Stories about: Information technology

Alexa: How are smart speakers helping patients, caregivers and clinicians?

Susan Bennett, the voice of Siri, emcees the Voice.Health Summit
Susan Bennett, the original voice of Apple’s Siri, emcees the 2018 Voice.Health Summit. (PHOTOS COURTESY IDHA/BOSTON CHILDREN’S HOSPITAL)

Sarah Lindenauer is product and portfolio manager for the Innovation & Digital Health Accelerator (IDHA) at Boston Children’s Hospital.

Where can you hear the voice of Siri introducing a keynote speaker? Or see the developers of the first healthcare skill for voice present alongside leading pharmaceutical and health insurance companies? Experience demos of cutting-edge voice technologies from 20+ startups from around the world, in simulated healthcare environments?

It all went down October 17th in Boston at the Voice.Health Summit, presented by Boston Children’s Hospital’s Innovation and Digital Health Accelerator (IDHA) as a run-up to the Connected Health Conference. More than 300 leading innovators in voice tech in healthcare came from around the world for a day of immersion and to answer the question, “What’s next?”

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Science Seen: Using Twitter to map hospitals’ stance toward LGBT patients

Hswen Y et al. Social Science & Medicine Oct 2018. DOI: 10.1016/j.socscimed.2018.08.031  

How sensitive are hospitals to the needs of lesbian, gay, bisexual and transgender (LGBT) patients? In a 2010 survey by Lambda Legal, 70 percent of transgender patients and 56 percent of gay/lesbian/bisexual patients reported discrimination from health care providers. Clinicians refused to provide needed care, refused to touch them or used excessive precautions, blamed them for their health status, were verbally abusive or were physically violent.

A new exploratory study, published in the October issue of Social Science & Medicine, turned to social media for a view from the ground. The researchers, Yulin Hswen of Harvard T.H. Chan School of Public Health and Jared Hawkins, PhD, MMSc, of Boston Children’s Hospital’s Informatics Program, analyzed 1,856 publicly available tweets from 2015-2017.

“Information from social media and other online sources can help us gain authentic and unsolicited accounts from vulnerable patient groups, like LGBT individuals who are not typically represented,” says Hswen.

Based on the tweets, the team determined which hospitals were more supportive of LGBT patients (the blue dots in the above map) and which were less supportive (the red dots).

The identified tweets included Twitter handles from 653 hospitals and contained LGBT-related terms: LGBT, transgender, trans, intersex, sex change, transisbeautiful, tranny, drag queen, preferred pronoun, transhealth, genderodyssey, cis, gay, lesbian, queer, rainbowhealth, gender fluid, homosexual, bisexual, homo, homophob and transphobe. A tweet classed as supportive might read, “@Hospital is hosting a LGBT resource fair;” a negative tweet might read: “Having sex with men does not mean I deserve less @Hospital.”

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Patients with epilepsy and inflammatory bowel disease to get DNA sequenced in study

3000 exomes study to sequence patients with epilepsy, IBD
ILLUSTRATION: ADOBE STOCK

Boston Children’s Hospital has embarked on a strategic initiative to accelerate and expand its research genomics gateway, with plans to sequence the DNA of 3,000 patients with epilepsy or inflammatory bowel disease and their family members. Patients will have access to enroll in this pilot study if their condition is of likely genetic origin but lack a diagnosis after initial clinical genetic testing.

Sequencing will cover the entire exome, containing all of a person’s protein-coding genes. The Epilepsy and IBD were chosen for the pilot because Ann Poduri, MD, MPH and Scott Snapper, MD, PhD, have already made huge inroads into the genetics of these respective disorders. Both have built large, well characterized patient databases for research purposes, have disease-specific genetic expertise and have begun using their findings to inform their patients’ care.

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Precision medicine: Focus turns toward data sharing, costs, access

Precision Medicine 2018 at Harvard Medical School
(Paul Avillach via Twitter)

Precision medicine is often equated with high-tech, exquisitely targeted, million-dollar drug treatments. But at Precision Medicine 2018, hosted by Harvard Medical School’s Department of Biomedical Informatics (DBMI) this week, many of the speakers and panelists were more concerned about improving health for everyone and making better use of what we already have: data.

“We’re not going to make major changes in 21st century medicine without embracing data-driven approaches,” said HMS dean George Q. Daley in his opening remarks.

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Diagnosing autism in infants? EEG algorithms make accurate predictions

autism EEGs
EEG nets are easily slipped over an infant’s head and cause no discomfort. (Credit: Nelson Lab)

The earlier autism can be diagnosed, the more effective interventions typically are. But the signs are often subtle or can be misinterpreted at young ages. As a result, many children aren’t diagnosed until age 2 or even older. Now, a study shows that electroencephalograms (EEGs), which measure the brain’s electrical activity, can accurately predict or rule out autism spectrum disorder (ASD) in babies as young as 3 months old. It appears today in Scientific Reports.

The beauty of EEG is that it’s already used in many pediatric neurology or developmental pediatric settings. “EEGs are low-cost, non-invasive and relatively easy to incorporate into well-baby checkups,” says study co-author Charles Nelson, PhD, director of the Laboratories of Cognitive Neuroscience at Boston Children’s Hospital. “Their reliability in predicting whether a child will develop autism raises the possibility of intervening very early, well before clear behavioral symptoms emerge.”

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Families and data scientists build insights on Phelan-McDermid syndrome

querying stacks of data

This is the third year that Jacob Works has made the trip down to Boston Children’s Hospital from Maine. With research assistant Haley Medeiros, he looks at pictures, answers questions, manipulates blocks and mimes actions like knocking on a door. His father, Travis, and another research assistant look on through a window.

“At first, we had to practically bribe him with an iPad with every task,” Travis says. “This year he’s more excited, because he understands more and is more confident and able to share more.”

Jacob, 11, was diagnosed in 2011 with Phelan-McDermid Syndrome, a rare genetic condition that typically causes children to be born “floppy,” with low muscle tone, and to have little or no speech, developmental delay and, often, autism-like behaviors. At the time, Jacob was one of about 800 known cases. But through chromosomal microarray testing, introduced in just the past decade for children with autism symptoms, more cases are being picked up.

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Giving voice a voice in health care

voice technology in healthcare

Physicians, like consumers in general, are increasingly embracing voice technology and smart home speakers. But does voice have a role in health care itself, beyond simple dictation of clinical notes? Boston Children’s Hospital is among those experimenting. The hospital’s Innovation and Digital Health Accelerator (IDHA) describes its learnings in an article published today by Harvard Business Review.

After hosting a Voice in Healthcare hackathon in various simulated clinical environments in 2016, IDHA ran three pilots with voice-based systems. In the intensive care unit, clinicians used voice as a hands-free way to get basic information, saving time while maintaining infection control standards. The pediatric transplant team used voice prompts to guide them through the pre-operative organ-validation and checklist process.

voice technology in health care Harvard Business ReviewThe third, longest-running pilot is in patients’ homes: Through KidsMD, parents have logged more than 100,000 interactions with Amazon’s voice assistant, Alexa, receiving personalized guidance around common illnesses like ear infections, fever and the common cold. More types of wellness and disease-specific “skills” are in the works to create true home health hubs.

Voice has its limitations, but in a Boston Children’s survey, only 16% of physicians stated they would not try voice.

Read more in HBR and check out IDHA’s portfolio.

 

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Digital doctoring, big data and AI: Five takeaways

digital health

Big data and artificial intelligence are reshaping our world. Earlier this month, at Computefest 2018, organized by the Institute for Applied Computational Science at Harvard University, held the symposium, “The Digital Doctor: Health Care in an Age of AI and Big Data.” Speakers were:

  • Finale Doshi-Velez, PhD, Assistant Professor of Computer Science, Harvard University
  • Matt Might, Director, Hugh Kaul Personalized Medicine Institute, University of Alabama at Birmingham
  • John Brownstein, PhD, Chief Innovation Officer and Director, Computational Epidemiology Lab, Boston Children’s Hospital
  • Marzyeh Ghassemi, PhD, Visiting Researcher, Google’s Verily; Postdoctoral Fellow, Computer Science and Artificial Intelligence Lab, Massachusetts Institute of Technology
  • Jennifer Chayes, Managing Director, Microsoft Research New England and New York City
  • Emery Brown, PhD, Professor of Medical Engineering and Computational Neuroscience, Massachusetts Institute of Technology

Here are Vector’s five takeaways from the symposium:

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News note: GIANT study homes in on obesity genes

obesity genes
Illustration: Elena Hartley

Yes, some obesity is due to genetics. The largest and most powerful study to date has pinned down 14 variants in 13 genes that carry variations associated with body mass index. They provide new clues as to why some people tend to gain weight and have more trouble losing it. Eight of the variants were in genes not previously tied to human obesity.

The study, published last month, was conducted by the Genetic Investigation of Anthropometric Traits (GIANT) consortium, an international collaboration involving more than 250 research institutions — the same group that brought us height-related genes last year. It combined genetic data from more than 700,000 people and 125 different studies to find rare or low-frequency genetic variants that tracked with obesity.

The study focused on rarer variants in the coding portions of genes, which helped pinpoint causal genes and also helped discover variants with larger effects that those previously discovered by the GIANT consortium. For example, carriers of a variant in the gene MC4R (which produces a protein that tells the brain to stop eating and to burn more energy) weigh 15 pounds more, on average, than people without the variant.

Computational analysis provided some interesting insights into what the 13 genes do. Some, for example, play a role in brain pathways that affect food intake, hunger and satiety. Other variants affect fat-cell biology and how cells expend energy.

This study provided an important confirmation of the role of the nervous system in body weight regulation,” says Joel Hirschhorn MD, PhD, a pediatric endocrinologist and researcher at Boston Children’s Hospital and the Broad Institute of MIT and Harvard, who co-led the study with Ruth Loos, PhD, of the Icahn School of Medicine at Mount Sinai. “Many of the genes from this study were not known to be associated with obesity, but our computational analysis independently implicates these new genes in strikingly similar neuronal pathways as the genes that emerged from our previous work. In addition, our approach newly highlighted a role for genes known to be important in ‘brown fat,’ a type of fat that burns energy and may help keep people lean.”

The researchers think the new findings could help focus the search for new therapeutic targets in obesity.  Read more in Nature Genetics and this press release from Mount Sinai.

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Science and medicine in 2018: What’s the forecast?

2018 predictions for biomedicine

Vector consulted its many informants to find out which way the wind will blow in 2018. Here are their predictions for what to expect in genetics, stem cell research, immunology and more.

GENETICS

Gene-based therapies mature

We will continue to see successes in 2018 reflecting the maturation of gene therapy as a viable, generalizable platform for curing many rare diseases. Also, we will see exciting new applications of other maturing platforms, like CRISPR/Cas9 gene editing and oligonucleotide therapies for neurologic diseases, building on the success of nusinersen for spinal muscular atrophy.

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