What a year it has been for Digital Health (DH) in general medicine and more in particular for the European Society of Cardiology (ESC). Only history will really tell us, but a quick peak already into the recent history of Pubmed learns that there were 54 papers published with Artificial Intelligence (AI) in their titles in 2016, while in 2019 there was a staggering number of 988 papers available. Measured in early December, so most likely the 1000 barrier will be broken. Perhaps the most remarkable publication was about the results of the Apple Heart study In the New England Journal of Medicine1. It stirred a large discussion about what the relation or connection is between “consumer” devices which can measure biological signals and what we are used to in our regular medicine. This discussion will be certainly be continued over the next months and years.
What we witness in the steeply increasing number of publications is also reflected in the growing attention rates for DH focused sessions at the different congresses. It Indicates the hunger of the clinical community to learn more and to become educated in this promising but complex area of future tools to bring medicine forward. With this in mind, the ESC picked up speed by increasing the number of podia’s and sessions at the annual congress in Paris. It was double the size as compared to the first year before. In addition, the ESC organised a Digital Health summit in early October in Tallinn and also launched a Digital Health Portal on the ESC website including this Virtual Digital Health Journal.
The DH sessions at the annual ESC Congress in Paris were again a great success. We eluded to that briefly in our previous journal issue. In addition to these reflections, Mark Nicholls recently published in-depth reports about some of the DH sessions in the Cardiopulse section of the European Heart Journal. One concerning “Cardiovascular Innovation: the next frontier”2, and the other: “Machine learning-State of the art”3. For those of you interested, this is excellent reading material to start off with and you can further explore the slides and recorded presentations of these sessions via ESC 365 - presentations on machine learning and Innovation.
After Paris the cardiovascular DH community met again for the ESC Digital Health Summit in Tallinn Estonia. Also this was a great success with different new and unique formats of sessions other than what we mostly see at other congresses, such as being Ted style talk presentations, roundtable discussions, debates to exchange new ideas and new technology pitches with a jury selection of the most promising presented ideas and developments, which were very popular. In 2020, again in Tallinn the DH Summit will congregate bringing together world leaders in digital health and cardiovascular medicine to chart the way forward. If you want to be involved in shaping the future of cardiology, discover the latest innovations in DH, want to enlarge your network and to actively participate in debates or show your ideas and developments, you should attend!
Having said all of this, it is with great pleasure that we can present to you a short review of the past very successful year for DH in the ESC year and a prospective view of 2020 for the Digital Health-related activities within the ESC by our Chair of the Digital Health Committee, Professor Martin Cowie. As Prof Cowie states, 2019 was a great success and 2020 promises to show even more and activities at a larger scale.
We, as your editorial team, were very pleased that we were able to present our first issue just at the start of the ESC Congress late August. We collected a number of key papers which were published recently at that time with as main focus artificial intelligence (AI) applied to cardiovascular medicine. We believe that AI will could provide unprecedented progress to optimise treatment. Cardiology, being a medical specialism depending on complex technology could profit extensively applying AI technology. We described that in a short review: Artificial Intelligence: a Prime Characterisation of the Digital Revolution in Medicine. This review also contains references which will guide you to the key papers. Some of these key papers we mentioned are being commented more in-depth by experts in the field as Prof. Ad Bogers, Prof. Eric Boersma and Prof. Filippo Cademartiri.
Early October we presented our 2nd issue for you including a mix between recent papers we believe are of high interest for us all and again being commented by experts as Prof. Lukasz Koltowski with a commentary: Artificial intelligence neural network approach detected heart failure from a single heartbeat with 100% diagnostic accuracy: a cautionary treatise. Dr. Peter van Dam exploring “The future of the Electrocardiogram”. The final commentary in that issue was provided by Prof. Filippo Cademartiri with: Artificial Intelligence for augmented Cardiovascular prediction; the thin line between something new and something improved.
After our first initial steps as a new ESC journal around Digital Health and spreading the news of our existence we are very pleased to be able to bring to you original experiences, stories and research, which started already in our 2nd issue and you will find more in our 3rd issue, more about that later. Dr. Sarah Hudson shared her experience being a Digital fellow: The Topol Digital Fellowship. Dr. Manuel Gonzalez-Garcia shared his eHealth experience: My Australian eHealth experience: a European cardiologist perspective. Finally, Dr. Aurore Lyon and Dr. Joost Lumens are presenting their vision about combining patient-specific data with computer modelling in a paper entitled: “Better together: how the combination of “data-driven” and “biophysical modelling” approaches can revolutionize cardiology research and care”.
We present to you now our 3rd issue at the end of 2019, which has been a remarkable year for DH in medicine and more in particular Cardiology. As the word spreads about our DH related ESC journal we also see an increase in submissions to our journal, which is very much welcomed. In this issue Dr. Joana Ribeiro and Prof. de Jaegere present their work describing: “Artificial Intelligence and Advanced Computer Modelling in Transcatheter Interventions for Structural Heart Disease - Implications for Clinical Practice”. This paper describes the clinical pathway, including the digital tools, of patients who will undergo a TAVI procedure. For such procedures already a lot of computer-assisted tools are being used today. However, this could perhaps even brought further by applying novel technologies such as AI into the game and to start to perform, if possible, patient-specific computer modelling predicting the possible outcome of such a procedure for a specific patient.
A core element today in science and medicine is the use of social media. Two experts in this field Professor Mamas Mamas and Dr. Purvi Parwani are presenting “Case Reports on Social Media”. As they describe, case reports are one of the oldest forms of medical communications. As we are now in the era transforming from paper to paperless by further digitation and the availability of digital communication tools such as social media, it is important to learn what this can do for teaching to improve medical care. There is a large potential using these tools, however, also some possible caveats.
We do hope that you enjoyed the first issues of our Digital Health Journal and we do wish you all the best for 2020! And please do not hesitate to submit your work to EditorsDHP@erasmusmc.nl