new orientations. These changes are mapped through the examination of data drawn principally from the United States, France, Great Britain, and to a lesser extent Brazil. The traditional standards approach competes with cost-benefit analysis and with systemic safety for influence; in addition, an emergent approach that analyzes accident causes in terms of social relations of work is detected. From Bhopal to Chernobyl, new technologies subject civilian populations to risks of catastrophic accidents, and the action of safety professionals comes under the spotlight. The analysis constructed permits new understandings of the past and the future of these professions.

Mapping the Ethical Issues of Digital Twins for Personalised Healthcare Service (Preprint)

2021 ◽  
Author(s):  
Pei-hua Huang ◽  
Ki-hun Kim ◽  
Maartje Schermer
Keyword(s):  
Ethical Issues ◽  
Digital Health ◽  
Personalised Medicine ◽  
Healthcare Services ◽  
Ethical Values ◽  
Ethical Concerns ◽  
Digital Twins ◽  
Research Gap ◽  
Process Oriented ◽  
Personalised Healthcare

BACKGROUND The concept of digital twins has great potential for transforming the existing healthcare system by making it more personalised. As a convergence of healthcare, artificial intelligence, and information and communication technologies, personalised healthcare services developed under the concept of digital twins raise a myriad of ethical issues. While some of the ethical issues are known to researchers working on digital health and personalised medicine, currently there is no comprehensive review that maps major ethical risks of digital twins for personalised healthcare services. OBJECTIVE This paper fills the research gap by identifying major ethical risks of digital twins for personalised healthcare services. We first propose a working definition for digital twins for personalised healthcare services (DTPHS) to facilitate future discussion on the ethical issues related to these emerging digital health services. We then developed a process-oriented ethical map to identify major ethical risks against each of the different data processing phases. METHODS This research aims to address this research gap by providing a comprehensive analysis of major ethical risks of DTPHSs. Due to the scarcity of literature on DTPHSs, we are unable to perform a systematic review of ethical concerns over DTPHSs. Thus, we resort to literature on eHealth, personalised medicine, precision medicine, and information engineering to identify potential issues. We develop a process-oriented ethical map to structure the inquiry in a more systematic way. The ethical map allows us to see how each of the major ethical concerns emerges during the process of transforming raw data into valuable information. RESULTS The process-oriented ethical analysis identified ten operational problems and the relevant ethical values. By structuring the operational problems and relevant ethical values in a clear logical flow, this process-oriented ethical map allows developers of DTPHSs and stakeholders to have a comprehensive overview of major ethical risks while refining the design of DTPHSs. The ethical values section on the map also helps developers of DTPHSs better understand which values they ought to consider while developing solutions for an operational problem they encounter.   CONCLUSIONS It is challenging to address all of the major ethical risks a DTPHS might encounter proactively without a conceptual map at hand. The process-oriented ethical map we propose here can assist developers of DTPHSs in analysing ethical risks in a more systematic manner. CLINICALTRIAL N/A

Extended model of online privacy concern: what drives consumers’ decisions?

2019 ◽  
Vol 43 (5) ◽  
pp. 799-817 ◽  
Author(s):  
Ivan-Damir Anic ◽  
Jelena Budak ◽  
Edo Rajh ◽  
Vedran Recher ◽  
Vatroslav Skare ◽  
...  
Keyword(s):  
New Technologies ◽  
Experimental Studies ◽  
Individual Characteristics ◽  
Online Privacy ◽  
The Internet ◽  
Extended Model ◽  
Perceived Benefits ◽  
Privacy Concern ◽  
Content Type ◽  
Internet Users

Purpose The purpose of this paper is to investigate the relationship between individual and societal determinants of online privacy concern (OPC) and behavioral intention of internet users. The study also aims to assess the degree of reciprocity between consumers’ perceived benefits of using the internet and their OPC in the context of their decision-making process in the online environment. Design/methodology/approach The study proposes comprehensive model for analysis of antecedents and consequences of OPC. Empirical analysis is performed using the PLS–SEM approach on a representative sample of 2,060 internet users. Findings The findings show that computer anxiety and perceived quality of regulatory framework are significant antecedents of OPC, while traditional values and inclinations toward security, family and social order; and social trust are not. Furthermore, the study reveals that perceived benefits of using the internet are the predominant factor explaining the intention to share personal information and adopt new technologies, while OPC dominates in explanation of protective behavior. Research limitations/implications Although the authors tested an extended model, there might be other individual characteristics driving the level of OPC. This research covers just one country and further replications should be conducted to confirm findings in diverse socio-economic contexts. It is impossible to capture the real behavior with survey data, and experimental studies may be needed to verify the research model. Practical implications Managers should work toward maximizing perceived benefits of consumers’ online interaction with the company, while at the same time being transparent about the gathered data and their intended purpose. Considering the latter, companies should clearly communicate their compliance with the emerging new data protection regulation. Originality/value New extended model is developed and empirically tested, consolidating current different streams of research into one conceptual model.

scholarly journals Digital Health Interventions for Healthy Aging: A Qualitative User Evaluation and Ethical Assessment

2020 ◽  
Author(s):  
Marcello Ienca ◽  
Christophe Schneble ◽  
Reto Kressig ◽  
Tenzin Wangmo
Keyword(s):  
Older Adults ◽  
Older People ◽  
Healthy Aging ◽  
Ethical Issues ◽  
Digital Health ◽  
Functional Independence ◽  
Community Dwelling ◽  
Healthy Ageing ◽  
Health Technologies ◽  
Community Dwelling Older Adults

Abstract BackgroundDigital health technologies are being increasingly developed with the aim of allowing older adults to maintain functional independence throughout the old age, a process known as healthy ageing. Such digital health technologies for healthy ageing are expected to mitigate the socio-economic effects of population ageing and improve the quality of life of older people. However, little is known regarding the views and needs of older people regarding these technologies. AimThe aim of this study is to explore the views, needs and perceptions of community-dwelling older adults regarding the use of digital health technologies for healthy ageing. MethodFace-to-face, in-depth qualitative interviews were conducted with community-dwelling older adults (median age 79.6 years). The interview process involved both abstract reflections and practical demonstrations. The interviews were transcribed verbatim and analyzed according to inductive content analysis. ResultsThree main themes and twelve sub-themes emerged. The three main themes revolved around the following thematic areas: favorable views and perceptions on technology-assisted living, usability evaluations and ethical considerations. ConclusionsOur study reveals a generally positive attitude towards digital health technologies as participants believed digital tools could positively contribute to improving their overall wellbeing, especially if designed in a patient-centered manner. Safety concerns and ethical issues related to privacy, empowerment and lack of human contact also emerged as key considerations.

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